Tennis Elbow
(Lateral Epicondylitis)

What is Tennis Elbow?

Tennis elbow is a form of tendinosis which means chronic degeneration of the tendon or tendons. You will have tenderness on and around the tendons that attach to the small bony part on the outside of your elbow (lateral epicondyle), and perhaps a bit of swelling but not much. Tennis Elbow tendinosis is commonly caused from the overuse of the tendons located in your forearm that help to extend your wrist and fingers. The wear and tear on these tendons is a result of small tears in your tissue that don't heal properly. The inability of your tendon to heal properly causes the tendons to weaken until the tissues become very thin, and eventually wear out.

Have You Developed Chronic Tennis Elbow?

Tendinosis will get worse over time if not dealt with properly. Your body is trying very hard to heal the damaged tissue. This cycle of pain, swelling and unhealing causes tennis elbow to go on for a very long period of time (ie. years). Why? Failed healing, not inflammation; if you cannot rest the elbow while you are healing then your odds of healing it for good are quite low.

Tennis elbow can affect anyone. In 75% of cases, tennis elbow occurs on your dominant arm. It affects about an equal number of men and women, generally between the ages of 35-65 years old. (source: NCBI U.S. National Library of Medicine)

Tendinosis: What is it?

Tendonosis is a noninflammatory, degenerative condition of the collagen fibers in the tendon often caused by repetitive stress injury of the tendon fibers. As the collagen breaks down, the typically straight and flexible fibers become a tangled mess with little pockets of jelly.

Tendonosis is caused by repetitive motion which causes an accumulation of microinjuries. The tendon tries to repair itself but eventually the breakdown of the collagen fibers exceeds the repair speed and the new collagen is produced with an abnormal structure and composition.

Unlike tendonitis, there are no inflammatory cells with a tendonosis injury making it hard to diagnose visually as there are no visible symptoms such as swelling, heat and redness. However, both injuries cause pain, tenderness and stiffness of the joints.

If not treated correctly the tendon will continue to degenerate causing further injury.

Visiting your doctor when you have elbow pain is always recommended, as there are many possible issues that can happen within the arm and elbow. Sometimes, one set of symptoms can result in multiple diagnoses. Tennis elbow is sometimes misdiagnosed as bursitis or arthritis.

Infection (Septic Bursitis). The closer the bursa is to the surface of the skin, the more likely the chance of infection from specific bacteria that are commonly found on the surface of the skin. This bacterial infection is known as septic bursitis and it is caused by the Staphylococcus Epidermis (or Staphylococcus Aureus) bacteria. Septic Bursitis occurs most commonly in men (85% of all cases occur in men) and you are at higher risk of contracting this if you

• have Diabetes
• have recently experienced trauma
• are undergoing steroid treatments
• have a certain kidney condition

Crystal Deposits. Some people with diseases such as rheumatoid arthritis, gout or scleroderma may contract bursitis from crystalline deposits in the joints. Although not much is known about how this process happens, it is common knowledge that Uric acid is a normal byproduct of daily metabolism. If you are diagnosed with gout then you are unable to break down this uric acid properly, leading to crystallization of this excess acid which deposits in joints, a painful symptom that can often lead to bursitis.

Golfer's Elbow Tendonitis. (medial epicondylitis). Golfer's Elbow is signified by pain, swelling and inflammation that is felt on the inside of the elbow. The tendons attached to the bone at your elbow are connected to muscles in your forearm, which is why these injuries will sometimes cause pain in your forearm. These injuries are usually caused by racquet sports, golf and overuse from gardening and repetitive movements of your hand or wrist (ie. using a screwdriver).

The good news is that most cases of tennis elbow will heal with simple home conservative treatments and surgery is often not needed! It's generally understood by doctors and surgeons, that surgery will introduce more scar tissue into the elbow. This added scar tissue will be problematic, requiring visits to the Physio clinic and conservative treatment options post-surgery. This is why surgery is only performed as a last resort for chronic elbow injuries or a fractured bone that won't heal with conservative treatment methods.

Some conservative treatment methods recommended include:

• Rest - This is important for initial healing to reduce pain, swelling and inflammation in the early stage of your elbow injury. Too much rest can also be harmful to elbow injuries because joint immobility can actually cause stiffening in the elbow (and even shoulder) joint. This is why rest should be used when reducing initial pain and swelling, but should not be considered for more long-term conservative treatment.
• Avoid Activities that Caused Your Injury - While resting your elbow, it's important to avoid activities that may have caused your injury in the first place and this definitely includes pretty much any type of sport where your upper body is involved. Continuing on with regular activities will not only make your injury worse, but trying to 'work around' your injury will eventually give rise to over-compensation injuries in other areas of your body.
• Use a Cold Compress or Ice Pack - Cold is very effective at reducing pain and inflammation - use at the onset of the injury and during flareups.
• Use an Elbow TShellz Wrap^® (Circulatory Boost device) - You can use your own blood flow to maximize your rehabilitation, maintain healthy blood flow to your arm and elbow, decrease recovery time, and reduce re-injury risk.. Promoting blood flow to your elbow using a warming treatment will help to minimize the growth of scar tissue and increase flexibility. This is why we recommend TShellz Wrap before undergoing activity - an increase in flexibility should help reduce risk of further injury while also assisting in the battle against atrophy.
• PT - Surgery is usually the last resort. This means doctors or surgeons typically won't perform a surgery until they feel that their patient has put effort into treating their injury with conservative treatment methods. This includes 4 to 6 months of visits to a physical therapist (PT). If you haven't experienced any improvement in your condition during that time then surgery may be considered. Agressive PT approaches will focus on forced or manual manipulation of the elbow and wrist - this means your physical therapists will be trying to move you past the point of comfort as they strive to increase range of motion and prevent further atrophy. This can be painful and end up making your injury worse if not done correctly. (reference: 1)
• Stretching - Stretching your elbow and arm in PT and at home will help you to regain your range of motion much faster than not stretching at all. Stretching in many ways is key for maintaining good Range of Motion (ROM) in the elbow, and stretching can be made much easier with use of a TShellz Wrap before to warm up soft tissue, and a Cold Compress or Ice Pack treatment after to prevent any return of swelling and inflammation.

