Orthopedics-Online

Tennis elbow

The tennis elbow is a painful inflammation of the tendons at the elbow.
Dr. As a tennis player, Nicolas Gumpert has specialized in the treatment of tennis elbow and gives his experiences and therapy options on .
Tennis elbow in particular, which lasts for several months, is difficult to treat and requires sufficient experience.
I would be happy to advise you in my tennis elbow consultation.

What is a tennis elbow?

Tennis elbow or tennis elbow - also called epicondylitis humeri lateralis / radialis - is a painful irritation of the tendons that attach to the outside of the elbow.

Permanent overuse of the forearm muscles, which is caused by monotonous movements without adequate relief, is seen as the main trigger.
The forearm muscles, which are primarily responsible for stretching the wrist and fingers, attach to the elbow and upper arm via the respective tendons.
Most tennis elbows heal with the right therapy; the limitation is rarely chronic.
Important information on causes, treatment options and exercises as well as the course and prognosis of the tennis elbow are discussed in more detail below.

How is a tennis elbow treated?

The treatment of tennis elbow can be divided into a conservative and an operative one.

As a rule, conservative therapy is started, which in addition to protecting and possibly immobilizing the elbow joint also includes regular cooling. Pain reliever or cortisone-containing ointments (bandages), bandages or cuffs, physiotherapeutic treatment (strengthening training, stretching exercises, massages, etc.) and acupuncture are also among the conservative treatment measures.

Syringes containing a mixture of local anesthetics and cortisone can also be injected locally into the elbow area.

Painkillers can also be taken as tablets, preference being given to non-steroidal anti-inflammatory drugs (NSAIDs, e.g. diclofenac, ibuprofen), which have an anti-inflammatory effect in addition to the analgesic.

If the conservative therapy of the tennis elbow is unsuccessful, the next step can be taken to the surgical therapy, whereby there are various methods to relieve the tennis elbow.
Another attempt at therapy for chronic complaints is the injection of botulinum toxin (also known as botox) into the muscle to “paralyze” it for 2-3 months so that it can recover.

You should also read this article:

Tennis elbow therapy
This is how long periosteum inflammation lasts

Appointment with a tennis elbow specialist?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".

As a former performance-oriented tennis player, I specialized early on in the conservative treatment of chronic tennis elbow.
In the last few years I have successfully treated several thousand tennis arms.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert.

Bandage / brace

One possibility of conservative therapy for tennis elbow is to put on and wear a tennis elbow bandage or tennis elbow brace.
Therapy with a bandage or brace plays a very important role in the acute phase, while the two aids become less efficient in the chronic phase.

If the tennis elbow is still in place, this can, together with cooling, rest, painkillers, physiotherapy and stretching exercises, help to relieve the affected muscles and help heal, but also prevent recurrence after successful therapy and persistent heavy strain on the forearm muscles.

A bandage / brace does not restrict freedom of movement as consistently as a plaster of paris, for example, but rather ensures an unrestricted range of motion.

The purpose of such a bandage / brace is the exertion of targeted pressure, concentrated on the attachment point of the tendons on the elbow, which means that the muscles of the forearm are relieved and pain can be alleviated.

Such cuffs can be purchased over the counter in various sports and medical supplies stores, but you should first seek advice from the doctor treating you as to which type of bandage / brace is most suitable. Care should also be taken to ensure that the size and fit are correct, as otherwise even further unpleasant complaints can be caused by a bandage that is too tight and constricting.

Your doctor can easily tell you whether you benefit more from a bandage or brace.
How long the bandage, brace or cuff is worn depends on various factors.
As a rule, the aids should only be worn during exercise (during sport, on the PC) in order to relieve the tendon. Where the elbow is not exposed to stress, bandages or the like should not be worn, as this disrupts the healing process through compression.

For more information on this topic, see our article: Bandage for a tennis elbow

Taping

Taping as part of a tennis elbow can also be viewed as a supportive therapy measure and support conservative treatment, i.e. non-surgical treatment.

