Tennis Elbow, Golfer's Elbow, Humeral Epicondylitis

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Tennis Elbow, Golfer's Elbow, Humeral Epicondylitis
Tennis Elbow, Golfer's Elbow, Humeral Epicondylitis

Video: Tennis Elbow, Golfer's Elbow, Humeral Epicondylitis

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Video: Tennis Elbow / Golfer's Elbow - Everything You Need To Know - Dr. Nabil Ebraheim 2023, January
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Tennis elbow and golfer's elbow

Tennis elbow (tennis elbow) and golfer's elbow are names for painful complaints in the area of ​​the elbow. The cause is acute or chronic tendon overload. In most cases, the symptoms are not caused by tennis, but by frequently repeated movements of the hand with one-sided or heavy loads. These movements occur naturally in sports such as tennis or golf. Many people also perform these movements in other activities, such as working on the computer, doing handicrafts, etc. In the case of tennis elbow, the symptoms occur on the outside, and in golfers' elbow on the inside of the elbow.

Tennis elbow affects around two percent of the adult population. A golfer's elbow is much rarer. The symptoms usually occur between the ages of 35 and 60, with a similar frequency in women and men. Popular athletes are more often affected than professionals. In most cases, the symptoms can be cured by avoiding the stressful movements and special exercises.

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  • What is the difference between tennis elbow and golfer's elbow?
  • What are the causes of a tennis elbow or a golfer's elbow?
  • What are the symptoms?
  • How is the diagnosis made?
  • How is a tennis elbow or golfer's elbow treated?
  • What exercises can help prevent and heal?
  • Whom can I ask?
  • How are the costs going to be covered?

What is the difference between tennis elbow and golfer's elbow?

The hand and fingers are moved by different muscles of the forearm. The muscles for bending and stretching the hand and fingers are attached to two protrusions on the humerus (lat. Humerus) with tendons. These bony protrusions are part of the elbow joint and are called the epicondyle (Latin epicondyle). The extensor muscles attach to the outer (lateral) epicondyle. The flexor muscles attach to the inner (medial) epicondyle. An overload syndrome at this point is therefore also called epicondylopathy. If the overload persists, the affected tendons can become inflamed (epicondylitis).

Graphic tennis elbow © bilderzwerg

In tennis elbow (tennis elbow, Latin epicondylitis humeri lateralis or epicondylitis humeri radialis), the tendons of the extensor muscles of the hand and fingers are overloaded or inflamed. In the case of a golfer's elbow (Latin epicondylitis humeri medialis), the tendons of the flexor muscles are affected.

What are the causes of a tennis elbow or a golfer's elbow?

Triggers are usually unfamiliar strains caused by frequently repeated or vigorous movements of the hand, such as stretching, bending, turning, holding or lifting. These include:

  • Sports, e.g. tennis, rowing, canoeing, badminton, squash etc.
  • Working on the computer with the mouse ("mouse arm")
  • Handicrafts, e.g. painters, carpenters
  • Playing musical instruments, e.g. piano, violin

What are the symptoms?

Typical symptoms are:

  • Tennis elbow : pain on the outside of the elbow, especially when stretching the hand.
  • Golfer's elbow: pain on the inside of the elbow, especially when bending the hand.
  • The pain can also radiate to the forearm and upper arm.
  • Pressure pain at the respective tendon attachments, sometimes associated with hardening and swelling.
  • Pain in everyday movements, such as opening a bottle, shaking hands, lifting or holding objects, etc.

How is the diagnosis made?

First of all, the doctor asks about the nature of the symptoms, where the pain occurs and with which movements. The doctor collects the medical history and asks about previous illnesses. He or she then performs various arm examinations and movement tests on the patient. If epicondilytis is suspected, the doctor can usually make a diagnosis after the physical examination. The results of the physical examination are rarely unclear or another condition is suspected. In this case, further imaging examinations may be necessary for clarification, e.g. X-rays.

How is a tennis elbow or golfer's elbow treated?

