How can I have tennis elbow if I don’t play tennis?

 Special promotional content provided by Thomas A. Little, MD.

Unfortunately, you don’t have to play tennis to develop tennis elbow—sometimes all it takes is a weekend of yardwork!

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Tennis elbow is a lay term orthopedists use to describe chronic pain on the bony bump on the outside of your elbow joint. The medical term for tennis elbow is lateral epicondylitis, which is a misnomer, because while the suffix -itis implies inflammation, tennis elbow is a case of degeneration.

Which leads to another question: Why is the outside of my elbow degenerating? The simple answer is overuse. Let me explain:

Any time you squeeze or lift an object (like a tennis racquet … or a rake or a jar of pickles), you activate the muscles on the back side of your forearm (where the hair is). As it happens, gripping an object isn’t just about what you do with your hand. Those gripping muscles actually have their origin in your forearm and elbow. Try making a fist with your wrist extended downward so that your fingers point toward the ground—pretty hard to tighten a fist, isn’t it? To make a strong fist or to grip an object, you need to flex your wrist slightly upward—which is done by the muscles on the back of your forearm.

(If you want to feel these muscles in action, place your left hand on your right forearm, then make a fist with your right hand. You’ll feel those forearm muscles tighten. Then try holding that fist while you flex and extend your wrist up and down—you’ll feel the forearm muscles tighten when your wrist flexes upward and lengthen when your wrist extends downward.)

The long and short of it is that every time you grip something with your hand, your forearm muscles are active. Those muscles attach to the bony bump on the outside of your elbow (your lateral epicondyle). When those muscles get overworked or too tight, their attachment to the bone can start to degenerate, causing the pain we call tennis elbow.

The best way to prevent tennis elbow is to be aware of when you’re doing a lot of gripping or lifting and take plenty of breaks to rest and stretch those forearm muscles. Here’s a good stretching routine for preventing tennis elbow: Straighten your right elbow, then use your left hand to bend your right hand and fingers up toward the sky as far as you can (flexing your wrist upward), then hold for a good 30 seconds. You should feel a gentle stretch on the underside of your forearm. Then use your left hand to bend your right hand and fingers toward the ground (extending your wrist downward), and hold for 30 seconds. You should feel a gentle stretch in the muscles on the top of your forearm. Repeat these stretches with your right elbow bent, then repeat all four stretches on your left arm.

If it’s too late to prevent tennis elbow and you’re already in some pain, these stretches can still really help. So can massaging the tight, overworked muscles on the back of your forearm—not the bony spot on your elbow where you actually feel the pain. Physical therapy and sometimes a steroid injection can also help, but as in most cases when it comes to chronic overuse injuries, resting and stretching are usually your best first option.

Thomas A. Little, M.D. is an orthopedic surgeon practicing at Gettysburg Orthopedics and Sports Medicine. You can learn more about him at GettysburgOrtho.com. You can reach his office at (717) 549-2331.

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