See ony ‘What is tennis elbow? Lateral epicondylitis (tennis elbow’ or backhand tennis elbow’) is inflammation of an important forearm muscle tendon atthe point of attachment tothe outer side of the elbow bone, Tennis players are not the only sufferers. It is common in golfers, carpenters, bricklayers, violinists and homemakers, especially those between 35 and 55 years of age. humerus tenis goter's ebow bow cuter ie Inner side tam ofam ‘Anatomy ofthe elbow ‘What causes it? ‘Tennis elbow is the result of repeated bending and twist- ing movements of the arm, such as when playing golf and tennis, using a screwdriver, wringing wet clothes, carrying buckets or picking up bricks. It affects tennis players who use alot of wrist action ina faulty backhand movement, especially when they are unfit. The force of the ball hitting the racquet is greater than the strength of the muscle; the muscles of the forearm thus become overstrained, The strains, initially painless, cause small tears in the tendon. As they start to heal, more tears occur and painful inflamed scar tissue forms. What are the symptoms? ‘The outer bony projection of the elbow (the lateral epi- condyle) is painful. or some people the pain is constant and can interfere with sleep. ‘The forearm aches with grasping and lifting move- ‘ments such as pouring tea, turning stiffhandles, ironing clothes and typing. Even simple things like picking up a glass, shaking hands or brushing teeth can cause pain, What is the treatment? ‘Tennis elbow is stubborn to treat but almost always curable. The two bases of treatment are: «+ rest (avoiding the cause, eg, stop playing tennis) «+ exercise (to strengthen the forearm muscles, which bend the wrist) Your general practitioner might recommend a cortisone injection to speed recovery. Sometimes it can take I to 2 years to heal. A course of anti-inflammatory drugs is ‘worth a trial—take for 2 to 3 weeks before reviewing their effect. Exercises Use a dumbbell or similar type of weight such as a bucket of water. Start with 0.5 kg (1 Ib) and build up gradually to 5 kg. 1. Sitin a chair beside a table. 2. Rest your arm on the table so that the wrist is over the edge. 3. With your palm facing downwards, grasp the ‘weight. 4, Slowly raise and lower the weight 12 times. Rest for 1 minute. 5. Repeat twice. Do the exercise every day until you can play tennis, work or use your forearm without pain, ‘The dumbbell exercise The towel-wringing exercise ‘This hurts at first, but usually cures the problem by 6 weeks. Roll up a handtowel and, with your arms straight, rasp the towel, then wring it slowly so that your “wrist is fully bent forwards. Hold for 10 seconds, then reverse the wringing action to extend your wrist; hold for 10 seconds. Gradually increase the time by 5 seconds until you can hold for 60 seconds, Do this twice a day, twice in each direction. Many people prefer to do this exercise using a large face washer while showering, Tennis Do not use a tightly strung, heavy racquet or heavy tennis balls. Keep your strokes smooth and try not to bend the elbow, Start the game quietly, taking time to warm up toit, The ‘other’ tennis elbow ‘Medial epicondylitis (forehand tennis elbow, ‘golfers! elbow’ or ‘pitchers’ elbow’) is less common and usually less severe. The treatment i the same, but the palm must face upwards for the dumbbell exercise. ‘Armbands Some tennis players use a non-stretch band or brace around the arm, about 7.5 cm (3 inches) below the elbow. ‘You might not find it helpful, but itis worth trying, Bands are available from (some) pharmacists, tennis shops and orthopaedic appliance firms, 193