Tennis elbow is a condition that affects the muscles and tendons in your elbow, often due to wear and tear over time. One main muscle involved is the extensor carpi radialis brevis (ECRB), a forearm muscle that helps stabilize your wrist and extend your fingers. The injury typically develops from repeated arm movements, which is why it’s common among tennis players. However, you don’t have to play tennis to experience tennis elbow—many people who perform repetitive arm motions can develop it.
If you have tennis elbow, you may have a hard time playing your favorite sport or doing other daily activities. Experts at Summit Orthopedics locations in the Minneapolis/St. Paul area are experienced in diagnosing and treating elbow conditions, including tennis elbow, with the highest level of care.
Symptoms of Tennis Elbow
The symptoms of tennis elbow usually develop over time. They may start mild and gradually worsen over weeks or months. There is often no single specific injury that marks the start of the problem. The most common symptoms include:
- Decreased or weak grip strength
- Difficulty with simple movements, like picking up a coffee cup or shaking hands
- Elbow pain that increases with activity and improves with rest
- Pain or burning in the outer part of your elbow
- Pain that can extend from the outer part of the elbow down through the forearm and the back of the hand, particularly during twisting or gripping motions.
- Tenderness when the provider gently presses on the lateral epicondyle area
What Causes Tennis Elbow?
The underlying cause of tennis elbow is repeated strain and overuse. When you perform activities that involve repeated gripping or wrist extension, you put strain on the muscles and tendons in your arm. Over time, this overuse can cause small tears in your tendon.
Anyone whose work or hobbies require repetitive use of the forearm muscles or repeated wrist twisting can develop tennis elbow. Automobile mechanics, painters and plumbers are more likely to get this condition than the general public.
Diagnosing Tennis Elbow
A physical exam is one of the main ways of diagnosing tennis elbow.
During the exam, your provider will check for tenderness. They will also use tests to see if certain movements increase your elbow pain. For example, if you feel pain when trying to straighten your wrist or fingers against resistance, this suggests that the tendons are unhealthy or inflamed.
Imaging tests are not always required for diagnosis. However, if your doctor thinks another issue is causing your elbow pain, or if your symptoms do not respond to treatment, they may recommend additional tests:
- Electromyography (EMG). This test helps rule out nerve compression, which can sometimes have symptoms similar to tennis elbow. Doctors typically order an EMG when symptoms include numbness or tingling in the fingers.
- MRI scan. An MRI scan provides detailed images of soft tissues, like muscles and tendons. An MRI can show the severity of the tendon damage and help determine whether another condition is causing your symptoms.
- X-rays. These can rule out problems with the bones, such as arthritis or fractures.
Treatment Approaches
Providers can often treat tennis elbow successfully without surgery, although full recovery may take up to a year after the initial injury or when you first notice pain. Your provider may initially recommend resting your forearm and avoiding activities that cause pain, physical therapy, anti-inflammatories and bracing. If symptoms persist, your provider may recommend additional treatments, such as injections and minimally invasive procedures.
In addition to resting and pain medication, your nonsurgical treatment plan may include:
- Bracing. This involves wearing a strap or compressive sleeve on the upper forearm to relieve tension on the tendons during strenuous or painful activities.
- Injections. Steroid injections containing cortisone, an anti-inflammatory drug, can provide fast relief for elbow pain. However, these are often considered controversial or only for short-term benefit, as repeated use can potentially weaken the lateral epicondyle.
- Platelet-rich plasma (PRP). PRP is another type of injection. It involves taking a small blood sample, concentrating the platelets and injecting them back into a specific area of your body. PRP has shown better long-term potential for pain relief and healing compared to steroid injections.
- Physical therapy. Physical therapy for tennis elbow focuses on exercises that stretch and strengthen your forearm muscles.
- The Tenex procedure. This minimally invasive procedure uses high-frequency sound waves to break up calcium deposits and scar tissue while protecting healthy tissue.
Does Tennis Elbow Require Surgery?
Surgery is considered a last resort in the management of tennis elbow. Surgery is typically only recommended if your symptoms include long-lasting pain and have not improved after six to 12 months of treatment.
During surgery, doctors remove the damaged or diseased tendon and reattach the remaining healthy tendon to the bone. They may use open surgery (with an incision over the elbow) or arthroscopy (using small instruments).
Preventing Tennis Elbow
You can help prevent tennis elbow by taking steps to avoid repetitive strain and overuse that can damage your forearm’s tendons. Here are key tips for preventing tennis elbow:
- Ask your coach about changes you can make to your technique, such as using a two-handed backhand in tennis.
- Avoid holding or lifting heavy objects with a completely straight arm. Instead, keep your elbow partially bent.
- If you play tennis, using a stiffer racquet or one with looser strings can help reduce the stress on your forearm muscles.
- If you work on a computer, using wrist support or a roller mouse might help reduce strain.
- Take breaks when doing repetitive hand and wrist motions.
- Use both hands when holding heavy tools.
Care for Tennis Elbow at Summit Orthopedics
We provide expert diagnosis and treatment for tennis elbow, regardless of your activity level. Our goal is to ensure you recover complete hand strength and motion.
Summit Orthopedics surgeons are available at nearly 30 convenient locations across the Minneapolis/St. Paul area, serving Minnesota and western Wisconsin. Our state-of-the-art, comprehensive orthopedic centers offer same-day appointments from a team of experts who offer the full scope of orthopedic care.
Find your Summit Orthopedics expert, request an appointment or call us at (651) 968-5201 to schedule a consultation.