Both elastic tapes (e.g. Kinesio tapes) and inelastic tapes (e.g. Leukoplast) can be taped.
Elastic kinesio tapes are used to support healing. Inelastic tapes help athletes to be less painful during sport.

Which type of tape should be used depends entirely on what exactly is to be achieved with the tape: inelastic tapes - similar to bandages or tight bandages - have a rather "shining" function, so they restrict the range of motion in the elbow somewhat and support calmness.

Elastic tapes (Kinesio tapes), on the other hand, restrict movement less or not at all, at most support the movements and promote oractivate the blood circulation, the poorly stressed muscles and the lymphatic drainage, so that pain relief, decongestion and inflammation can be achieved.

The tapes should always be put on or glued by experts, since incorrectly glued or too tightly glued tapes also lead to further complaints, such as Circulatory disorders.

For more information on this topic, see our article: Taping a tennis elbow

stretching

Stretching exercises can be performed during an acute tennis elbow and help to heal, but they can also be used regularly in everyday life after a tennis elbow has been overcome to prevent it from recurring.

For example, the following exercise can be performed 2-3 times a day: The arm is stretched straight forward at a 90 ° angle away from the body, the elbow should not be bent. With the palm pointing upwards, the hand in the wrist is then bent downwards and held in this position for about 30 seconds with the help of the other hand.

You can find more important information and more exercises here: Stretching exercises for a tennis elbow

Pain While Stretching - Carry On?

It often happens that pain occurs during stretching exercises and exercises with the Theraband.
At the beginning of therapy, an uncomfortable feeling on the outer elbow can lead to the end of the respective stretching exercise.
However, pain should never arise while stretching or stretching should be carried out beyond the pain threshold. Whenever the stretching exercises can be performed painlessly, the repetition of the exercises during the day can be increased.
However, this should be done in consultation with the attending physician or the supervising physiotherapist.

Please also read our topic: Tennis elbow pain

Illustration of a tennis elbow

Figure tennis elbow: below - right forearm, muscles of the extensor side (dorsal side)

Spoke shaft -
Corpus radii
Ellschaft - Corpus ulnae
Upper arm shaft -
Corpus humeri
Long spoke side
Hand straightener -
Extensor muscle
carpi radialis longus
Shorter spoke side
Hand straightener -
Extensor muscle
carpi radialis brevis
Long thumb spreader -
Abductor pollicis longus muscle
Short thumb stretcher -
M. extensor pollicis brevis
Long thumb stretcher -
M. extensor pollicis longus
Elbow - Olecranon
Knobby Muscle - M. anconeus
Elbow side hand extensor -
M. extensor carpi ulnaris
Finger extensor -
Extensor digitorum muscle
Little finger extensor -
M. extensor digiti minimi
Extensor tendon strap -
Retinaculum musculorum extensorum

You can find an overview of all Dr-Gumpert images at: medical illustrations

Exercises

Various exercises can be performed to support healing, which are often used as part of physiotherapy.
These include strengthening exercises for the forearm and hand muscles as well as stretching exercises to prevent incorrect strain and muscle shortening.
Stretching exercises should be carried out in addition to pain therapy, but strengthening exercises should only be done in the pain-free stage or after complete healing in order to prevent a recurrence of tennis elbow.

Exercises with the Theraband

Exercises with the Theraband are a popular way to treat tennis elbow symptoms. By using the Theraband, the tendon is stretched and strained. With correct and regular use, this can heal the disease and significantly alleviate the symptoms.

The flexible exercise stick from Thera Band is gripped with both hands during the exercises and then turned forward with the hand of the affected side while the other hand holds the stick. Then the hand is slowly moved back to its starting position.

Important: There should be no pain during the exercises. In treatment, exercises are measures that support healing and tend to be harmful in the acute phase of tennis elbow!

