Tennis Elbow Fix: New Technique Eases Pain for Weekend Warriors
By Charlotte Libov | Wednesday, 08 Mar 2017
A new technique that relieves severe tennis elbow faster and more quickly than traditional surgery can provide relief for this painful condition, a top expert says.
“In the past, there have been types of surgical options available to relieve the pain of tennis elbow, but there is a new procedure becoming popular that requires less recuperation time,” Dr. Kevin Plancher tells Newsmax Health.
That new technique, called the Tenex FAST procedure, is for people with the severe form of the condition who need surgery, says Plancher, a leading New York-area orthopedist and expert in sports medicine.
But not all people who get tennis elbow need surgery. In fact, the vast majority do not, says Plancher.
Another myth about tennis elbow is that people develop it from playing the game. Not always, says Plancher.
“Tennis elbow is a bit of a misnomer. In fact, this is a condition that is seen much more often in people who don’t play tennis. In fact, they don’t play racquet sports at all,” says Plancher.
Known medically as lateral epicondylitis, tennis elbow affects about 1-3 percent of the population. But less than 5 percent of tennis elbow diagnoses are actually related to playing tennis, according to the American Academy of Orthopaedic Surgeons (AAOS).
The condition, known medically as lateral epicondylitis, occurs more often in men and most commonly occurs in those between ages 30 and 50, the AAOS says.
“Those whose sports or activities require repetitive arm, elbow, and wrist movement – such as golfers, baseball players, bowlers, lawn workers, painters, carpenters, and others – are the most prone to developing tennis elbow,” Plancher says.
Tennis elbow actually is a type of tendonitis, or the swelling of the tendons that stems from overusing the forearm.
“Tennis elbow is an inflammation of the tendon that attaches to the ulna, one of the three bones that make up the elbow joint,” he says.
Like the Achilles tendon or rotator cuff in the shoulder, this tendon has a poor blood supply and gets injured easily.
“This means that anyone who uses this area of their arm repetitively can develop the condition, including those whose work involves lifting, or people who pursue other hobbies, or sports like golf and baseball,” says Plancher, the official orthopedic surgeon of the U.S. Olympic ski and snowboard teams.
“In fact, more golfers get tennis elbow than tennis players do.”
There are different degrees of tennis elbow, so the treatment must be customized, says Plancher, a clinical professor in Albert Einstein College of Medicine in New York.
In its mildest form, the tendon becomes inflamed, but an MRI shows no sign of injury.
“The approach for this type of condition is known as ‘RICE’ – Rest, Ice, Compression, and Elevation. No further treatment is usually required,” says Plancher.
A more serious form is when the MRI shows a partial tear.
“Fifty percent of people in this category can be treated with physical therapy, but, for that to be successful, it must be performed by an occupational hand therapist,” he says.
But what about the 5 percent of people who do suffer a complete tear of their tendon and require surgery?
In the past, this has involved an operation to remove the dead tissue around the tendon – which is the cause of the pain, says Plancher – and then the healthy muscle is reattached back to the bone.
This can be done either as open surgery, or performed arthroscopically.
Tradition surgery involves making a two-inch incision in the shoulder area, but, when the operation is done arthroscopically, the surgeon makes a few small cut, and, using a camera, performs the operation using miniature instruments.
But no matter whether open surgery or arthroscopy is used, a 4- to 6-month recuperation period is required, Plancher says.
This is where the Tenex FAST (or “Focused Aspiration of Scar Tissue”) procedure comes in.
The Tenex procedure is performed on an out-patient basis under light sedation. A tiny incision is made to insert a toothpick-sized device that uses ultrasound to remove the dead tissue, says Plancher.
“It’s a quick, 20-minute procedure with a small incision, so small at times it doesn’t require stitches,” he says.
Instead of a 4- to 6-month recuperative period, patients can return to their regular sports or work activities in one or two months, Plancher says.
Although the procedure is geared for the 5 percent of people who require surgery, the Tenex procdure may make it more feasible for those who have the moderate form of the condition, he adds.
“This is a wonderful procedure. You make a small nick in the skin, restore the good tissue, and get people back to full activity in a rapid fashion,” he says.
If you do play racquet sports, here are Plancher’s tips for preventing tennis elbow:
Warm it up. Always spend a few minutes prior to a game or match gently warming up the muscles and areas of the body that will be used during any sport. For the elbow, gentle arm circles and bicep stretches will allow fluid to flow into the elbow joint, providing protection to the joint.
Be aware. Most tennis elbow cases are the result of repeated awkward and forceful movements involving the elbow joint. Be aware of your form, and use only the amount of force necessary to accomplish each move. Ask a professional to evaluate your stroke.
Let it rest. To avoid overuse injuries, it’s important not to overuse the joint. Engage in sports that use different muscles and joints on alternating days, giving each joint a day or two to recover.
Check your equipment. People who play racquet sports and develop tennis elbow should check their equipment for proper fit. Racquets that are stiffer and/or looser-strung can lower stress on the forearm, or a smaller racquet head may help prevent recurring symptoms.