Tennis Elbow Specialist In Singapore

What is Tennis Elbow?

Tennis elbow, medically known as lateral epicondylitis, is a condition characterised by pain and inflammation where the extensor tendons attach to the bone in the elbow. It typically arises from the overloading of these tendons, often due to repetitive wrist and arm motions.

While the name suggests a connection to tennis, the condition can affect individuals engaging in activities beyond racquet sports. It can affect anyone who is involved in tasks or activities that put repetitive stress on the forearm muscles and tendons.

Symptoms

Tennis elbow encompasses a range of symptoms centred on the elbow’s outer part, impacting the forearm muscles and tendons involved in wrist and finger extension.

• Persistent Pain: A notable discomfort or burning sensation is experienced on the elbow’s outer part. This pain may initially be mild but can intensify over time, especially after engaging in activities that strain the forearm muscles.
• Weakness: Individuals may notice a reduction in grip strength, making it challenging to hold or manipulate objects.
• Tenderness: The area around the lateral epicondyle may become tender to the touch, indicating inflammation.
• Morning Stiffness: Stiffness in the elbow and forearm, particularly in the morning or after periods of inactivity, is common.
• Radiating Pain: For some, the pain may radiate from the outside of the elbow into the forearm and wrist.
• Nighttime Discomfort: Pain may persist into the night, potentially disrupting sleep.
• Exacerbation with Activity: Symptoms are often aggravated by activities that involve using the forearm muscles, such as gripping, lifting, or twisting motions. Even simple actions like turning a doorknob or shaking hands can provoke discomfort.

Causes and Risk Factors

Tennis elbow results from the overuse and strain of the muscles and tendons in the forearm and elbow.

• Repetitive Motion
  The primary cause is the repetitive or strenuous use of the forearm muscles, especially in activities requiring gripping, twisting, or lifting motions. This repetition can lead to tiny tears and inflammation in the tendons attached to the lateral epicondyle.
• Specific Activities
  Playing tennis or other racquet sports is a well-known contributor. Other activities and jobs such as painting, plumbing, carpentry, cooking, and butchery, which involve similar arm movements, also pose a risk.
• Age
  Tennis elbow is most common in adults between 30 and 50 years of age.
  
• Previous Injury
  A history of elbow or forearm injury may predispose an individual to tennis elbow.
• Muscle Strain
  Overexertion or inadequate warm-up before engaging in physical activity can lead to muscle strain, contributing to the development of tennis elbow.

Non-Surgical Treatment Options

Non-surgical treatment is often effective in managing tennis elbow, with a focus on relieving pain and restoring normal arm function.

• Rest and Activity Modification
  The primary step involves resting the affected arm and avoiding activities that exacerbate the symptoms. This rest period allows the inflamed tendons to heal.
• Physical Therapy
  Physical therapy involves exercises to strengthen and stretch the forearm muscles. Therapists may also employ techniques such as ultrasound, ice massage, or muscle stimulation to facilitate healing.
• Brace or Splint
  Wearing a brace or splint centred over the back of the forearm can help rest the muscles and tendons, reducing symptoms.
  
• Medications
  Over-the-counter pain relievers like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help reduce pain and inflammation.
• Steroid Injections
  For more severe or persistent pain, cortisone, a potent anti-inflammatory medication, may be injected into the painful area to provide relief.
• Platelet-Rich Plasma (PRP) Injections
  This treatment involves injecting a concentration of the patient’s own platelets to promote the healing of injured tendons.
• Extracorporeal Shock Wave Therapy
  This novel approach uses sound waves to stimulate healing in the elbow.

Surgical Treatment Options

In cases where non-surgical treatments do not provide sufficient relief, and symptoms persist for 6 to 12 months, surgical intervention may be considered. This can be conducted in two different ways:

Open Surgery

The surgeon makes an incision over the elbow to gain direct access to the damaged tendon. The procedure involves removing the diseased muscle tissue and reattaching the healthy muscle back to the bone. This method aims to alleviate pain by releasing tension on the tendon attachment.

Arthroscopic Surgery

This is a less invasive alternative to open surgery. It involves the use of miniature instruments inserted through small incisions around the elbow. This technique allows the surgeon to repair the tendon with minimal disruption to surrounding tissues.

Prevention Strategies

Preventing tennis elbow involves measures to reduce strain on the muscles and tendons of the forearm and elbow.

• Proper Technique and Equipment: For athletes, especially those in racquet sports, use the correct technique and equipment. This includes selecting racquets with the appropriate grip size and weight and using strings at a suitable tension to reduce stress on the forearm.
• Ergonomic Workspace: For individuals whose work involves repetitive arm and wrist motions, setting up an ergonomic workspace can help. This might involve adjusting the height of chairs and desks or using tools that require less force.
• Regular Stretching and Strengthening: Engaging in exercises that strengthen and stretch the forearm muscles can help prevent tennis elbow. These exercises improve muscle endurance and flexibility, reducing the risk of injury.
• Adequate Rest: Allow sufficient time for rest and recovery between activities that involve forearm use. Overuse without adequate rest is a primary risk factor for developing tennis elbow.
• Gradual Increase in Activity: Gradually increasing the intensity and duration of activities, especially new sports or exercises, can help prevent muscle strain.