Tennis arm

Das Bild zeigt einen Tennisspieler mit Ellenbogenschmerzen. Bei derartigen Beschwerden im Sport oder Alltag ist es wichtig, der Ursachen auf den Grund zu gehen.

How it starts, how it can be treated

Tennis arm (epicondylitis lateralis humeri) is frequently underestimated at first. To begin with, the typical strain-induced pain on the outer elbow quickly subsides. But if it is not treated at any early stage, it can pose a serious risk to the affected muscle insertions. In the early stages, tennis arm can generally be treated successfully without surgery – but the longer it goes untreated, there is a greater risk of irreversible and chronic damages.

Darstellung der Anatomie des Ellenbogens mit einer Tennisarm-Erkrankung.

The term tennis arm is misleading: even though this condition commonly affects active athletes, the characteristic symptoms of tennis arm are usually caused by work or everyday activities. The most common cause by far is when muscle insertions on the outer elbow are subjected to excessive strain. This is where the muscles that stretch the wrist and extend the fingers are attached to the strong bony protrusion (epicondyle) of the humerus.

Frequent repetition of the same movements over a long period of time initially causes localized irritation and a permanent increase in tension in the extensor muscles of the forearm (hypertonia). The tense muscles create a continuous pull on the insertion, which causes minute injuries known as microtraumas. This results in inflammation. In this phase, tennis arm can still be fully resolved through targeted therapy. If left untreated, the symptoms quickly turn chronic. If this happens, the excessive irritation of the muscle/tendon insertions is no longer reversible. As the condition progresses, this can weaken the insertions so badly that it leads to muscle ruptures.

Illustration zu den Risikofaktoren eines Tennisarms: Nicht nur Sport belastet das Ellenbogengelenk, sondern auch regelmäßige Belastung in Beruf und Freizeit.

90% of people affected by tennis elbow are craftsmen, musicians, or computer users - not tennis players.

Mann mit Fahrradhelm fährt bei klarem Himmel lächelnd Fahrrad, trägt die EpiTrain Ellenbogenbandage von Bauerfeind am rechten Arm zur Unterstützung des Gelenks.

With early-stage tennis arm, stabbing pains occur in the area of the outer elbow, generally after stressful activities such as lifting loads, using heavy tools or long periods of work with keyboard and mouse. This pain quickly subsides in the beginning, which is why this symptom is often paid little attention. However, the muscle attachments on the outside of the elbow are already painful when pressure is applied – a key indication that tennis arm is forming.

Over time, discomfort and abnormal sensations increase, meaning that the triggering movements can no longer be carried out without pain. Typical tennis arm pain is felt when lifting a hand lying on the tabletop or the middle finger against resistance. The tense muscles can be clearly felt, and existing inflammation can cause swelling and reddening of the skin at the affected insertion.

Bildausschnitt einer Person mit einem grünen T-Shirt, die aufgrund eines Tennisarms Dehnungsübungen durchführt. Die Person trägt eine EpiTrain, eine schmerzlindernde Ellenbogenbandage von Bauerfeind, in der Farbe Beige.

In most cases, the condition only requires non-surgical (conservative) treatment. Conservative treatment of tennis arm is based on two principles: relieving tension on the muscle insertions and fighting inflammation. Various measures can be used to achieve this. The first step is to avoid the activities that trigger the condition. Complete immobilization of the arm is not necessary in most cases. Very rarely and only in case of severe symptoms, a splint is used for two weeks. Anti-inflammatory medications or ointments and compressive supports promote pain alleviation. Physiotherapy treatment can also begin as early as the acute stage.

For long-lasting or very severe symptoms, an intramuscular injection of botulinum toxin (botox) may also be an option. This temporarily paralyzes the affected muscles, substantially reducing muscle traction on the insertion.

Physiotherapeutic treatment should help to further reduce the inflammation and minimize the traction on the muscle attachment, for example with exercises to stretch and relax the affected muscles. Ultrasound or cryotherapy in the form of short-term ice treatment can contribute to reducing inflammation.

Surgical treatment is necessary in less than ten percent of cases. This mainly applies to cases in which

the patient has had the condition for a long time
attempts at conservative treatment are not working
there are frequent recurrences (relapses)
the tendons or muscles have ruptured

Common surgical procedures include:

a transverse incision into the affected tendon (Hohmann procedure)
longitudinal incisions into the affected tendon (Goldie procedure)
denervation of the nerves in the affected area (Wilhelm procedure)

Partial division of the tendon reduces muscle traction, whilst denervation prevents pain signals from being transmitted. The two procedures can also be used together.

When treating tennis arm, relief and protection of the affected muscle attachments is essential. At the same time, however, active movement of the arm should be maintained to prevent muscle breakdown or loss of mobility. The EpiTrain support massages the tissue during movement and stimulates circulation. The support stabilizes the elbow joint and applies gentle pressure to the muscles using specially adapted cushions (pads). This relieves tension and encourages swelling to subside. The pain is also reduced thanks to the gentle massage effect of the EpiTrain. Thanks to its anatomical shape and breathable material, the EpiTrain fits perfectly and adapts to movements without constricting. It also prevents excessive heat buildup around the joint. The support optimally assists with the main goals of therapy and prompts rapid healing of the irritated muscle attachments in cases of tennis arm.

EpiTrain®

Elbow support for pain relief

EpiTrain alleviates pain in the elbow and improves its mobility. The effective knitted fabric and specially contoured pads provide relief and make it possible to start mobility training at an early stage.

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