Tennis elbow doesn't just strike tennis players



DEAR DR. DONOHUE: I played tennis since I was a young boy and continued to play it twice a week through my adult years. I retired three months ago, and now have been playing tennis daily. I have come down with tennis elbow. How could this happen when I've played regularly most of my life? How do I go about treating it? -- P.L.

Dr. Donohue

ANSWER: Let's orient readers to where your problem is. Let your arm dangle down at your side with the palm facing forward. On the thumb side of your elbow toward the back you'll feel a nubbin of bone, the lateral epicondyle. It's the place of attachment for muscles on the back of the forearm, the hairy side. Inflammation and small tears of the attachment are tennis elbow.

Tennis elbow isn't unique to tennis players. Carpenters, gardeners, painters and briefcase carriers are examples of people other than tennis players who develop the problem. Shaking hands, turning doorknobs and pouring milk from a full carton bring on great pain.

Overuse is the primary cause of tennis elbow. Even though you played tennis throughout life, you were not playing it daily. In addition to overuse, a racket handle that is too small or too large contributes to it. Backhands hit off center make a contribution, too. Excessive use of topspin is another element that is partly responsible for the condition.

Rest is essential for cure. Don't play until the pain has gone. Icing the lateral epicondyle four times a day for 15-minute sessions speeds healing. NSAIDs, nonsteroidal anti-inflammatory drugs (Aleve, Advil, Motrin, etc.), lessen pain and inflammation. Sometimes, when progress is slow, an injection of a cortisone drug into the area of the epicondyle brings quick relief.

When the pain is gone, begin a program of strengthening forearm muscles to prevent a recurrence. While sitting, with forearms resting on thighs, and hands holding a lightweight dumbbell with palms facing upward, bend and straighten the arms 10 times. Then reverse the position -- palms facing downward -- and perform 10 bends.

DEAR DR. DONOHUE: I am a golfer, but I think I have tennis elbow. I never played tennis in my life. Is this possible? -- B.J.

ANSWER: Golfer's elbow is pain in the medial epicondyle, the nubbin of bone toward the back of the elbow on the side of the elbow next to the body when the arm dangles down with palm facing forward. Even though it's called golfer's elbow, only 20 percent of those with the condition are golfers.

The same program for tennis elbow works for golfer's elbow.

DEAR DR. DONOHUE: My husband is 55 and hasn't been active in the 30 years we've been married. Now he decides he wants to run in a marathon.

I told him this would be dangerous for someone his age and his lack of exercise. Furthermore, running in the summer's heat only adds to the danger.

Will you please talk some sense to him? -- W.O.

ANSWER: Mr. W.O., listen to your wife. You haven't been physically active for 30 years. You can't jump into such demanding exercise without first seeing a doctor. Furthermore, summer heat is not the best time to begin running long distances.

Once you've gotten your doctor's clearance, you can get into shape gradually. It will take you an entire year before you're ready for a marathon. Running slightly more than 26 miles isn't a piece of cake.

However, I have to admit marathon running isn't an invitation to death. Investigating 10 years of the safety of long-distance running turned up 59 cardiac arrests in the millions of runners entered into such races. A cardiac arrest is a stoppage of all heart action. Of those 59 cardiac arrests, 42 runners died. That's a small but significant number. You don't want to be included in that statistic.

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Dr. Donohue

Last modified: July 15, 2012