Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "

Case study ( 7863 views as of December 21, 2024 )

Dan is a 38-year-old man who presents to his physician with a six-month history of pain to the lateral aspect (outer side) of his dominant elbow. His problem started gradually after beginning a new exercise program at the gym. His symptoms have become worse, to the point that he has great difficulty lifting a dumbbell or at times even using a salt shaker. He has had to give up his exercise program as this has not improved his symptoms.

On examination there are no visible changes to his elbow. He has tenderness over the right lateral epicondyle (tennis elbow). Any stress applied on the radial wrist extensors exacerbates his symptoms.

Dan could potentially benefit from seeing a physiotherapist for mobilization of the joint, an orthopedic surgeon to assess if surgery is necessary and his local pharmacist for pain control medications. A bracing specialist may also be able to help with joint stabilization which may help him in his daily activities. Lastly, seeing a nutritionist may help him choose foods that help reduce inflammation caused by arthritis.

Author: Dr. Bertrand Perey

Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "

Case Introduction

Tennis Elbow - Surgical and Non-Surgical Treatment Options

Presented by

Dr. Bertrand Perey

MD, FSRC

Orthopaedic Surgeon

Treatments

Tennis Elbow Management Using Braces

Practitioner help from:

Ernest Porthouse

Bracing & Equipment Specialist
Tennis Elbow and Maintaining Strength With Exercise Bands and Tubing

Practitioner help from:

Tommy Caldwell

Personal Trainer
Tennis Elbow Pain and Possible Symptoms

Practitioner help from:

George Taouil

Physiotherapist

Treatments

How Pilates Can Help You Maintain Overall Strength When Suffering From Tennis Elbow

Practitioner help from:

Kerry Nicholson González

Pilates Instructor
Injuries Which Can Occur When You Are Suffering From Tennis Elbow

Practitioner help from:

George Taouil

Physiotherapist
Tennis Elbow and Other Causes of Elbow Injury

Practitioner help from:

George Taouil

Physiotherapist

Conversation based on: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "

Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "

Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 01 January 2024

Tennis Elbow (Lateral Epicondylitis): This type of tendinitis affects the outer side of the elbow. It is typically caused by repetitive wrist extension movements, such as those involved in playing tennis, hence the name "tennis elbow." However, it can also be caused by other activities like painting, typing, or using hand tools. Golfer's Elbow (Medial Epicondylitis): Golfer's elbow affects the inner side of the elbow. Contrary to its name, it is not limited to golfers and can affect anyone who performs repetitive wrist flexion movements. Activities like golfing, throwing, or swinging a racket can contribute to this condition. Overuse and Repetitive Motions: Excessive and repetitive use of the elbow joint can strain the tendons, leading to tendinitis. This can occur in various professions or hobbies that involve repetitive arm movements, such as painting, plumbing, carpentry, or playing musical instruments. Symptoms: The common symptoms of tendinitis in the elbow include pain and tenderness on the affected side of the elbow, a weakened grip, difficulty in fully extending or flexing the forearm, and discomfort when performing activities that involve the affected tendon. Treatment: Initially, rest and avoiding activities that worsen the symptoms are recommended. Applying ice packs and using over-the-counter pain relievers can help reduce pain and inflammation. Physical therapy exercises may also be prescribed to strengthen the affected muscles and tendons. In severe cases, corticosteroid injections or surgery may be considered. If you're experiencing persistent or severe elbow pain, it's always

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "
Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 31 December 2023

