Tennis Elbow: Teen Version

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KEY POINTS

• Tennis elbow is a painful problem with the tendons that attach the bony bump at the outer side of your elbow with the muscles in your forearm and wrist.
• You will need to change or stop doing the activities that cause pain until the tendon has healed.
• Treatment may include stretching and strengthening exercises, a brace or elastic bandage, medicine, or surgery.
• Warm-up exercises and stretching before activities can help prevent injuries.

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What is tennis elbow?

Tennis elbow is a problem with the tendons that attach the bony bump at the outer side of your elbow with the muscles in your forearm and wrist. Tendons are strong bands of tissue that attach muscle to bone. You use these muscles and tendons when you bend your wrist backward.

Tendons can be injured suddenly or they may be slowly damaged over time. You can have tiny or partial tears in your tendon. If you have a complete tear of your tendon, it is called a rupture. Tennis elbow is also called lateral epicondylitis, elbow tendinopathy, tendinosis, or wrist extensor tendinopathy.

What is the cause?

Tennis elbow is usually caused by activities that overuse the tendons and muscles in your forearm that straighten and raise your hand and wrist. Examples of these activities are tennis and other racket sports, carpentry, machine work, computer work, and knitting. Tennis elbow may also be caused by a sudden injury that twists or tears your tendon.

What are the symptoms?

Symptoms may include:

• Pain or tenderness on the outer side of the elbow
• Pain when you straighten or raise your wrist and hand, or lift a heavy object
• Pain when you make a fist, grip an object, shake hands, or turn door handles
• Pain that shoots from the elbow down into the forearm

How is it diagnosed?

Your healthcare provider will examine you and ask about your symptoms, activities, and medical history. Tests may include:

• X-rays
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of your elbow area

How is it treated?

You will need to change or stop doing the activities that cause pain until the tendon has healed. For example, you will need to avoid racket sports, hammering, or unscrewing jars until your symptoms go away. If you play tennis, you may need to use a tennis racket with a larger grip or change the way you hold or swing your racket, or get exercise by walking or running instead of playing tennis. Try to lift objects with your palm facing up to keep from overusing the tendons and muscles in your arm.

Your healthcare provider may recommend stretching and strengthening exercises to help you heal.

You may need to put an elastic bandage around the elbow, or a strap just below the tender spot on the elbow. It may help to wear a wristbrace to prevent bending of your fingers and wrist.

If the pain does not go away, your provider may give you a shot of a steroid medicine.

In severe cases, you may need surgery to repair the tendon.

The pain often gets better within a few weeks with self-care, but some injuries may take several months or longer to heal. It’s important to follow all of your healthcare provider’s instructions.

How can I take care of myself?

To help relieve swelling and pain:

• Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth, on the area every 3 to 4 hours for up to 20 minutes at a time.
• Do ice massage. To do this, first freeze water in a Styrofoam cup, then peel the top of the cup away to expose the ice. Hold the bottom of the cup and rub the ice over your tendon for 5 to 10 minutes. Do this several times a day while you have pain.
• Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don't take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.

Moist heat may help relax your muscles and make it easier to move your arm. Put moist heat on the injured area for 10 to 15 minutes at a time before you do warm-up and stretching exercises. Moist heat includes heat patches or moist heating pads that you can purchase at most drugstores, a wet washcloth or towel that has been heated in the dryer, or a hot shower. Don’t use heat if you have swelling.

Follow your healthcare provider's instructions, including any exercises recommended by your provider. Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid, including how much you can lift, and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent tennis elbow?

Warm-up exercises and stretching before activities can help prevent injuries. If your arm hurts after exercise, putting ice on it may help keep it from getting injured.

Follow safety rules and use any protective equipment recommended for your work or sport. For example, be sure your tennis racket has the proper grip size. In job-related activities, make sure your posture is correct and that the position of your arms during your work doesn't put stress on your elbow or arm muscles.