Cumulative (overuse) Injuries And Tennis Elbow Injuries

Overuse injuries and tennis elbow injuries are the result of repetitive use, stress and trauma to the soft tissues of the body (muscles, tendons, bones and joints) when there is not enough time for proper healing. They are sometimes called cumulative trauma, or repetitive stress injuries. They begin as a small, nagging ache or pain, and can grow into a debilitating injury if they aren't treated early.

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Lateral epicondylitis, also referred to as "tennis elbow injuries," is a very common cause of elbow pain. It is considered a cumulative trauma tennis elbow injury that occurs over time from repeated use of the muscles of the arm and forearm, leading to small tears of the tendons (Tendonitis).

In racket sports, overuse of the forearm muscles and repeated impact can increase the risk of tennis elbow injuries developing. Other factors that may contribute to tennis elbow injuries include lack of strength, poor technique, and more duration or intensity of play. There is some controversy over the racket's string tension being related to higher impact forces on the forearm muscles. There is little evidence of any relationship between racket grip circumference and tennis elbow injuries symptoms.

Sometimes the pain and inflammation of the tendon is caused by a direct injury or impact. Occasionally, the muscles may partially tear.

Symptoms: Tennis Elbow Injuries

Pain on the outside of the elbow, usually during or after intense use, is the first sign of tennis elbow injuries. In some cases, lifting or grasping objects may be difficult. Some people have pain that radiates down the arm.

Treatment: Tennis Elbow Injuries

Because this injury if caused by overuse of the wrist extensors (muscles that pull the hand up) rest is the first treatment step. Discontinuing activities that cause the pain is recommended. Using the R.I.C.E. method (rest, ice, compression and elevation) of acute injury treatment is extremely helpful to reduce pain and swelling. Icing the elbow for 10-15 minutes at a time will decrease the inflammation and swelling and relieve pain. Wrapping the forearm near the elbow may help protect the injured muscles as they are healing.

A physical therapist may use ultrasound or other modalities to help heal the damage of an injury. Additionally, they may prescribe flexibility and strengthening exercises to allow you to return to the activity. In some cases, a wrist splint or brace may be recommended.

Anti-inflammatory medication may help reduce inflammation and pain. In chronic or intense cases, a cortisone injection may relieve the discomfort.

New Exercise May Relieve Tennis Elbow Injuries Pain

A simple exercise for tennis elbow injuries pain has been showing promising and immediate results for many patients. The exercise is a simple eccentric wrist extensor movement using a flexible rubber bar. The exercise involves twisting a rubber Flexbar with one hand and resisting the bar as it untwists using the injured arm. The result is an eccentric contraction (movements that cause muscle to contract while it lengthens) of the wrist extensor muscles on the injured forearm.

Because recurrence of this condition is common, return to activity should not occur too quickly, and preventive exercises that stretch and strengthen the muscles should be done consistently.

If nonsurgical forms of treatment do not eliminate the pain of this condition, surgery may be recommended. A hand surgeon will offer advice regarding potential treatments and the possible outcomes of various surgical options. Lateral epicondylitis left untreated, is often a nagging or chronic condition sometimes requiring many months for healing to occur. Prompt diagnosis and treatment is important for anyone suffering from tennis elbow injuries.

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What Is Bursitis of the Elbow?: Tennis Elbow Injuries

The elbow contains a slippery, fluid filled sack called the bursa to help the skin slide over the bone in that area. The olecranon bursa, covers the olecranon process (the extension of the ulna that fits into the humerous). It lies between the skin of the elbow and the bones of the forearm.

Causes of Bursitis of the Elbow: Tennis Elbow Injuries

Normally, the bursa acts as a cushion between the skin and the bone. But if the elbow is hit, or if it is constantly irritated, the bursa can become inflamed and fill with fluid. This is called bursitis. The bursa starts to swell, and may create a lump over the end of the elbow. Gradual swelling indicates a chronic or long-lasting condition, while sudden swelling may signal a traumatic injury or an infection in the elbow. Red and hot skin may indicate an infection. Motion in the elbow may be limited, especially if there was a traumatic impact to the elbow.

Treatment of Bursitis of the Elbow: Tennis Elbow Injuries

Generally, R.I.C.E. is the first line of treatment for bursitis.

Rest: Take a break from whatever activity is causing the elbow to swell or become painful.

Ice: Apply ice packs for short periods of time (15 to 20 minutes, three or four times a day).

Compression: Wrap an elastic bandage around the elbow to keep swelling down.

Elevation: Elevate the elbow above the level of your heart.Usually bursitis will resolve on its own. Often you are left with a bursa sac that has stretched and is too large for the space it now occupies. The sac may develop wrinkles that over time, will harden.