Tennis Elbow (Lateral Epicondylitis): This type of tendinitis affects the outer side of the elbow. It is typically caused by repetitive wrist extension movements, such as those involved in playing tennis, hence the name "tennis elbow." However, it can also be caused by other activities like painting, typing, or using hand tools. Golfer's Elbow (Medial Epicondylitis): Golfer's elbow affects the inner side of the elbow. Contrary to its name, it is not limited to golfers and can affect anyone who performs repetitive wrist flexion movements. Activities like golfing, throwing, or swinging a racket can contribute to this condition. Overuse and Repetitive Motions: Excessive and repetitive use of the elbow joint can strain the tendons, leading to tendinitis. This can occur in various professions or hobbies that involve repetitive arm movements, such as painting, plumbing, carpentry, or playing musical instruments. Symptoms: The common symptoms of tendinitis in the elbow include pain and tenderness on the affected side of the elbow, a weakened grip, difficulty in fully extending or flexing the forearm, and discomfort when performing activities that involve the affected tendon. Treatment: Initially, rest and avoiding activities that worsen the symptoms are recommended. Applying ice packs and using over-the-counter pain relievers can help reduce pain and inflammation. Physical therapy exercises may also be prescribed to strengthen the affected muscles and tendons. In severe cases, corticosteroid injections or surgery may be considered. If you're experiencing persistent or severe elbow pain, it's always

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "
Michelle Kaarto, BScK, CSEP CEP 22 March 2016

Once Dan has completed his rehab with a physiotherapist, he could benefit from working with a kinesiologist on making sure he adapts his exercise program appropriately given his injury. If he is new to the gym, an injury can be very demotivating and it would be a shame if Dan stopped working out. There are many ways a kinesiologist can help him understand how to safely exercise once he has clearance from a physiotherapist.

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "
brenda burton 28 January 2016

Forgot to mention , that this has been going on for over a year now !

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "
brenda burton 28 January 2016

I first had pain in the outer elbow area , was diagnosed with tennis elbow and was pprescribed ant immflamatories , which did nothing , I then was recommended for therapy , but only for pain management , I then noticed pain in my bicep , that was worse than the elbow pain , after an assessment , I was told by my therapist that my bicep was not retracting and was finally sent for an MRI , which showed a tear in my tendon and bursitis on my long head bicep tendon, I was then sent to an orthopedic surgeon who gave me a cortisone shot in the back of my shoulder and he sent me for an ultrasound guided cortisone shot for my elbow ( which I waiting 4 months for ), he never asked me to come back for a follow up , and when my family doctor called him to ask why not , he said he was going on a years leave the following week, well,neither shot helped at all, and i ended up developing frozen shoulder ! finally saw a competent surgeon who is recommending surgery

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "
- K. Michael 14 March 2016
  
  @BrendaBurton that's awful. I've heard a number of stories about tennis elbow that ends up being a condition caused by shoulder issues. I hope you've managed to find some relief
K. Michael 02 September 2015

I'd be curious to know if the entire arm were examined or just the elbow. I have tennis elbow that is actually caused by water retention due to shoulder tendinitis.

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "
Joy 14 May 2015

Is the problem caused by tennis elbow gripping, or lifting, or both?

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "
- K. Michael 09 July 2015
  
  It can be both depending on the severity of your case. You can also have numbness and muscle weakness
Dr. Bertrand Perey MD, FSRC Orthopaedic Surgeon, New Westminster, BC 27 April 2015 Specialist Referral Clinic, Vancouver, BC

Tennis elbow, also known in medical terms as lateral epicondylitis, is a painful condition to the lateral aspect of the elbow.

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "
Mariana Paz Physiotherapist, Thornhill, ON 08 March 2015

Foam rolling and friction massage have a similar effect on the muscle tissue: -Both mechanically deform the tissue which will help to break up adhesions (microscopic scar tissue that is laid down when the muscle is strained or injured -both methods will improve circulation of the area which will increase oxygen supply and metabolic process at the tissue

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "
- Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 31 August 2015
  
  I agree with Mariana in that creating friction is a great way to treat the Symptoms of Tennis Elbow. I recommend seeing a physiotherapist to get the right location pin pointed and a lesson in the motion to get the most effective treatment
- K. Michael 11 August 2015
  
  How would you use foam rolling to help with elbow pain ? Would you be rolling the forearm ?
Mr. Ram Nayyar High Performance Director Badminton Canada Business Coach, Vancouver, BC 18 February 2015

Essentially what happens is the injured party finds an area that is sensitive and holds a ball or hard object ( to level of tolerance) over it by moving the affected area in a controlled manner. Always followed by icing down.