Cortisone injection

Another therapy option is the administration of a syringe to the area of the inflamed elbow joint, whereby this syringe consists of a mixture of local anesthetic and cortisone.
The cortisone has an anti-inflammatory effect, the anesthetic quickly and temporarily relieves the pain.
A cortisone injection is an efficient way to end the disease, especially in the early stages of tennis elbow. In phases of a chronic tennis elbow, an isolated cortisone injection can no longer help.
The side effects of a locally placed cortisone injection are usually manageable and are often overestimated by those affected. Tendon tear - as often described elsewhere - I, as a practitioner of thousands of tennis arms, cannot confirm if used correctly. Nevertheless, the use of the cortisone syringe is not a method of first choice.

Read a lot more information on the topic at: Cortisone injection

Interview with Mein-Allergie-Portal.com: Tennis elbow - mouse arm: What to do with painkiller intolerance?

On this topic, Dr. Nicolas Gumpert conducted an interview with mein-allergie-portal.com: "Tennis elbow - mouse arm: What to do with painkiller intolerance?"

Shock wave therapy

Like radiation, shock wave therapy is part of a non-invasive therapy option for tennis elbow, i.e. therapy that does not penetrate, i.e. does not open up the body surface, as would be the case with an operation.

This procedure is used by various orthopedic surgeons to treat severe, protracted, chronic tendinitis.

Strictly speaking, shock waves are electro-magnetically generated acoustic waves that are directed to the affected part of the body and exert pressure there due to the impulse and energy transfer. This pressure should stimulate the respective tissue, blood circulation and cell metabolism should be stimulated and complex healing processes should be promoted.

The pain symptoms can also be reduced through the use of shock waves, but the exact mechanism of action in all its details has not yet been precisely deciphered.

Shock wave therapy is an efficient reserve method if other therapy methods have failed or the complaints persist for more than 6 months.
As with all therapy methods, the success of the shock wave treatment depends particularly on the experience of the user.

Read more on this topic in our article: Shock wave therapy for a tennis elbow

OP

An operation on a tennis elbow is usually only considered if the success of an exhausted conservative therapy fails and there is no improvement in the symptoms after a good 6 months of conservative therapy.

The operation can be carried out on an outpatient or inpatient basis, the former being the actual standard procedure. In addition, the operation can be done under local anesthesia, so that only the arm is anesthetized, but general anesthesia can also be used if desired or under certain circumstances.

There are three different surgical options:

the Hohmann operation, in which the affected tendon is detached from the elbow joint
the Wilhelm operation, in which the nerves responsible for the sensitive supply of the elbow are severed and obliterated
and
the minimally invasive operation, in which one of the two contents of the operation is carried out through a very small, only 1cm-wide skin incision.

The operation - with the exception of the minimally invasive one, which can be performed in 5-10 minutes - usually takes between 30-45 minutes posed. The minimally invasive method does not usually require immobilization.

You can find more information on this topic in our topic: Operation of a tennis elbow

Stretching exercises after the operation

In an operation on tennis elbow, the affected tendon and muscle attachments are usually separated from the protruding bone.
After immobilization for 1-2 weeks, the arm should be moved again.
Careful stretching exercises are also part of the physiotherapeutic follow-up treatment after an operation on a tennis elbow. These can prevent the tendon from growing again on the elbow and thus prevent the tennis elbow from recurring.
The intensity of the exercises can be determined together with the treating physiotherapist and can also be carried out independently at home.

You can find more important information and more exercises here: Stretching exercises for a tennis elbow

Irradiation

Irradiation in the context of a tennis elbow is what is known as X-ray stimulation.

As the name suggests, X-rays are used, which are directed specifically to the area of the elbow and which is a long-established method for treating inflammation at tendon attachments. The irradiation of a tennis elbow, like the operation, is only a reserve therapy that can be used after at least 6 months of unsuccessful conservative therapy.
Usually 6 applications are carried out, 2 of them in a week. Often the symptoms first worsen during treatment, which is not a bad thing, but rather stands for the good response of the treatment. The final result, i.e. the alleviation of the symptoms, often only occurs 3-4 months after the last radiation treatment.

physiotherapy

The performance of physiotherapy or physiotherapy is very important in the treatment of tennis elbow, both for regeneration and for preventing a new tennis elbow.
Areas of physiotherapy include targeted strengthening exercises that strengthen the forearm muscles, stretching exercises and massages.

