Monday, June 11, 2018

How to Manage an Overuse Injury: Tennis Elbow

Sports Overuse Injury:  Tennis Elbow

Back in December, I played tennis outside in Long Island.  The temperature was 49 degrees.  I returned one of my daughter’s ferocious serves and wow my elbow hurt.  We played the next day again and it hurt worse.  My 12 year old daughter and I had a weekend rivalry;  it was always a close game.  Everything was fine until it got cold.  Why did my elbow hurt?
Because she is a FIERCE player and in order to compete with her I have to grip hard to serve hard, return hard, volley hard and lunge for shots that put me in positions that compromise the arm/elbow/wrist/grip mechanism… leading to TENNIS ELBOW!!Besides all the gripping and smashing, the repetition of 2 matches within 24 hours was a major pain contributor.    The cold contributed too as I had to grip harder because my fingers felt numb! This onset of elbow pain had all the indicators of trouble:  2 sessions close together, changing playing style in the cold and playing through the pain.   
How did I make it through the game?
I tried to focus on hitting the ball in front of me.  I let the balls that were out of position go (easier to do that when you are playing against your child!)  And I realized when I was picking up or receiving balls I was much better off using my opposite hand and not scooping with my racket or hitting it in the air to stop the ball.  I conserved the use of my right forearm muscles to light activities, applied ice a few times a day and it bothered me very little. 
The pain started to return when I became obsessive about knitting January through February.  Thick, heavy yarn.  Knitting for an hour a night.  I finally had to put away the needles and my elbow pain resolved, only to return in March when I had to run through the airport twice in a week carrying overnight bags.  My tennis elbow came back.  Worse than ever.  In fact it was so bad one night it kept me up and I even wondered if something was seriously wrong.  Night pain is a sign you have bad pain. 
But some strong anti-inflammatories, some office treatments and rest improved it.
Now it is tennis season again.  A  month ago I still had pain with each shot.  Physical therapy and taping was the answer. In fact I was  miraculously better.  Home exercises and icing help too. 
Since this is my business, I knew what to do.  For those of you who do not, here are the steps to resolving your pain from tennis elbow, golfers elbow, knee pain, ankle sprain, shoulder pain, wrist tendinitis and any other overuse injury. 
1)ICE: If you feel even a hint of soreness, ice the area after play, working out, lifting, or anytime it is sore.  Also ice it at the end of the day…Just for 5-10 minutes
2) LIMIT PAINFUL ACTIVITY to what you really love.  If you don’t want to give up tennis, don’t take up any other activity that may bother it such as fishing or golfing. 
3) CONSIDER MEDICATION: If the pain bothers you at rest, take an anti-inflammatory (ibuprofen or naproxen) as directed on the bottle. 
4) CONSIDER A BRACE: A brace that limits motion will decrease irritation and let the joint heal.

If your pain persists despite a week of these instructions, see a health professional.  In New York, you can also start directly with physical therapy which may be the ultimate cure.  If 1 or 2 visits do not help schedule a doctor appointment.  An accurate diagnosis will guide more effective treatment.  Your doctor can also prescribe stronger medications and may recommend change in treatment or even an injection.  There are non-cortisone injections that are very effective.    

Final tips include returning gradually back to the irritating sport.  I am currently playing only 30 minutes of tennis twice a week and gradually building up.  Consider scheduling a lesson as good technique can reduce the offending motion.  Equipment is also important  In the case of tennis elbow, changing to a lighter racket with less vibration and the proper grip size is essential.  When it comes to lower body injuries, a new pair of well cushioned, stable shoes can be the final cure. 
While you are healing, cut the activity down to pain free motion, and make up for it with a new activity.    It’s the time of year when outside sports prevail.  I am loving biking, jogging, and kayaking!  And keep that ice pack in the freezer just in case….