Tennis Elbow

　　The tendons in the wrist straighten and tense when gripping objects (such as tennis rackets), excessive use of these muscles can cause tendinitis, degeneration, and tears in the tendons near the muscle, causing symptoms known as tennis elbow. Any occupation or daily action that requires repeated forceful wrist movement can lead to tennis elbow, and the risk factors include:

　　1. Incorrect technique when hitting tennis balls, inappropriate racket size or string tension, incorrect golf grip or swing technique, etc.;

　　2. Excessive activity of certain arm movements, such as tennis, badminton hitting, baseball pitching; other work such as painting, chefs cutting vegetables, butchers cutting meat, rowing, using hammers or screwdrivers, etc.;

　　3. Playing tennis, golf, or baseball;

　　4. Engaging in activities that require repetitive wrist extension in a fist-clenched state, such as painting, chefs cutting vegetables, butchers cutting meat, rowing, using hammers or screwdrivers, etc.;

　　5. Muscle imbalance;

　　6. Decreased flexibility;

　　7. Age increase.

　　Tennis elbow usually does not cause complications, but if it is not treated in time, it can also cause other diseases over a long period of time. The main possible complications include tendinitis of the common extensor tendons of the forearm, epicondylitis of the lateral humeral epicondyle, osteitis (a chronic bone disease with progressive rheumatoid-like joint pain, deformation of the spine and limbs, pathological fractures, and symptoms of brain and spinal cord compression as the main characteristics.), degenerative changes of the annular ligament, hypertrophy of the synovial fold of the humeroradial joint, entrapment of nerves and blood vessels, etc.

　　Tennis elbow disease usually has a slow onset, mainly manifested as pain and tenderness on the lateral side of the elbow joint, pain can radiate from the forearm to the hand, the muscles of the forearm are tense, the elbow joint cannot be fully extended, the elbow or wrist joint is stiff or the range of motion is limited. In the early stages of the symptoms of tennis elbow, patients may only feel pain on the lateral side of the elbow joint, patients feel pain when moving the upper part of the elbow joint, and sometimes the pain can radiate upwards or downwards, feeling sore and uncomfortable, not willing to move. The hand cannot grasp objects with force, movements such as holding a shovel, lifting a pot, wringing a towel, knitting, etc. can aggravate the pain. Generally, there is a localized tender point on the lateral epicondyle of the humerus, sometimes the tenderness can spread downwards, and even there is mild tenderness and activity pain on the extensor tendons. There is no redness and swelling locally, the extension and flexion of the elbow joint is not affected, but the pain may occur during the rotation of the forearm. Severe cases may cause pain when extending the fingers, extending the wrist, or holding chopsticks. A few patients may feel increased pain during rainy and cloudy weather.

　　Tennis elbow is a typical example of overuse syndrome. It is more common in tennis and badminton players, as well as in housewives, bricklayers, carpenters, and others who repeatedly use their elbow joints for a long time. Measures to prevent and reduce the occurrence of tennis elbow include:

　　1. Maintain strong muscles to absorb the energy of sudden movements of the body.

　　2. Warm up before exercise, and then stretch the muscles of the forearm.

　　3. When engaging in sports that require forearm activity, learn the correct technical movements.

　　4. If you are a tennis enthusiast, please have a tennis expert check your hitting technique (especially backhand), the size of the racket, the tension of the net, and whether the material of the frame is appropriate.

　　5. Enhance self-protection awareness, fully understand the consequences of elbow joint injury, understand and master the basic knowledge and methods of preventing elbow joint injury, and prepare warm-up activities during training, master correct techniques, develop good habits such as not hitting the ball randomly, not serving randomly, etc., if the elbow joint is injured, then it should be actively rested and treated. At the same time, you can use a wrist brace and elbow pad with good support to protect the wrist and elbow, and limit the rotation of the wrist and elbow.

　　6. Prepare thoroughly. Through certain activities to enhance the excitability of the central nervous system, make the body fully prepared physically and mentally before entering intense exercise. To overcome the inertia of physical activity, enhance the activity ability of muscles, the elasticity and range of flexibility of tendons, mobilize the functions of various organs, especially in the cold season, it is necessary to do a thorough warm-up, because low temperatures will increase the viscosity of muscles, and warm-up activities can raise body temperature and reduce the 'viscosity' of muscles.

　　7. Choose the racket rationally. Choosing the appropriate tennis racket is the guarantee for mastering the movements and improving the skills; it is also an important factor in preventing tennis elbow. Beginners should not choose overly heavy rackets, do not use heavy-headed rackets, and do not let the strings be too tight to prevent excessive burden on the wrist and elbow joints during practice, which may lead to injury.