To take a deep dive into conservative treatment options for soft tissue injuries in the elbow and forearm, please go to our tennis elbow treatments page.

A Note On OverCompensation

Since you are reading this, you probably know that serious elbow tendinosis injuries do not just disappear. Over time, they usually wreak havoc on your shoulder & wrist due to lack of movement and over-compensation. It will also wreak havoc on your opposite elbow due to overcompensation. Recovery takes a longer time for such chronic (long term) injuries, but proper healing is essential to regain strength and get you back to the activities you enjoy.

The longer your injury endures, the greater the risk of running into serious overcompensation injuries.

To Stop Re-Injury & Reduce the Risk of a More Serious Overcompensation Injury, You Need to Heal Quickly & Completely!

Anyone in need of rapid recovery and complete healing must consider a comprehensive treatment plan that includes an effective means to minimize swelling and inflammation yet also stimulate healing and tissue elasticity. We have found no better set of tools that can be used at home than this:

Conservative treatment tools just like these have been used successfully by thousands of tendinosis injury sufferers - just like you.

We believe the use of TShellz Wraps^® for boosting blood flow to soft tissue in the elbow and forearm is one of the most under-utilized home treatment options available on the market today. We have client after client that have tried many options out there and have been amazed at how effective and fast the TShellz Wrap treatment can relieve pain and increase blood flow in soft tissue.

With regular use of the Elbow TShellz Wrap:

• Your pain will be reduced.
• Due to increased blood flow, soft tissue in the treatment area will be expected to recover at an accelerated rate with reduced potential for re-injury.
• Your elbow should experience a larger range of motion and increased extensibility of collagen tissue due to the heat effect on soft tissue. This should translate into a reduced rate of re-injury occurrance as soft tissue is known to lengthen and become more flexible when exposed to warm temperature. (Chapter 9 of "Therapeutic Heat and Cold", 4th edition. (amazon.com link - Ed. Justus F. Lehmann, M.D., Williams, and Wilkin)

Doctors and Surgeons are always improving the techniques used in surgery, and results from surgery now are much more positive than they were in the past. However, all surgeries introduce scar tissue, and recovery from elbow surgery can be less than ideal and take longer than anticipated.

If you do wind up getting surgery, know that rehabilitation at-home while attending regular PT or doctor appointments is vital for your overall recovery.

Consistent exercise and conservative treatment on a daily basis during your rehabilitation while working with your doctor or physical therapist is key. This is why you should seriously consider maximizing your recovery by using the TShellz Wrap^® at home once you are approved for PT.

The more consistent you work at enhancing blood flow to surgically repaired soft tissue, the more consistent the healing process will be. Nourishing the tissues will more oxygen and nutrients (which are carried through the blood stream) will give the body a better ability to produce new, healthy collagen. In effect, you will help the body produce stronger tissues while potentially reducing the number of setbacks that can occur following surgical procedures.

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The Key Point To Keep in Mind When Treating Your Elbow Injury

Make Sure That Complete Healing is Your #1 Goal

We all know that if the injury was healed, the pain would go away but what about the opposite situation? If the pain is gone, does that mean the injury is better? Unfortunately, this is not always true.

Too many people only focus on suppressing pain symptoms while providing less attention to the true healing aspects of the body. Experiencing less pain, while obviously a good short-term goal, never equates to underlying healing. Scar tissue can remain for months after one gets to a point of being relatively pain-free. However, as long the weak and brittle scar tissue remains, you are susceptible to re-injury or re-aggravation. Certain motions or movements can cause the weaker tissue to easily tear - resulting in some reversal of the recovery up until that point.

This is why we recommend for people to continue with their doctor or therapist recommended exercises and to continue with mild treatments of the TShellz Wrap^® for a period of time - to better ensure complete healing.

Ongoing treatments to enhance circulation will soothe, relax and promote healing of your damaged elbow muscles and tendons. Elbow T•Shellz treatments will also allow your soft tissue to extend further due to the deep warming sensation created by the enhanced circulation to the treatment area. The more extensibile your tissues are, the less likely they are to strain or sprain.

The Elbow TShellz Wrap^® is intended to be used as a vital part of a conservative treatment protocol for people recovering from elbow, forearm, upper arm or general elbow injuries - such as muscle tears, tendon tears, strains, tendonitis, tendinopathy, tendinosis, impingements, elbow bursitis, and any pain associated with trigger points, scar tissue, and arthritis in the arm, elbow or forearm.

Prevention and Promotion of Lifelong Health

If you want to avoid re-injury, manage pain and increase circulation for lifelong health benefits, a conservative treatment protocol involving rest, the use of a Cold Compress or Ice Pack, an Elbow TShellz Wrap^® and a stretching/exercise program will most likely provide the results you are looking for.

Why spend time in pain, off from work, and missing out on your active lifestyle when you can be proactive about your injury and the health of your body? Talk to your doctor about incorporating a regular routine the Elbow TShellz Wrap^® in your home treatment plan.

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If you have questions, call our office at 1-866-237-9608 (toll free continental US).
We are currently offering FREE SHIPPING and a 60 day trial period on all our Wraps.

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During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. Always consult your doctor and/or Physical Therapist before using any of our outstanding products, to make sure they are right for you and your condition. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!