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Tennis Elbow (Lateral Epicondylitis)

Definition:
Tennis elbow is the common name for the inflammation or injury of elbow tendons, which are tough bands of tissue that connect muscle to the bone. Despite its name, this condition is not limited to tennis players. Any occupational or recreational activity that involves repetitive elbow use (weight lifting, hammering, etc.) can lead to lateral epicondylitis.

Symptoms:
· Pain in the elbow that spreads into the upper arm or down the forearm
· Weakness and difficult time with activities that require arm strength
· Pain can be sudden or develop gradually over time
· Usually affects the dominant arm (e.g. right arm in people who are right-handed)

Diagnosis:
The diagnosis is usually based on symptom description and physical exam. It should be differentiated from medial epicondylitis, which affects the inner part of the elbow (also known as “Golfer’s Elbow”).

Therapy:
· Over the counter NSAID medications such as Advil or Motrin usually provide pain relief and may help to decrease the inflammation.
· Elbow bracing: a specially designed brace helps to reduce pressure on the injured tendon in the elbow. It can be used while working or playing sports. You may need to wear the brace for up to six weeks.
· Elbow exercises can help to improve your arm’s strength and ability to move.

Outcome:
Most people with improve with the conservative therapy outlined above. You may have some pain during work or sports for up to 6-12 weeks.
If your pain is very severe or persists for longer than expected, a steroid injection into the painful tendon might help to relieve the pain. However, the injections should only be used sparingly and only in addition and not in place of the elbow
rest, otherwise they can make the problem more likely to reoccur.
Surgery is usually not needed unless symptoms have not improved after six or more months of treatment.

Prevention:
· Reduce or avoid lifting objects with the arm extended
· Reduce repetitive gripping and grasping
· Work or weight-train with the elbow in a partially bent position. Use wrist supports when weight-training.
· Wear gloves when using tools repetitively to increase griping surface
· Use a two-handed backhand in tennis. When hitting a tennis stroke, use your entire lower body and focus on the proper technique. It may also be beneficial to find the largest grip that is comfortable and to use softer string

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