Lateral epicondylitis: Is it preventable?

Injuries of the arm are common in sports. The lateral epicondyle is more common among tennis players. It occurs when there is a strain on the outer part of the elbow.
Two structures are mainly responsible for the pain. The first one is the extensor carpi radialis brevis (ECRB) which is the most significant culprit. The other one which is less likely to cause the injury is the extensor carpi radialis longus (ECRL).

Lateral epicondyle is also called the tennis elbow because its primary cause is the repetitive motion of the arm. But it is even more likely to occur as a result of the wrong manipulation of the arm in a backhand stroke.

How can tennis players avoid the injury?

Tennis players fall victim to elbow pain due to the amount of effort they exert on the tendons that lead to the elbow, that is, the ECRB and the ECRL. There are few things they can learn that can prevent a lateral elbow injury. They include:

  • Using the second arm for support

The backhand stroke is not a natural movement. It requires a lot of effort, and this is the reason why it is the main reason for the ECRB and ECRL tear and consequent elbow injuries. One of the simplest and most effective ways of preventing these injuries is to support the acting arm with the other arm as you maneuver the move.
This ensures that the arm ligaments are less strained and that they can withstand the force. Alternatively, the player can opt to flex their elbow to prevent the pressure on the tendons.

  • Choosing a tennis racquet that is suited for your hand

As with every other part of our bodies, all our hands are not equal. Some people have larger palms than others. The size of the handle of the racquet is another reason why tennis players get elbow injuries.
One of the ways you can do this is by using the index finger test. When looking for a racket, hold it in your playing hand. While holding it, with your other hand, put your index finger between your thumbs and your fingers, do not force it. If your index finger fits tightly, that is your racket. When your finger leaves a lot of space, that racquet is too big for you, and if there is no space to fit it, the racquet is too small for you.
This test may not work for all other tools you use, but you should do your research or try some to see which one works best without hurting you.

  • Relax a little

Sometimes players tend to react too aggressively to the ball. These reactions may increase the force of the ball on the racquet causing your arm to work harder hence straining your ligaments. The strained ligaments may then start to tear leading to pain.
See a sports medicine professional
While you may have a trainer, a professional in sports medicine may be better suited in helping you out. Your trainer is only out to see you win tournaments but a person with a medical background will keep you in the game longer.

  • Strengthen your ligaments

This is another way of preventing injury. You can do exercises that help you to improve your arm strength. Resistance exercises would be best as they help you combat extra force from the ball.

 

Final thoughts

We earlier mentioned that lateral epicondylitis is not only a tennis injury. It can also affect people who do jobs that require them to move their arms in a particular direction over long periods of time. Other people who are prone to elbow injuries include painters and people who use hammers and other tools that operate the same way.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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