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "
- Dr. Bertrand Perey MD, FSRC Orthopaedic Surgeon, New Westminster, BC 29 April 2015 Specialist Referral Clinic, Vancouver, BC
  
  Tennis elbow is caused by a tear in the muscle that inserts into the lateral epicondyle. It is the wrist extensors that attach into this bone, and patients can get a tear with a very trivial injury, or with a very heavy impact. Most of the time it’s not caused by any major trauma, patients just notice pain in the elbow, and it can be after lifting a box of groceries.
- K. Michael 08 March 2015
  
  Is this similar to foam rolling ?
Mr. Ram Nayyar High Performance Director Badminton Canada Business Coach, Vancouver, BC 18 February 2015

I've found relief to this by using friction massage and Ice Massage for some of my athletes as well

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "
- Dr. Bertrand Perey MD, FSRC Orthopaedic Surgeon, New Westminster, BC 29 April 2015 Specialist Referral Clinic, Vancouver, BC
  
  Good points Ram. Friction is a great tool to relieve tension.
- ShirleyG 18 February 2015
  
  What is a friction massage and how does this help ?
ShirleyG 08 February 2015

Is there a common cause related to tennis elbow ? How can it be prevented ?

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "
- Mariana Paz Physiotherapist, Thornhill, ON 17 February 2015
  
  Common causes of tennis elbow are repetitive movement in one direction at the elbow, either repetitive bending or repetitive straightening or repetitive twisting of the elbow. This can cause a joint restriction and present with tennis elbow symptoms. The other common cause is repetitive gripping, more often and of greater strength output than one is use to doing ie. gripping a pencil to write and gripping a gardening tool to dig are both very different. The latter of the two can cause a 'tennis elbow' presentation where the tendons of the forearm extensors have been strained to much too soon and now they are inflamed. In the case study above, 6 months of pain is too long for his problem to only be due to inflammation. The inflammatory process only lasts 7 to 10 days. A mechanical assessment of the elbow would be the first step to determine if he has a joint restriction and how to treat it.
stravers82 08 December 2014

I believe regular physiotherapy could really help regain the mobility in his elbow

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "
- Dr. Bertrand Perey MD, FSRC Orthopaedic Surgeon, New Westminster, BC 27 April 2015 Specialist Referral Clinic, Vancouver, BC
  
  Patients with tennis elbow, or lateral epicondylitis, all have pain; it’s a painful condition. Some patients may experience some associative weakness, but by and large it’s associated with pain.
- K. Michael 23 December 2014
  
  Once you have injury to a joint you often have to modify how you exercise going forward.
- Yuan Lew, MSc MBA 11 December 2014
  
  @Kimberley, that is a very good point. He needs to mention to his physiotherapist that his tennis elbow just started a new exercise program. His physiotherapist will have insights into what to avoid in initiating new exercise programs to avoid tennis elbow/pain or injury.
- K. Michael 10 December 2014
  
  And when he returns to exercise he would be best to ease back in to his program. Perhaps the exercise program he was doing wasn't the right one for him
Yuan Lew, MSc MBA 05 December 2014

I am curious to know what kinds of foods are considered anti-inflammatory as so many conditions are caused by inflammation, such guidelines can help many people, not just for tennis elbow.

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "
- Yuan Lew, MSc MBA 03 January 2015
  
  This website, Health Choices First, has a good video on the types of anti-inflammatory foods to have.
- K. Michael 06 December 2014
  
  I know that a low salt and potassium diet are often recommended for people who need to avoid water retention and swelling. Not sure if they are also good for anti-inflammatory diets
K. Michael 03 December 2014

My husband developed tennis elbow after re-flooring our basement. He found pain relief through a brace and seeing a physiotherapist

Reply to: Symptoms of Tennis Elbow " Dan a 38-year-old man with six-months of pain to the lateral aspect (outer side) of his dominant elbow "