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The symptoms causes and treatment of the tennis elbow a tendon inflamation

Causes Why did I develop tennis elbow? Overuse of the muscles and tendons of the forearm and elbow are the most common reason people develop tennis elbow. Repeating some types of activities over and over again can put too much strain on the elbow tendons. These activities are not necessarily high-level sports competition. Hammering nails, picking up heavy buckets, or pruning shrubs can all cause the pain of tennis elbow.

In an acute injury, the body undergoes an inflammatory response. Special inflammatory cells make their way to the injured tissues to help them heal. Conditions that involve inflammation are indicated by -itis on the end of the word. For example, inflammation in a tendon is called tendonitis.

Inflammation around the lateral epicondyle is called lateral epicondylitis.

  1. Shock wave therapy is a newer form of nonsurgical treatment. We may apply ice and electrical stimulation to ease pain and improve healing of the tendon.
  2. Working on a computer, doing yard or housework or playing racquet sports are all common causes of tennis elbow.
  3. Doctors call this condition tendonosis.
  4. Some cases of tennis elbow may require physical therapy to improve strength in the arm and reduce pain associated with inflamed and irritated tendons. Our Physical Therapist may begin with light isometric strengthening exercises.

However, tennis elbow often does not involve inflammation. Rather, the problem is within the cells of the tendon. Doctors call this condition tendonosis. In tendonosis, wear and tear is thought to lead to tissue degeneration.

  1. We generally begin active therapy about two weeks after surgery. We now know that most cases of chronic tennis elbow and other chronic tendinopathies are mainly degenerative worn or broken down in nature rather than inflammatory2; there is rarely any inflammation present in the involved tendon.
  2. These exercises work the muscles of the forearm without straining the healing tissues. Your doctor may suggest using ultrasound to guide a needle into the sore area.
  3. However, tennis elbow often does not involve inflammation. With each recurrence of symptoms, the patient typically gets even worse and more frustrated.
  4. We now know that in order to effectively treat chronic tennis elbow, the focus must be on regenerating or re-healing tendons rather than on reducing inflammation.

A degenerated tendon usually has an abnormal arrangement of collagen fibers. Instead of inflammatory cells, the body produces a type of cells called fibroblasts. When this happens, the collagen loses its strength. It becomes fragile and can break or be easily injured. Each time the collagen breaks down, the body responds by forming scar tissue in the tendon. Eventually, the tendon becomes thickened from extra scar tissue. No one really knows exactly what causes tendonosis. Some doctors think that the forearm tendon develops small tears with too much activity.

The tears try to heal, but constant strain and overuse keep re-injuring the tendon. After a while, the tendons stop trying to heal. The scar tissue never has a chance to fully heal, leaving the injured areas weakened and painful.

Scar Tissue Symptoms What does tennis elbow feel like? The main symptom of tennis elbow is tenderness and pain that starts at the lateral epicondyle of the elbow. The pain may spread down the forearm. It may go as far as the back of the middle and ring fingers. The forearm muscles may also feel tight and sore. The pain usually gets worse when you bend your wrist backward, turn your palm upward, or hold something the symptoms causes and treatment of the tennis elbow a tendon inflamation a stiff wrist or straightened elbow.

Grasping items also makes the pain worse. Just reaching into the refrigerator to get a carton of milk can cause pain. Sometimes the elbow feels stiff and won't straighten out completely. Diagnosis How can my health care provider be sure I have tennis elbow? You will need to answer questions about your pain, how your pain affects you, your regular activities, and past injuries to your elbow.

The physical exam is often most helpful in diagnosing tennis elbow. Our Physical Therapist may position your wrist and arm so you feel a stretch in the forearm muscles and tendons.

This is usually painful with tennis elbow. There are also other tests for wrist and forearm strength that we can used to detect tennis elbow. Tennis elbow symptoms are very similar to a condition called radial tunnel syndrome, a condition caused by pressure on the radial nerve as it crosses the elbow. If your pain does not respond to treatments for tennis elbow, your doctor may suggest tests to rule out problems with the radial nerve.

Our Treatment Non-surgical Rehabilitation The key to nonsurgical treatment is to keep the collagen in your tendon from breaking down further. Our goal is to help the tendon heal. We may apply tape to take some of the load off the elbow muscles and tendons. Our Physical Therapist may advise that you wear an elbow strap that wraps around your upper forearm in a way that relieves the pressure on the tendon attachment.

