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Portland Chiropractor - Tennis Elbow

Brad Farra - Tuesday, January 12, 2010


Tennis Elbow

Last spring I wrote a blog on Tennis elbow.  I thought it was time to re-post and update some information.  As a Sports Chiropractor in Portland Oregon I treat a lot of sports and extremity injuries and tennis elbow is very common.  Tennis elbow has also been called carpenters elbow and is referred to by health care professionals as lateral epicondylitis. All of the activities associated with tennis elbow include some type of hand use. Tennis players are only responsible for a small percentage of these injuries. In addition to the activities listed above there are many other possible causes including: computer terminal use, plumbing, carpentry, bowling, and too many others to list.  Tennis elbow is a repetitive use injury, not caused by a single traumatic event.

Tennis elbow usually comes on slowly with pain in the outside (lateral side) of the elbow. Sometimes the condition will go away on its own by removing the offensive activity, but it usually requires treatment for full recovery and avoidance of flare ups. Current research provides evidence that this is not an inflammatory condition, but more of a chronic degenerative condition; this explains why cortisone shots and anti-inflammatory drugs are ineffective for this condition. It should also be mentioned that cortisone shots have been shown to weaken tendons and connective tissues and should not be injected directly into a tendon.  Treatment should always begin with conservative measures. Tennis elbow is at times slow to respond to treatment, but rarely needs more invasive treatments like surgery. Conservative therapy usually includes modification or elimination of the offensive activity; for example a tennis player may need to take a break from tennis, limit the backhand swing, or at a very minimum use the two handed backhand and improve technique. In office treatment consists of soft tissue therapy, elbow joint manipulation, and ultrasound. An extremely effective type of soft tissue manipulation for tennis elbow is Graston Technique (www.grastontechnique.com). It is important to begin rehabilitation exercises including stretching and strengthening as soon as you have your elbow condition diagnosed. In less than 5% of cases surgery is needed where conservative therapy has failed. Surgery for tennis elbow is 80-90% effective.

If you did acquire your tennis elbow with your powerful backhand a few tips might be helpful if you are unwilling to take a break from tennis and you want to continue playing while receiving treatment: change your racket (avoid high string tension), get in a long warm up, use a larger hand grip, avoid Kevlar string, use string dampers, counter weight handle of racket (retrofit handle), use a brace (counter force strap), play on slow surfaces with new and dry balls.

If you are like most people and have acquired a nasty case of tennis elbow from too much computer use.  Have someone work with you on your work station ergonomics and posture.

If you are seeking treatment for this condition go to www.drbradfarra.com for information about scheduling.

I hope you find this information helpful and as always if you have any questions please don't hesitate to contact me. drfarra@drbradfarra.com

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