　　8. Master the correct technical movements, correct the wrong stroke actions. Beginner tennis players should practice step by step under the guidance of a teacher, from easy to difficult. Before mastering the correct technical movements and forming a good dynamic stereotype, the exercise intensity should not be too high to maximize the protection of the elbow joint and the safety of the body. If tennis elbow is diagnosed, stop practicing, wait for complete recovery, and correct the wrong actions before resuming training.

      The main examinations for tennis elbow include radiographs of the limbs, arthroscopy, and joint examination. During the examination, it can be found that the origin of the radial side wrist short extensor muscle, that is, the lateral epicondyle of the elbow joint, is tender. Joint mobility is normal, and local swelling is uncommon. When the patient's forearm is internally rotated and the wrist is flexed and then extended repeatedly during the repetitive injury mechanism, pain will appear on the lateral epicondyle of the elbow. Generally, it is not necessary to take X-rays, but if necessary, X-rays can be used to understand whether the elbow joint bones are normal and whether there is calcification of the tendons near the proximal end.

　　Diet for tennis elbow: Eat foods that promote blood circulation and remove blood stasis, and open the orifices, such as notoginseng, hawthorn, agastache, allium fistulosum, and shepherd's purse. In addition, eat more fresh vegetables, fruits, and legumes, and increase the intake of various vitamins. Consume high-calcium foods such as milk, eggs, soy products, vegetables, and fruits, and supplement calcium if necessary.

　　The doctor will formulate an individualized treatment plan based on the specific situation, with the aim of alleviating or eliminating symptoms and preventing recurrence.

　　More than 90% of tennis elbow cases can achieve satisfactory therapeutic effects through non-surgical treatment, especially in the early stage or initial onset of tennis elbow. By taking the following non-surgical treatment measures, symptoms can be eliminated, and adhering to functional rehabilitation exercises can prevent recurrence.

　　First, non-surgical treatment

　　1. Rest: Avoid activities that cause pain, do not exercise before the pain subsides, especially tennis.

　　2. Ice packs: Apply ice packs to the outer side of the elbow for a week, 4 times a day, for 15-20 minutes each time. Wrap the ice pack with a towel to prevent the ice from touching the skin to avoid frostbite.

　　3. Medication: Aspirin or non-steroidal anti-inflammatory painkillers (such as ibuprofen, etc.).

　　4. Protective gear: Use a compression resistance brace on the forearm to limit the force generated by the forearm muscles.

　　5. Heat therapy: Use heat therapy only when returning to physical activity (exercise), and apply it before stretching therapy and warm-up exercises.

　　6. Stretching therapy: Start gentle stretching of the elbow and wrist as prescribed by a doctor after the acute pain subsides, without causing pain, maintain the stretching position for 10 seconds, and repeat 6 times.

　　7. Strength training: Perform exercises to strengthen the wrist extensor muscles as prescribed by a doctor.

　　8、逐渐恢复运动：按医生建议，开始锻炼运动项目（工作活动）需要的手臂运动（如网球中的抽球、高尔夫球的挥杆、油漆工的动作等）。

　　Eighth, Gradual Return to Exercise: According to the doctor's advice, start training exercises that require arm movements (such as tennis serve, golf swing, painter's actions, etc.).

　　Ninth, Local Corticosteroid Closure: Injection of corticosteroids at specific sites of the elbow joint can reduce inflammation and relieve pain. The requirements for injection sites, time intervals, and frequency are high and require careful handling by experienced physicians.

　　Tenth, Plaster Treatment: Due to the high viscosity of plasters, they have a series of advantages such as high content of effective ingredients, slow release rate, long-lasting effect, and local therapeutic effects. The most commonly used external plaster is Anmo Shuao Tie, which can cure tennis elbow. If used continuously for a month, it is certain to be cured.

　　The treatment methods for this condition are mainly acupuncture, injection of corticosteroids, or surgery. The main cause of tennis elbow is overuse. Excessive movements or exercises can overload the tendons of the wrist extensors, leading to inflammation, degeneration, or pain, and even affecting the range of motion, which is tennis elbow. It is estimated that half of tennis players suffer from this, and golfers, plumbers, painters, gardeners, and accountants carrying briefcases are all common groups of tennis elbow.

　　Second, Surgical Treatment

　　If it is the late stage or refractory tennis elbow, after half a year to one year of regular conservative treatment, if the symptoms are still severe and affect daily life and work, surgical treatment can be adopted. The surgical methods include minimally invasive arthroscopic surgery and open surgery with minimal trauma, the purpose of which is to remove necrotic and unhealthy tissues, improve or reconstruct local blood circulation, and promote the healing of tendons and bones.

　　Third, Conservative Therapy

　　Shortcomings: Auxiliary therapy, cannot be used independently, and conservative therapy is ineffective when the disease is severe.

　　Fourth, Closure Therapy

　　Treatment: Corticosteroids can be injected into the submuscular space near the lateral epicondyle of the humerus.

　　Shortcomings: No essential effect on diseases, prone to recurrence, multiple closures can cause significant damage to local tissues.