Ask the Lab: Elbow Pain

February 14, 2011 02:49 PM
A common cause of elbow pain in tennis players is the backhand stroke.
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Question: I am getting pain in my elbow when I hit backhands, is there anything I can do to stop the pain?
Dr. George C. Branche III: Elbow pain is a frequent problem in tennis players from the casual player and up to the most elite level. It is important to establish whether this is a chronic problem or the result of an acute injury.
In the event of an acute injury, there is often a feeling of a pop or snap that can be followed by swelling, severe pain, bruising, and deformity. If something like this occurs, one should seek an orthopedic evaluation immediately due to the fact that a tendon or ligament injury to the elbow can be a major problem that often requires surgery and prolonged rehabilitation.
Fortunately, most elbow problems in tennis are not the result of an acute injury, but more from factors such as overuse, equipment problems, and technique problems. Most elbow injuries involve irritation of the tendons that move the forearm muscles either on the outside or the inside of the elbow. The tendons attach to two relatively small areas and thus can be irritated rather easily in tennis. Common treatments involve proper warming up prior to playing and stretching, icing, and anti-inflammatories after playing. Tennis elbow straps are used very commonly and can help alleviate the pressure. I recommend fully evaluating the cause of the problem prior to implementing some of these treatments. The most common reason for elbow problems in tennis is that the elbow is taking on too much of the stress during the backhand stroke. It is advisable to have the stroke evaluated either with video or with a teaching tennis professional to determine whether the other parts of your body are contributing enough to your backhand stroke to unload the stress on your elbow. Occasionally, more invasive treatments such as corticosteroid injections and surgery are necessary, but fortunately, the vast majority of elbow problems associated with tennis can be treated quite successfully with proper pre and post tennis participation treatment, technique evaluation, and modification.
About the Author
As an orthopedic surgeon specializing in sports medicine, Dr. George C. Branche III draws on personal experience as both a tennis and basketball player. He graduated from Princeton University and Howard University College of Medicine. Post graduate training involved a general surgery internship at Harlem Hospital in New York City and an orthopedic surgery residency at Howard University. He joined Anderson Orthopedic Clinic located in Arlington, Virginia in 1989. The surgical aspect of his practice is dedicated to arthroscopy of the knee and shoulder. Dr. Branche has served as a medical staff member for professional tennis tournaments for the last 19 years and is currently a member of the USTA Sport Science Committee.