In the very acute stage of the disease, i.e. when the inflammation is still most pronounced, physiotherapy should not be performed yet, especially no stretching exercises and massage applications, as these could sometimes promote and worsen the inflammation.

Furthermore, the triggering circumstances are determined as part of physiotherapy, so the patient is also examined for incorrect posture and posture corrections are made (e.g. in the spine or at the workplace).

Further physiotherapeutic measures can also:

the electrotherapy
the ultrasound therapy
and the plant of
Tape dressings (kinesio tape)

be.

Further information on this topic can be found on our website: Physiotherapy for a tennis elbow

homeopathy

Homeopathy can also be used to support a tennis elbow.
The following homeopathics are used in particular:

Apis (honey bee)
Arnica (Bergwohlverleih)
Calcium phosphoricum (calcium hydrogen phosphate)
Bryonia (red berry bryony)
Potassium iodatum (potassium iodide)

You can find a lot more information on this topic at: Homeopathy for a tennis elbow

Osteopathy

Furthermore, an osteopath can be consulted who will manually diagnose the functional disorders causing the problem and not only focus on the overloaded forearm muscles, but also take a holistic look at the cervical / thoracic spine, shoulder and ribs.
Osteopathy only plays a subordinate role in the treatment of tennis elbow.

ointment

The use of ointments can be part of the therapy and definitely be tried.
As a rule, the ointments to be applied and rubbed in contain certain active ingredients that are primarily used to combat pain symptoms or are even supposed to have an anti-inflammatory effect.
Known are ointments such as Voltaren Emulgel®, which contain the active ingredient diclofenac, which is a pain reliever from the group of non-steroidal anti-inflammatory drugs (NSAIDs).
In addition, ointments containing cortisone, which also have an anti-inflammatory effect, can be used.

Does heat or cold get on the tennis elbow?

Because tennis elbow is an inflammatory process, the application of cold is the method of choice in this case.
Cold relieves symptoms of inflammation such as pain, swelling, redness, and overheating.
If you apply heat to an inflammation, it can even come to the point that the pain and inflammation itself worsen, which is triggered by the increased blood flow that this causes (heat leads to the expansion of the blood vessels so that more blood can flow in).
Cooling compresses or ice can be used, but too long or intensive use should be avoided to prevent skin damage.

plaster

With regard to a consistent immobilization of the elbow joint for therapy of the tennis elbow, an upper arm cast can be used, but immobilization through independent protection, bandages, tapes, etc. should be preferred.

It is therefore not the remedy of choice and also not a permanent therapy option, but the cast should, if at all, only immobilize for a short time.

Immobilization with an upper arm cast that includes the elbow causes the muscles to recede very quickly. If the subsequent training for rebuilding is carried out incorrectly, a renewed incorrect / overloading can easily occur, which can result in a renewed tennis elbow.

Duration of a tennis elbow

How long the symptoms of tennis elbow last cannot always be stated across the board, it depends on a number of factors that influence the course of the disease.
In addition to the correct, accompanying therapy, the consistent immobilization of the elbow and protection are decisive for the healing.

Nevertheless, tennis elbow is often a persistent complaint that can persist for several weeks despite therapy. These should then be treated symptomatically with cooling, painkillers and, if necessary, an injection with cortisone and local anesthetic.

The immobilization can be done either independently or with a bandage, tape or even a cast.

If the symptoms persist for more than six months, one speaks of a chronic tennis elbow, in which, under certain circumstances, an operative therapy procedure can be considered.

Unfortunately, it is not possible to quantify the exact duration of a tennis elbow. A tennis elbow that has existed for a few weeks can usually be healed in 2 weeks.
Chronic tennis elbow sometimes need months before they are pain-free and fully resilient again.

