Sports Safety

By Abbott Kagan II, MD
And Jim Marshall, ATC/L

__Lateral epicondylitis, better known as tennis elbow, and medial epicondylitis, golfer’s elbow, can be very debilitating to today’s athlete. Although these are very painful injuries, they are both treatable and preventable.
__The words "lateral" and "medial" refer to the part of the elbow where the injury has occurred. Lateral refers to the outside and medial refers to the inside of the elbow. The epicondyle is the bony protrusion that one can feel when touching her elbow. The suffix "itis" means inflammation. Tendons connect muscle to bone and this is where the problem originates. The tendon becomes irritated at the spot that it connects to the bone.
__There are several contributing factors that can lead an athlete into these conditions. Weak muscles, muscle imbalances, overuse, improper equipment, and poor playing technique may be some reasons for medial or lateral epicondylitis. When strengthening, one must work on both the wrist flexor muscles (used to bend the wrist) and wrist extensor muscles (used to extend the wrist). To avoid overuse, the athlete should play in moderation with adequate rest. Stretching the forearm muscles before, during and after lessons or matches may be helpful. The kind of equipment a player uses is a very important issue. Having the proper grip size and string tensioning on your racquet are good preventative measures. Oversized and lighter weight racquets tend to be a little easier on the elbow. Using a two-handed grip whenever possible will reduce the amount of stress, especially when hitting backhand shots.
__Most people who have tennis elbow usually have pain when pressure is applied to the outside of the elbow. They may also have pain when shaking hands, turning doorknobs, picking up objects or, as mentioned, hitting a backhand shot. The most effective way to treat athletes with lateral eplicondylitis is R.I.C.E: rest, ice, compression and elevation. The athlete must maintain flexibility and regain the muscle strength as well as balance the muscles out. Sometime a counter-force strap may provide some relief. Only in severe cases of lateral epicondylitis is surgery required. Most can be treated with strengthening exercises. If rest, compression and strengthening exercises don’t help, one may need to see an orthopedic surgeon.

Originally printed in the Spring/Summer 2000 issue of SportsFront.