Tennis Elbow, a Condition Caused more often by Activity Off.... Than On the Tennis Court

As summer sports heat up and we scramble to fill the long days of daylight with activities we’ve waited all winter to do, injuries and other overuse conditions affecting the hand, wrist and elbow are bound to occur.

A common overuse condition we see in the office throughout the year and particularly during the summer months is Tennis Elbow, also known as lateral epicondylitis.  “Epicondylitis” refers to inflammation at the epicondyle (where tendon and muscle attaches to the humeral condyle of the elbow).  “Lateral” refers to the outside portion of the elbow.

Considered an overuse or repetitive stress, tendinopathic condition affecting the lower arm muscles and tendons along the outside of the elbow, the condition is named after the sport first identified as a primary cause - affecting five out of 10 recreational and professional tennis players.  Though the condition is caused by many different types of activities causing repeated twisting and strain on the lower arm and elbow - including playing certain musical instruments, sports, manual labor and other everyday activities.

Tennis elbow is frequently seen in those between the ages of 40 and 60.

Symptoms

Symptoms of tennis elbow may initially cause only moderate pain in the outer portion of the elbow, but over time may spread down the forearm and back of the middle and ring fingers.  If left untreated, the pain can cause severe pain and weakness limiting arm function.  

Diagnosis and Treatment

Tennis elbow is generally diagnosed by discussing the discomfort and observing the pain a patient experiences when performing certain arm movements.  In many cases tennis elbow is addressed non surgically with conservative treatment that may include refraining from the activity, anti inflammatory medication or physical therapy with instruction on behavior modification.

If conservative treatment does not resolve the condition, a surgical procedure known as lateral epicondyle release is performed to relieve the tension.

Read more about repetitive stress conditions affecting the hand, wrist and elbow.

Wrist Fractures

The vital role that our hands play in daily life is often times only fully understood when we lose use of one or both as a result of an injury.  The wrist joint is particularly vulnerable because of its range of motion and location - involved in lifting, twisting, hammering, blocking a blow and softening the impact of a fall.  As a result, wrist fractures are among the most common fractures of the hand and upper extremity.

Some of the most common types of wrist fractures include:

Distal Radius Fractures

Scaphoid Fractures

Each of these fractures has their own unique challenge, which is why it is important that wrist fractures are treated by a hand and wrist specialist who understands the delicate bones of the hand and wrist, the blood supply to these bones and the intricate network of ligaments, tendons and nerves.  The wrong treatment, or lack of treatment, could result in long term damage to the joint and decreased hand function.

Distal Radius Fractures

A distal radius fracture is one of the most common types of wrist fractures.  It is named for the location of the break and bone it affects - the distal end of the larger forearm bone known as the radius.  This type of fracture should be carefully examined to determine if the fracture extends into the wrist joint (intra articular fracture) or does not impact the wrist joint (extra articular fracture).  The type of fracture will determine the type of treatment.

Scaphoid Fractures

A scaphoid fracture is a fracture of the scaphoid bone in the wrist, located at the thumb side.  These types of fractures require special attention, as the blood supply for the scaphoid bone enters from the top and most fractures occur in the middle or bottom portion.  This compromises the blood supply and can impede healing. Ensuring its stability is essential in preserving the integrity of the wrist joint  and avoiding avascular necrosis.

The treatment for these types of wrist fractures will depend on the severity of the fracture and other soft tissue damage.  Treatment will also be based on other aspects of a patients overall health and level of activity.  Ensuring the proper alignment and healing of the fracture is important in avoiding future problems in the hand and wrist.  

All treatment is followed by hand therapy and rehabilitation exercises to ensure that there is no loss in arm strength and function.  The goal of Dr. Collins and his hand and upper extremity support staff is to return patients to their daily lives quickly and as strong as they were before the injury.