We may apply ice and electrical stimulation to ease pain and improve healing of the tendon. This treatment is especially helpful for patients who can't tolerate injections. Our Physical Therapist will also instruct you in exercises used to gradually stretch and strengthen the forearm muscles.

What’s Really Wrong?

Because tendonosis is often linked to overuse, we will work with you to reduce repeated strains on your elbow. When symptoms come from a particular sport or work activity, our Physical Therapist will observe your style and motion with the activity.

We may provide tips about how to perform the movement so your elbow is protected. We can also check your sports equipment and work tools and suggest how to alter them to keep your elbow safe.

When symptoms are from tendonosis, you can expect healing to take longer, usually up to three months. If your tendonosis is severe, it may take at least six months for complete healing.

Physical Therapy in Linwood for Elbow

Post-surgical Rehabilitation Rehabilitation takes much longer after surgery. Immediately after surgery, your elbow is placed in a removable splint that keeps your elbow bent at a 90-degree angle. Our Physical Therapist may also use massage and other types of hands-on treatments to ease muscle spasm and pain. We will gradually have you work into more active stretching and strengthening exercises. You just need to be careful to avoid doing too much, too quickly.

We generally begin active therapy about two weeks after surgery. Our Physical Therapist may begin with light isometric strengthening exercises. These exercises work the muscles of the forearm without straining the healing tissues. You will also use your own muscle power in active range-of-motion exercises. At about six weeks, we will have you begin more active strengthening. As you progress, our Physical Therapist will teach you exercises to strengthen and stabilize the muscles and joints of the wrist, elbow, and shoulder.

You will also do exercises to improve fine motor control and dexterity of the hand. Some of the exercises you'll do are designed get your hand working in ways that are similar to your work tasks and sport activities. Other exercises will work your elbow in ways that are similar to your work tasks and sport activities. Our Physical Therapist will help you find ways to do your tasks that don't put too much stress on your elbow.

Although each patient recovers at a different rate, you may need to attend your Physical Therapy sessions for two to three months. It could take four to six months to get back to high-level sports and work activities. Before your therapy sessions end, our Physical Therapist will teach you a number of ways to avoid future problems.

Although we will continue to be a resource, you will eventually be in charge of doing your exercises as part of an ongoing home program. The X-rays mostly help your doctor rule out other problems with the elbow joint. The X-ray may show if there are calcium deposits on the lateral epicondyle at the connection of the extensor tendon. Tennis elbow symptoms are very similar to a condition called radial tunnel syndrome.

This condition is caused by pressure on the radial nerve as it crosses the elbow. A magnetic resonance imaging MRI scan is a special imaging test that uses magnetic waves to create pictures of the elbow in slices. The MRI scan shows tendons as well as bones.

Ultrasound tests use high-frequency sound waves to generate an image of the tissues below the skin. As the small ultrasound device is rubbed over the sore area, an image appears on a screen. This type of test can sometimes show problems with collagen degeneration. If the problem is caused by acute inflammation, anti-inflammatory medications such as ibuprofen may give you some relief. If inflammation doesn't go away, your doctor may inject the elbow with cortisone.

  • Historically, most health care providers and lay people have used the terms "tendonitis" or "tendinitis" to apply to all tendon dysfunction painful structures in and around tendons and the term lateral epicondylitis to refer to tennis elbow pain coming from ECRB tendon in the elbow;
  • Before your therapy sessions end, our Physical Therapist will teach you a number of ways to avoid future problems.

Cortisone is a powerful anti-inflammatory medication. Its benefits are temporary, but they can last for a period of weeks to several months. Your doctor may suggest using ultrasound to guide a needle into the sore area. The ultrasound gives a clear picture of areas in the tendon that contain scar tissue. Poking holes in the tendon breaks up scar tissue and gets the tendon to bleed. Bleeding in the tendon helps stimulate the healing response.

Shock wave therapy is a newer form of nonsurgical treatment. It uses a machine to generate shock wave pulses to the sore area. Patients generally receive the treatment once each week for up to three weeks. It is not known exactly why it works for tennis elbow, but recent studies indicate that this form of treatment can help ease pain, while improving range of motion and function.

In these cases, surgery may be necessary. Tendon Debridement When problems are caused by tendonosis, surgeons may choose to take out debride only the affected tissues within the tendon. In these cases, the surgeon cleans up the tendon, removing only the damaged tissue. Tendon Release A commonly used surgery for tennis elbow is called a lateral epicondyle release.