Accordingly, the duration of a sick leave is difficult to predict. Someone who works in the office usually benefits from a week's relief. For craftsmen, a sick leave can last for several weeks.

The same applies to an operation. An office worker is able to work with minimally invasive technology in 14 days. Someone who has to lift heavily every working day can miss many weeks in an open operation.

Healing a chronic tennis elbow

The healing of a chronic tennis elbow is much more difficult than that of an acute tennis elbow.

Generally speaking, the treatment measures are inevitably more invasive and radical, often the only thing that helps at this stage is a surgical procedure in which the affected tendon is severed (tenotomy) and the symptoms are eliminated.

In addition to the operation, another measure is the injection of botulinum toxin into the affected muscle. The drug, also known as "botox", switches off the nerve innervation of the muscle, paralyzing it so that it can relax and regenerate in peace.

In the chronic stage, heat should be used to accompany the symptoms, in contrast to the acute inflammatory stage, in which only cold relieves the symptoms.

These symptoms will tell you that you have tennis elbow

The typical symptoms of a tennis elbow are:

Pain on the outside of the elbow
Pain when grasping the elbow
Pain when lifting the wrist
Pain when stretching fingers

In addition to the typical pulling, burning pain on the outside of the elbow that may radiate into the upper arm, which can occur both through pressure and even at rest, there are other characteristic symptoms associated with a tennis elbow.

Pain can arise especially when the elbow is stretched, as well as rotating movements in the forearm (e.g. when screwing) and when lifting heavy loads.

In addition to the pain, in some cases there may be impaired sensation. Sensory disturbances are numbness that is often limited to the elbow area, but in some cases can also affect the forearm.

In the case of severe inflammation, external signs of inflammation can rarely be observed, such as reddening, swelling and overheating of the elbow joint.
However, this is seldom the case with a tennis elbow, rather such symptoms point to an inflammation of the joint (arthritis) or the bursa (bursitis).

The following article is also highly recommended: Symptoms of tennis elbow

Pain

Typical of the tennis elbow or tennis elbow is, on the one hand, the pain that can be triggered by pressure on the outside of the elbow - where the tendons of the forearm muscles attach - and, on the other hand, the pain that is intensified solely by the movement of the affected forearm muscles . The pressure pain is caused by the local inflammation that irritates the tissue and skin in the area of the elbow.

Movement pain is primarily provoked by stretching the fingers and stretching the wrist (especially against resistance).

Sometimes it can even hurt to close your fist or twist your forearm.

For more information on this topic, see our article: Tennis elbow pain

Specific localized symptoms

Symptoms in the forearm

With tennis elbow, the accompanying symptoms are mainly in the area of the forearm. The pain is mainly concentrated on the outside of the elbow, which can be triggered by pressure. In addition, pain occurs when the fingers and wrist are stretched, often also when the fist is closed and the forearm rotates.

Initially, the pain can often only be felt in the area where the tendons attach to the elbow, but as the disease progresses or when the muscles are subjected to increased strain, it can then radiate clearly into the forearm.

Symptoms in the upper arm

Depending on how severe the inflammation is in a tennis elbow, the pain can also spread beyond the elbow.

In severe cases, the pain can radiate to the upper arm, even during exercise, certain movements or sometimes even at rest.

More often, however, one finds a radiation of pain in the upper arm and the forearm in the golfer's elbow, where it is not the tendon attachments on the outer elbow that are inflamed, but those on the inside.

Here it can happen that the entire arm hurts.

Symptoms in the shoulder

If, in addition to the pain in the elbow, there is also pain or painful movement restrictions in the shoulder, this can sometimes be a sign that there are incorrect loads, incorrect posture or incorrect movements in the area of the upper body.

In some cases, a severely inflamed tennis elbow can even cause pain to radiate into the shoulder, and vice versa, a painful shoulder can also lead to poor posture and incorrect strain on the forearm muscles, which in turn can cause tennis elbow if overloaded.

