TennisElbow,lateralepicondylitis,lateralepicondylosis.Thisinformationaimstohelpyouunderstandyourconditionandgainmaximumbenefitfromyourtreatment.Itcoversthemostcommonlyaskedquestions.However,everyindividualisdifferent,andyoushouldaskasmanyquestionsasyoulike.ElbowAnatomyTenniselbowisaproblemwiththetendonsthatattachtothelateralepicondyle,whichisthebonybumpontheoutersideoftheelbow.Themuscleswhichattachherepullthewristupwardsandarecalledextensormuscles.Thesemusclesjointogethertoformacommonextensortendon,whichattachestothelateralepicondyle.

TenniselbowItisnotknownexactlywhytenniselbowhappens.Itismorecommoninpeoplewhorepetitivelyusetheirhandandwristingrippingactivitieseitheratworkorrecreationally.Thereisaminorinjurywithinthesubstanceofthetendon;whichthentriestoheal.Thenormalhealingdoesnotworkproperly,leavingunhealthytissuebehind.Thetendontriestohealagainandtherepeatedprocessleavesanincreasingamountofpainfulunhealthytissueinthetendon.Tenniselbowisaverycommonproblem.Thevastmajorityofcasesgetcompletelybetterwithtimeontheirown.Asaresultmosttreatmentsseemverysuccessful.Manytreatmentsexist.Eccentricstrengtheningexercisesarecheapandeffective.EccentricstrengtheningexercisesTheseexercisesshouldbeperformedfor3setsof15repetitions.Have1minuterestbetweensets.Theexercisesshouldbedone2timesaday.Ifdonefor12weeks70%ofpatientshavenopain.ItisimportanttoexperiencesomediscomfortduringtheseexercisesPhase1WithyousorearmrestingonatableliftyourwristupwiththeunaffectedhandTakethehandawayandslowlylowerthewrist

Phase2ProgresswhenthePhase1exercisesarenotpainfulRepeattheexercisesbutaddsomeweighttothehandsuchasa500mlwaterbottle

Injections:Iftheconditiondoesnotrespondtotheexercisesinjectionsareoftenused.Steroidinjectionsarethemostcommonlyusedinjections,buttheywearoffafterafewmonthsandmaymaketheconditionworseinthelongterm.PlateletRichPlasma(PRP)injectionsaremoreeffectivethansteroidinjectionsbutaremoreexpensive.

TheoperationForveryseverecasesandthosethatfailtoimproveafterinjectionssurgerymaybenecessary.Theaimofthesurgeryistoremovetheunhealthytissueandtostimulateanormalhealingresponse.Youwillcometohospitalonthedayofsurgery.Youwillhaveageneralanaesthetic.Thesurgeryusuallytakes30minutes.Thesurgerymaybeperformedthroughanopenincisionorarthroscopically(keyhole).AftersurgeryYoumaygohomeeitheronthesamedayorthedayaftersurgery.Youwillseeaphysiotherapistbeforeyouleavehospital.Ifneededthedressingswillbechangedbeforeyouleavehospital.Useicewrappedinateatoweloverthedressingsforthefirst2weeks.Useregularpainkillersforthefirst2-4weeks.Thedressingsaresplashproof.Thespeedofrecoveryisvariable.Itcanberapidorseemslow.Mostimprovementoccursinthefirst6months.Theendofrecoveryisaround12-24monthsaftersurgery.AppointmentsaftersurgerywithDrSmith10-14days;6weeks,3months,6months,12months.RehabilitationexercisesSpecificrehabilitationexercisesheetswillbegiventoyouinhospitalandduringyourfollow-upvisits.Onlydotheexercisesshowntoyouinhospitalanddemonstratedtoyouinclinic.Yourtherapistwillsuggestwhetheryoucandotheexercisesyourselfathomeorwouldbebetterwithregularsupervisedphysiotherapysessions.Youwillneedtogetintothehabitofdoingtheexercisesseveraltimesadayforaround6months.Milestones0-2weeksOuterbandagescanberemovedafter48hrs.Usethearmfordaytodayactivitesastolerated2-6weeksStrengtheningbegins3-6months:Returntosports6months+:Fullactivities

Returntowork/sportsWork(lightduties/office) 1-2weeksSwimming 6-8weeksDriving 2weeks Work(manual)

Lightlifting 6weeksHeavylifting 12weeks

DrivingYoucandrivewhenyoufeelthatyouhavefullcontrolofthevehicle.Itisyourresponsibilitytomakethisdecision.LiftingStrengtheningexercisesshouldbecontinuedinthelongtermtopreventarecurrenceLikelyoutcomesThemainaimofsurgeryistoimprovepainandfunction.Patientsatisfactionratesaftersurgeryarearound95%.