Treatment is based on the exact diagnosis of irritation or inflammation. The aim is to heal the pain so that the patient can move and load the hand and arm normally.

Avoid excessive movements: The doctor advises the patient on how the affected tendons can be spared and relieved. It helps to avoid certain movements, reduce stress or improve the ergonomics of the workplace.

Physical therapies, strengthening and stretching exercises: The doctor can prescribe physical therapies, e.g. manual therapy, ultrasound therapy, local cold or heat applications or special exercises to strengthen and stretch the forearm and wrist. The doctor or the physiotherapist can recommend the patient to perform certain exercises independently. So-called eccentric strengthening exercises have proven to be particularly effective. The extensor muscles are strengthened and the tendons are stretched at the same time.

Drug therapies: Ev. Anti-inflammatory drugs (NSAIDs) may be prescribed to relieve pain. In certain cases, e.g. if the pain persists, the doctor may suggest local cortisone injections. However, these usually only have a temporary pain-relieving effect. Cortisone injections are usually only used a few times, as they can interfere with the healing process if used often.

Pressure bandage: A special pressure bandage, the epicondilytis brace, can help in certain cases as an accompanying therapy to relieve the affected tendon in order to accelerate the healing process or to prevent renewed overload. The pressure bandage is placed on the forearm under the elbow and, depending on the doctor's recommendation, usually worn for several weeks. The effectiveness of the treatment is considered to have not been adequately investigated.

Further therapies: For various other treatments, scientific evidence of the effectiveness is not yet available or only to a limited extent. These include injections with autologous blood or botox, shock wave therapy, laser therapy or acupuncture.

Surgery: More than 90 percent of epicondylitis cases can be treated without surgery. In very severe, chronic cases in which other treatments do not bring any improvement even after several months, the doctor can suggest an operation.

What exercises can help prevent and heal?

Certain stretching and strengthening exercises can help the pain go away faster. And they help to avoid recurring complaints. In addition to the two exercises described below, the doctor or physiotherapist can show you other exercises for independent training in everyday life.

  • Exercise example for eccentric training of the extensor muscles of the forearm: Place the affected arm on a table, the hand hangs down over the edge of the table (the back of the hand points towards). You are holding a weight in your hand, e.g. a light dumbbell or a water bottle. Or they stretch an exercise band (e.g. Thera band) over the back of the hand. Slowly move your hand up and down about 10 to 15 times. After a short break, you can do one or two more passes, preferably three times a day.
  • Exercise example for stretching the extensor muscles of the forearm: Hold the affected arm straight forward with the back of the hand pointing upwards. Let your hand hang down loosely, fingers pointing down. With the other hand, grab the hand of the affected arm (thumb grips the palm) and pull it towards the body. Hold the stretch for about 30 seconds. After a break of about 30 seconds, repeat the stretch two more times. Do the stretches about twice a day.

Note You can find a description of strengthening and stretching exercises with short videos at www.gesundheitsinformation.de.

Whom can I ask?

If you suspect epicondylitis (tennis elbow, golfer's elbow), you can contact the following offices:

  • General practitioner
  • Specialist in orthopedics and traumatology
  • Specialist in orthopedics and orthopedic surgery
  • Specialist in physical medicine
  • Occupational physician

An inpatient stay is necessary for surgical treatment.

The physical therapy or exercise therapy can be performed by a doctor established by physiotherapists / physical therapists or occupational therapists / occupational therapists.

How are the costs going to be covered?

The e-card is your personal key to the benefits of the statutory health insurance. All necessary and appropriate diagnostic and therapeutic measures are taken over by your responsible social insurance agency. A deductible or contribution to costs may apply for certain services. You can obtain detailed information from your social security agency. Further information can also be found at:

  • Right to treatment
  • Visit to the doctor: costs and deductibles
  • What does the hospital stay cost?
  • Prescription fee: This is how drug costs are covered
  • Medical aids & aids
  • Health Professions AZ

and via the online guide to reimbursement of social insurance costs.

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