General symptoms

Numbness

As a rule, the tennis elbow or tennis elbow is not accompanied by a feeling of numbness or by so-called sensitivity disorders (e.g. tingling feelings). Only when the disease is very pronounced can the skin become slightly numb on the outside of the elbow or on the outer forearm down to the wrist.

The reason for this is believed to be that the inflammatory process at the elbow causes simultaneous irritation of the cutaneous nerves running along there. If, on the other hand, the hand or individual fingers are completely numb with a tingling sensation, other, possibly more serious diseases should be considered (e.g. herniated disc, carpal tunnel syndrome, sulcus ulnaris syndrome, etc.).

Tremble

If a tremor occurs for the first time in the context of a tennis elbow and the tremors are only limited to the side affected by the inflammation, there is no need to worry for the first time, as the tremors in this case are most likely due to the tennis elbow.

Due to the overused muscles and the stressful pain, the forearm muscles in particular are quickly fatigued and more easily overused. This muscular exhaustion can then lead to tremors in the hand, arm or fingers. This is comparable to a tremor after strong muscle strain through training, e.g. Strength training.

The following article may also be of interest to you: Shaking hands

Which doctor treats tennis elbow?

If symptoms of a tennis elbow appear, the family doctor should first be consulted, who can make an initial suspected diagnosis based on a conversation and an examination of the elbow.

Often the family doctor initiates the appropriate therapy so that no further doctor has to be consulted at first.

If the therapy does not work satisfactorily and the symptoms persist, the tennis elbow becomes chronic. Even if the general practitioner cannot make the diagnosis with absolute certainty, there is usually a referral to the best orthopedic surgeon. The doctor repeats the examination again, possibly supplements it with imaging and can offer further therapy methods.

causes

The main cause of tennis elbow is overuse of the forearm muscles, which are responsible for stretching the fingers and the wrist.

Overuse can be triggered by various factors. On the one hand, permanent, constant incorrect stress in everyday life, at work (e.g. screwing, grinding) and leisure (e.g. sport) can lead to excessive strain, as can one-sided stress on the upper body (e.g. when using a mouse / keyboard at the workplace, while climbing, etc.).

Incorrect techniques in punch sports such as tennis or golf can also lead to increased strain on the forearm muscles, as can certain arm postures during sleep (lying on your side, lying with your head on your elbow).

Painful tendon attachment points on the elbow in the context of other diseases such as fibromyalgia must be distinguished.

This is a chronic, incurable disease in which the muscles, joints and tendon attachments in alternating muscles, joints and tendon attachments can repeatedly cause pain in bursts.

diagnosis

In order to be able to make the diagnosis of tennis elbow, the attending physician first begins with an anamnesis, i.e. taking a medical history, whereby the focus is on the characteristic pain symptoms.

The elbow is then examined, whereby pain on the outside pressure, as well as redness, swelling, overheating or even a relieving posture can often be noticed.

The diagnosis can often already be made now, if doubts persist, further clinical tests can follow: on the one hand, the chair test, in which the patient has to lift a chair with an arm extended and forearm turned inward; on the other hand, the Thomson test, in which the hand is closed in a fist and the wrist is to be bent backwards against resistance (further tests: Bowden test, Mill test, Cozen test).

In addition, blood tests can confirm signs of inflammation (CRP, sedimentation rate, raised white blood cells). Finally, various imaging methods can be used to resolve uncertainties in the diagnosis: ultrasound examination of the elbow, an X-ray of the arm and / or magnetic resonance imaging (MRI) can be used.

Please see our article for more information: Diagnosis of tennis elbow

MRI for a tennis elbow

As a rule, the tennis elbow can be diagnosed solely through the anamnesis, i.e. through the conversation between doctor and patient, and the subsequent physical examination, i.e. the examination of the elbow by the treating doctor.

If the examination findings are not entirely clear, the doctor can use imaging to help, whereby in addition to the X-ray and the ultrasound examination, magnetic resonance tomography (MRI elbow) is also used. With the help of the MRI of the elbow, soft structures can be shown particularly well, including the tendons and muscles on the affected elbow. The extent of inflammation can then be determined and possible complications such as muscle / tendon tears can be excluded.