If the bursitis swelling comes on suddenly or if you experienced a direct blow to the elbow, see your physician right away, as you may need X-rays to rule out the possibility of a fracture. Depending upon the cause of the swelling, you doctor may recommend aspirating, or draining, the bursa. The fluid from the bursa is removed with a syringe. An anti-inflammatory medication such as ibuprofen can help reduce pain and swelling. An elbow protector or padding can help reduce the risk of further injury.

Cortisone injections may be used to treat this one of tennis elbow injuries of bursitis, as surgery, as a final option to remove the bursa.

Definition

Rotator cuff tendinitis is an inflammation (irritation and swelling) of the tendons of the shoulder.

Alternative Names

Swimmer's shoulder; Pitcher's shoulder; Shoulder impingement syndrome; Tennis shoulder; Tendinitis - rotator cuff

Causes

The shoulder joint is a ball and socket type joint where the top part of the arm bone (humerus) forms a joint with the shoulder blade (scapula). The rotator cuff holds the head of the humerus into the scapula.

Inflammation of the tendons of the shoulder muscles can occur in sports requiring the arm to be moved over the head repeatedly as in tennis, baseball (particularly pitching), swimming, and lifting weights over the head. Chronic inflammation or injury can cause the tendons of the rotator cuff to tear.

The risk factors are being over age 40 and participation in sports or exercise that involves repetitive arm motion over the head (such as baseball).

Symptoms

Pain associated with arm movement

Pain in the shoulder at night, especially when lying on the affected shoulder

Weakness with raising the arm above the head, or pain with overhead activities (brushing hair, reaching for objects on shelves, etc.)

Exams and Tests

A physical examination may reveal tenderness over the shoulder. Pain may occur when the shoulder is raised overhead. There is usually weakness of the shoulder when it is placed in certain positions.

X-rays may show a bone spur, while MRI may show inflammation in the rotator cuff. An MRI can show a tear in the rotator cuff.

Treatment

Treatment involves resting the shoulder and avoiding activities that cause pain. Ice packs applied to the shoulder and nonsteroidal anti-inflammatory drugs will help reduce inflammation and pain.

Physical therapy to strengthen the muscles of the rotator cuff should be started. If the pain persists or if therapy is not possible because of severe pain, a steroid injection may reduce pain and inflammation enough to allow effective therapy.

If the rotator cuff has had a complete tear, or if the symptoms persist despite conservative therapy, surgery may be necessary. Arthroscopic surgery can be used to repair some tears and remove bone spurs and inflamed tissue around the shoulder. Some large tears require open surgery to repair the torn tendon.

Outlook (Prognosis)

Most people recover full function after a combination of medications, physical therapy, and steroid injections. For patients with tendinitis and a bone spur, arthroscopic surgery is usually successful in restoring them to their pre-injury level of activity.

People with tears of their rotator cuff tend to do well, although their outcome is strongly dependent upon the size and duration of the tear, as well as their age and pre-injury level of function.

Possible Complications

Bursitis

Complete rotator cuff tear

Treatment fails to improve symptoms

When to Contact a Medical Professional

Call for an appointment with your health care provider if persistent shoulder pain occurs. Also call if symptoms do not improve with treatment.

Prevention

Avoid repetitive overhead movements. Develop shoulder strength in opposing muscle groups.

These shoulder problems are closely related and often occur in combination, with shoulder tendinitis leading to an impingement syndrome. If the muscles and tendons of the rotator cuff or the bursa of the shoulder are injured, they become inflamed, and swollen. Because there is limited space in the shoulder joint, this swelling caused the muscles and tendons to be squeezed between the bones of the shoulder joint (the head of the upper arm bone (humerus) and the top of the shoulder blade (acromion). Repeated motion involving the arms, or motion over many years may also irritate the tendons, muscles, and surrounding tissue.

Tendinitis is inflammation (redness, soreness, and swelling) of a tendon. In tendinitis of the shoulder the tendons of the rotator cuff or the tendons of the biceps become inflamed and irritated. This is often a result of being pinched by surrounding structures. This injury can be mild or severe. When the rotator cuff tendon becomes inflamed and thickened, it may get trapped under the acromion (the top of the shoulder blade). This squeezing of the rotator cuff muscles is called impingement syndrome.

Bursitis of the shoulder occurs when there is inflammation of the fluid-filled sac called the bursa that lies between a tendon and skin, or between a tendon and bone.

Tendinitis and impingement syndrome are often accompanied by inflammation of the bursa sacs that protect the shoulder. An inflamed bursa is called bursitis. