Education:

Tennis and Golfer’s elbow are similar; they are just on opposite sides of the elbow. Tennis elbow occurs on the outside or lateral epicondyle. The lateral epicondyle anchors the common wrist extensor tendon; which branches into four muscles that extend the wrist, extend the long digit and supinate (palm up) the forearm. Golfers elbow occurs on the inside or medial epicondyle. The medial epicondyle anchors the common wrist flexor tendon; which branches into four muscles that flex the fingers and the wrist together and pronate (palm down) the forearm. Since the finger flexors automatically flex the wrist, the wrist extensors are required to activate to counterbalance the wrist. Forceful and repetitive gripping in an awkward posture can strain the tendon and cause microscopic tearing of the tissue. This creates an inflammation, which classifies as tendinitis. Treatment includes rest, ice & anti-inflammatories. Scar tissue generates to mend the torn tissue, which takes 21 days to attain 10% of the normal strength and can take several months to return to normal strength. Many times, the scar tissue repeatedly tears, and the tendon fails to heal. This problem classifies as tendinosis and treatment include heat, massage, and exercise. Anti-inflammatories may impede healing and so we recommend using Tylenol. Always read and follow the direction on the bottle before taking any medication.

Prevention:

  • It is important for handles to have a good grip, 1 ½ “diameter with at least 5” length with good friction.
  • Use power tools instead of manual tools.
  • Use jigs and fixtures to hold work.
  • Perform gripping activities with elbow at 90° with palms facing each other and wrists straight.
  • Frequently perform stretching to reduce fatigue.

Self-Care: Acute Tendinitis:

  • Ice 15 minutes, 4 times per day.
  • NSAID’s – Ibuprofen, Naproxen, and Aspirin. Read and follow directions on the bottle.
  • Rest: avoid repetitive or forceful gripping.
  • Wear a forearm strap during the day to help the tendon rest and heal.
  • Wear a wrist splint while sleeping to help the tendon rest and heal.

Chronic Tendinosis:

  • Moist heat 15 minutes, 4 x day
  • Deep tissue massage 5 minutes 2 x day
  • Gradual progression of stretching
  • Gradual progression of strengthening
  • Wear a forearm strap during the day to help the tendon rest and heal.
  • Wear a wrist splint while sleeping to help the tendon rest and heal.
  • Avoid NSAID’s such as ibuprofen, Naproxen, and Aspirin. Use Tylenol for pain relief. Read and follow directions on the bottle.