Read a lot more information on the topic at: MRI elbow

Notes specifically for tennis players

Reference to correct striking technique, if necessary through (renewed) coaching lessons.
slow training build-up
consistent warm-up and stretching / stretching exercises
Please also note our topic: Stretching exercises for a tennis elbow
Eventually changing the club, for example by using a more flexible, not so top-heavy club.
The Head Prestige Tour and the Babolat Pure Drive are particularly stressful.
I strongly recommend that performance-oriented tennis players or hobby players adjust the stringing (e.g. to a pre-stretched vibration-absorbing stringing (special tennis arm stringing and stringing technique)) in combination with coaching lessons from a sports doctor / orthopedic surgeon who is also a tennis trainer. Admittedly difficult to find ;-(

forecast

Most of the time, the tennis elbow has a good prognosis. Many patients can be treated conservatively for disease, i. surgery is not necessary in most cases. However, the disease may appear over a long period of time and, under certain circumstances, can only be healed with an operation. In rare cases, even surgery cannot provide permanent pain relief.

The prognosis of the tennis elbow is essentially influenced by the inflammation of the common extensor tendon (i.e. the "extensor vision").
It is prognostically unfavorable if there is a tear in the common extensor tendon (on the tennis elbow). In principle, however, torn tendons can also heal with optimal follow-up treatment.

How can I prevent recurrence after a tennis elbow?

In order to prevent or prevent the occurrence of a new tennis elbow, a few rules of conduct should be observed in everyday life.

On the one hand, care should be taken to avoid unilateral arm strain, as well as excessive, monotonous movements of the forearm muscles. Equal, balanced training of the arm and forearm muscles is important, so that incorrect loads, bad posture and excessive strain are avoided. Hand and forearm muscle-strengthening training can be useful to avoid fatigue too quickly and excessive strain.

Sufficient warming up of the muscles is essential, as is regular stretching exercises that should be done two to three times a day.

Since you can find triggering arm movements in everyday (work) life, it should be ensured that preventive measures are carried out in every area: the right tool should be used for craftsmen at home or at work, strenuous screwing in by hand can e.g. can be taken over by a cordless screwdriver, as well as grinding work by a grinder.

Correct sitting and arm posture should also be ensured in the workplace with a PC.

Summary

Tennis elbow is a localized inflammation in the area of the extensor muscles of the forearm and hand.
From a medical point of view, it is a so-called epicondylitis (humeri radialis).
The tennis elbow belongs on the one hand to the insertion tendinopathies (= disease of the tendons, tendon sheaths and ligaments), and on the other hand to the myotendinosis (disease of the muscle unit = myo and tendon = tendo). As a result, epicondylitis (humeri radialis) is a disease of the tendons and ligaments with involvement of the adjacent muscles.

Tendopathies (= tendinitis) can cause painful changes in tendons in the area of a muscle origin, muscle, ligament or capsule attachments. Tendopathy can therefore occur almost anywhere in the body.
In the case of tennis elbow / tennis elbow, characteristic pain occurs as a result of overuse of the muscles, which in some circumstances enormously restrict the usability of the affected arm. Tennis elbow occurs equally in men and women, most commonly in middle age.

The tennis elbow can be treated both conservatively and surgically.
Due to the now very good conservative treatment options, operations on tennis elbow are hardly necessary.
Usually one tries to treat the clinical picture of tennis elbow conservatively. This includes treatment methods such as:

Immobilization (this method is increasingly abandoned)
electromechanical stimulation
Cortisone injections
Ointment dressings
and
Shock wave therapy.

If the conservative measures do not work, surgery may be necessary. Here, the muscles that are needed to stretch the arm (= "forearm extensors") are loosened by notching or even completely cutting the tendon attachment.
Dr. Nicolas Gumpert focuses on the treatment of tennis elbow. The main features of his step-by-step plan can be found under: Step therapy tennis elbow