Tennis Elbow

Tennis Elbow Treatment in Wayne & Paramus, NJ

Lateral epicondylitis, commonly known as tennis elbow, is a condition of the elbow that often causes pain on the outside of the elbow with lifting, gripping and activities that involve wrist extension.

Tennis Elbow (Lateral Epicondylitis)

The humerus of the upper arm and the radius and ulna of the forearm meet to form the elbow joint. The elbow is surrounded by many different ligaments, vessels, nerves, muscles, and tendons. One tendon in particular contributes to the pain experienced by a patient with tennis elbow. This tendon originates on the outside of the elbow on the lateral epicondyle and turns into the extensor carpi radialis brevis muscle. This muscle is in charge of wrist extension. When this tendon experiences a significant amount of force and repetitive strain it can develop microtears that lead to tennis elbow. Tennis players may be predisposed to developing this condition, but it is common in many different athletes. It is also common among patients who have occupations that involve repetitive motion of the wrist and elbow, such as painters and plumbers.

Athletes that have developed tennis elbow will generally present with pain over the outside of the elbow. You will likely notice that the pain is worse while using the wrist in an extended position. Your pain on the outside of the elbow may be worse with lifting and gripping activities. The pain usually originates at the elbow, but may radiate down the forearm and into the wrist. You may have point tenderness directly over the outside of the elbow or the lateral epicondyle. This tenderness is directly over the area where the affected tendon originates. Our doctors can usually diagnose tennis elbow with physical examination alone. On occasion, they may order an MRI to take a closer look at the tendons and surrounding structures, but usually this is not necessary. They may take an x-ray during your appointment to have a look at the elbow joint itself and rule out any abnormalities. 

Initial treatment for tennis elbow will usually involve physical therapy and rest. Physical therapy can help stretch and strengthen the muscle attached to the affected tendon. Usually if physical therapy is prescribed, our doctors will recommend that you stick with it for at least 6 weeks to see if it actually makes an improvement. Oftentimes, patients are surprised by the improvement they have with physical therapy and they can return to their sport stronger than before. Our doctors may also recommend counterforce elbow brace and/or a wrist brace which can be used to help rest the affected tendon. Cortisone injections are generally not recommended for tennis elbow. Many times the cortisone can weaken the area of the tendon that is already damaged. The patient may notice immediate relief, but will likely have the same or worse pain once the cortisone wears off. If conservative measures do not seem to alleviate your pain or you have a more severe case our doctors will discuss other treatment options.

Platelet rich plasma injections can often be helpful for athletes that suffer from tennis elbow.  Platelet rich plasma or PRP injections involve injecting the patient’s own platelets at a high concentration into the site of the tendon injury to promote further healing. This may be done as a step prior to pursuing surgical intervention. The procedure is less invasive and can be done in the office. It may take several rounds of injections for patient’s to notice an improvement in their symptoms. 

When other treatment options are unsuccessful, surgical intervention is indicated. This usually involves debridement of the contributing ECRB tendon. The tendon debridement may be done open with a small incision directly over the area or arthroscopically with a camera introduced into the elbow joint. In either case, the ECRB tendon is identified and devitalized or frayed tissue is removed. This will promote healing and decrease pain. You will be placed in a soft dressing postoperatively and begin elbow range of motion right away. Physical therapy may be a part of your recovery process to help ensure you return to your sport safely. Generally, athletes can return to most activities within 4-6 weeks. Our doctors will follow you closely after surgery to ensure you are healing well and making improvements. They will let you know when they think it is safe to return to full play without restrictions. 

Tennis elbow can cause serious setbacks for any athlete. Our goal at Modern Orthopaedics is for you to return to your sport better than before. This may take time and patience, but we want you to experience a full recovery. We understand that each athlete and sport is unique and we will develop your treatment plans accordingly. We want to understand your goals and help you reach them. Please contact our office to have an initial evaluation for elbow pain and receive superior care from our doctors and staff. 

The humerus of the upper arm and the radius and ulna of the forearm meet to form the elbow joint. The elbow is surrounded by many different ligaments, vessels, nerves, muscles, and tendons. One tendon in particular contributes to the pain experienced by a patient with tennis elbow. This tendon originates on the outside of the elbow on the lateral epicondyle and turns into the extensor carpi radialis brevis muscle. This muscle is in charge of wrist extension. When this tendon experiences a significant amount of force and repetitive strain it can develop microtears that lead to tennis elbow. Tennis players may be predisposed to developing this condition, but it is common in many different athletes. It is also common among patients who have occupations that involve repetitive motion of the wrist and elbow, such as painters and plumbers.

