Sunday, August 4, 2013

Golfer's Elbow- the "Inside" Elbow Problem

Tennis elbow refers to the "outside" elbow pain of lateral epicondylitis. However, if your "inside" elbow is hurting, you may have GOLFER's elbow, known medically as medial epicondylitis. Both elbow problems are due to overuse injuries, and rarely do they occur in both arms at the same time.

Tennis elbow is much more common than golfer's elbow, with tennis elbow having a little over 1% prevalence, and golfer's elbow only 0.4%. Golfer's elbow is an overuse of the wrist as it flexes and pronates (turns palm down). Interestingly, tennis players with overly tight grips often end up with "golfer's elbow".

The main symptoms of golfer's elbow are pain on the inside (tender to touch and aches most of the time), worsened pain with resisted flexion and turning the palm downward, and worsened pain with gripping or handshake. The pain starts at the bony bump on your inside elbow and then may radiate downward to your forearm and wrist.

Once again, treatment includes relative rest (stop the repetitive activity that is worsening the problem), anti-inflammatory medications, compression wraps and icing. An ice massage is done by rubbing the ice in a wide circular motion over the painful side of your elbow for about 5 minutes. (Making the ice in a small paper cup will save your fingers from an uncomfortable session- just peel away the top part of the cup and then you have a paper holder.)

Symptoms that do not resolve within a week or two using these basic treatments may require formal physical therapy or steroid injections to fully resolve the problem.

BOTTOM LINE: Don't let overuse injuries of your elbows keep you off the courts or links- start treatment as soon as you begin to notice persistent elbow pain, and avoid developing full blown "tennis" or "golfer's" elbow.

Friday, August 2, 2013

Tennis Elbow- Racquet Optional!

Recently I talked about carpal tunnel syndrome and cubital tunnel syndrome of the wrist. Now I'd like to move up a notch and talk about issues with the ELBOW. Interestingly, we've got two different "sport" elbow problems- tennis elbow and golf elbow-and yet, you can develop either of these problems without ever picking up a racket or a club. Today, let's talk about tennis elbow.

The medical name for "tennis elbow" is lateral epicondylitis, and this occurs when the tendons on the outside of the elbow are torn or strained. Typically the symptoms begin with an ache on the outside of your elbow, that gradually worsens until it becomes an intense burning pain that is worse when you grab or twist anything (opening car doors, jars, lifting groceries, etc.)

What causes tennis elbow? Any action that causes a repetitive movement can cause swelling and pain in the joint being used, and tennis elbow is no exception. In this case, the movement is a repeated twisting of the wrist and elbow, such as in a tennis stroke. However, other activities- like hammering, sawing, giving massages or working in an assembly line-can also cause "tennis" elbow.

Do kids get this? Not too often- the typical patient with tennis elbow is 30-50 years old, with an equal distribution of men and women.

Do you need an X-ray? An x-ray will not "show" tennis elbow, but some times an x-ray is done to rule out an underlying fracture.

How is tennis elbow treated? There are multiple things to do to treat tennis elbow, but the most important is relative rest- not a cast, but avoidance of the activity that caused the problem. Additionally, taking consistent over-the-counter anti-inflammatory medications such as ibuprofen or naproxen will help reduce both the pain and the swelling. Ice packs applied a few times per day, especially after activity, will also help. An ACE wrap can help control swelling, plus serves as a reminder to you not to overdo it! If these treatments are not enough to resolve the symptoms, then physical therapy, splinting and steroid injections are the next level of treatment. Rarely, surgery is required.

Prevention: If you are taking up a racquet sport (or joining a league and greatly increasing your time on the court), make sure to maintain good strength and flexibility in your arm muscles with light weights or resistance bands.

BOTTOM LINE: If you are developing persistent "outside" elbow pain, you might have "tennis elbow"- try rest, ice, compression, and anti-inflammatories as soon as possible, but if it persists, it's time to see your family doctor.

PS- Happy August- change those air filters!