High-risk groups: 30-50 years old; more males than females; all occupations and life actions that require repeated forceful wrist activities can cause tennis elbow, such as: tennis, badminton, table tennis players; chefs, housewives, desk-bound workers, manual workers: cleaners, clampers, assembly line workers, etc. Clinical manifestations Tian Hongtao, Department of Orthopedics, Wuhan Union Medical College Hospital
Initially, patients only feel soreness and pain on the outside of the elbow joint. Patients feel pain from activities above the outside of the elbow joint, and the pain can sometimes radiate upward or downward, feeling sore and swollen and reluctant to move. The pain can be aggravated by movements such as lifting pots, wringing towels and playing sweaters. There is no local redness or swelling, and the elbow joint extension and flexion is not affected, but the pain can be felt when the forearm is rotated. In severe cases, pain can be caused when extending fingers, wrists or chopsticks. In a few patients, the pain is worse when it is rainy or cloudy.
Examination
The elbow joint is painful with pressure on the outside. The mobility of the joint is normal and local swelling is uncommon. Patients with internal rotation of the forearm will experience pain in the external supra-elbow joint.
X-rays are usually not necessary. If necessary, X-rays can be taken to find out whether the bones of the elbow joint are normal and whether there is calcium salt deposition at the proximal end of the extensor tendon.
Treatment: Generally 95% of patients can improve with non-surgical treatment, only 5% of patients need to receive surgical treatment.
1. Non-surgical treatment
(1) Rest Avoid activities that cause pain and do not play sports until the pain disappears, especially tennis.
(2) Ice: Apply ice to the lateral elbow for 1 week, 4 times a day, for 15-20 minutes. When wrapping ice with a towel, do not touch the ice to avoid frostbite.
(3) Take medication Non-steroidal anti-inflammatory drugs (such as ibuprofen).
(4) Brace Use a compression-resistant brace on the forearm to limit the force generated by the forearm muscles.
(5) Local closure with cortisone Injection of cortisone drugs in specific areas of the elbow joint can reduce inflammation and relieve pain.
(6) Extracorporeal shock wave therapy can improve local blood flow and reduce inflammation, which is more effective for tendon terminal disease.
(7) Heat application After the acute pain is reduced, you can try heat application, warming and moving the muscles before performing strength exercises.
(8) Strength exercises
Socks that can be gripped and rolled up: hold for 6 seconds, rest for 10 seconds, repeat 8-12 times, switch to the other hand.
grip exercise: sit down, put the arm flat on the platform (table), do the grip to the inside, move the hand up and down, repeat 8-12 times, change to the other hand, do 2 cycles per day
flat lifting heavy objects: sit down, put your arm flat on the platform, lift a 1-2 pound object (dumbbell, water cup, etc.), slowly lift your wrist, bend your wrist, and keep your arm against the platform, repeat 8-12 times, switch to the other hand; then flip, palm down, repeat the above exercise.
Sitting lifting: as shown in the figure, lean one hand on one thigh, slant the center of gravity to the other side of the body, lift the weight up and down to the level of the chest, repeat 8-12 times, change the other hand.
2. Surgical treatment
In advanced or persistent tennis elbow, after six months to one year of regular conservative treatment, the symptoms are still severe and affect life and work. There are minimally invasive arthroscopic surgery and less invasive open surgery to remove unhealthy tissues, improve or re-establish local blood circulation, and heal tendons and bones.
Prevention
1. Before learning tennis or badminton, it is best to ask professional coaches to help you: correct the straight arm stroke, so that the large arm and small arm maintain a fixed and flexible angle when swinging back or forward; warm up and stretch the wrist muscles before exercising.
2. Use wrist and elbow guards with strong support before exercise; limit wrist and elbow rotation and straightening.
3. Wrap an elastic bandage around the forearm muscle belly when playing, which can reduce the occurrence of pain, but the elasticity should be moderate.
Once you find that a certain posture can cause elbow discomfort in your work life, you should change your posture or take a proper rest.
Author: Hongtao Tian, Wuhan Union Orthopaedic Hospital
Title: Associate Professor, Associate Chief Physician
Specialties: artificial joint replacement Joint diseases: femoral head necrosis, knee osteoarthritis, rheumatoid rheumatoid arthritis, ankylosing spondylitis, joint infections, bone and joint deformities.
Clinic hours: all day every week on 1, 3 and 6.
Contact: Tel: 13908622515
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