The humerus of the upper arm and the radius and ulna of the forearm meet to form the elbow joint. The elbow is surrounded by many different ligaments, vessels, nerves, muscles, and tendons. One tendon in particular contributes to the pain experienced by a patient with tennis elbow. This tendon originates on the outside of the elbow on the lateral epicondyle and turns into the extensor carpi radialis brevis muscle. This muscle is in charge of wrist extension. When this tendon experiences a significant amount of force and repetitive strain it can develop microtears that lead to tennis elbow. Tennis players may be predisposed to developing this condition, but it is common in many different athletes. It is also common among patients who have occupations that involve repetitive motion of the wrist and elbow, such as painters and plumbers.

Lateral Epicondylitis -Tennis Elbow


Athletes that have developed tennis elbow will generally present with pain over the outside of the elbow. You will likely notice that the pain is worse while using the wrist in an extended position. Your pain on the outside of the elbow may be worse with lifting and gripping activities. The pain usually originates at the elbow, but may radiate down the forearm and into the wrist. You may have point tenderness directly over the outside of the elbow or the lateral epicondyle. This tenderness is directly over the area where the affected tendon originates. Our doctors can usually diagnose tennis elbow with physical examination alone. On occasion, they may order an MRI to take a closer look at the tendons and surrounding structures, but usually this is not necessary. They may take an x-ray during your appointment to have a look at the elbow joint itself and rule out any abnormalities. 

Initial treatment for tennis elbow will usually involve physical therapy and rest. Physical therapy can help stretch and strengthen the muscle attached to the affected tendon. Usually if physical therapy is prescribed, our doctors will recommend that you stick with it for at least 6 weeks to see if it actually makes an improvement. Oftentimes, patients are surprised by the improvement they have with physical therapy and they can return to their sport stronger than before. Our doctors may also recommend counterforce elbow brace and/or a wrist brace which can be used to help rest the affected tendon. Cortisone injections are generally not recommended for tennis elbow. Many times the cortisone can weaken the area of the tendon that is already damaged. The patient may notice immediate relief, but will likely have the same or worse pain once the cortisone wears off. If conservative measures do not seem to alleviate your pain or you have a more severe case our doctors will discuss other treatment options.

Platelet rich plasma injections can often be helpful for athletes that suffer from tennis elbow.  Platelet rich plasma or PRP injections involve injecting the patient’s own platelets at a high concentration into the site of the tendon injury to promote further healing. This may be done as a step prior to pursuing surgical intervention. The procedure is less invasive and can be done in the office. It may take several rounds of injections for patient’s to notice an improvement in their symptoms. 

When other treatment options are unsuccessful, surgical intervention is indicated. This usually involves debridement of the contributing ECRB tendon. The tendon debridement may be done open with a small incision directly over the area or arthroscopically with a camera introduced into the elbow joint. In either case, the ECRB tendon is identified and devitalized or frayed tissue is removed. This will promote healing and decrease pain. You will be placed in a soft dressing postoperatively and begin elbow range of motion right away. Physical therapy may be a part of your recovery process to help ensure you return to your sport safely. Generally, athletes can return to most activities within 4-6 weeks. Our doctors will follow you closely after surgery to ensure you are healing well and making improvements. They will let you know when they think it is safe to return to full play without restrictions. 

Tennis elbow can cause serious setbacks for any athlete. Our goal at Modern Orthopaedics is for you to return to your sport better than before. This may take time and patience, but we want you to experience a full recovery. We understand that each athlete and sport is unique and we will develop your treatment plans accordingly. We want to understand your goals and help you reach them. Please contact our office to have an initial evaluation for elbow pain and receive superior care from our doctors and staff. 

Video: Elbow Arthroscopy for Tennis Elbow (Lateral Epicondylitis)

“For my patients in whom rest and rehab has failed, I like to treat this definitively with an elbow arthroscopy, extensor carpi radialis brevis (ECRB) release, and synovectomy. Here’s a short video on how I do it!” – Dr. DeNoble

Transcript:

Hey guys, it’s Dr. Denoble. In this 90 second video, I’m going to show you how I can treat the worst cases of tennis elbow with a simple surgery. Let me show you how I do it.

This is what it looks like on the outside and straighten it all the way out one more time. Good. Excellent. And you’re feeling pretty good then.

Personalized care

As our patient, you will have an in-depth consultation with one of our doctors. We will create an individualized treatment plan together, tailored to your problem and lifestyle. Our doctors prefer non-invasive treatments whenever possible, including physical therapy and/or injections. If your problem ultimately does require surgery, our doctors prefer the least invasive surgical techniques possible. Our goals are the same as yours: to get you back to living your best life, pain free. 

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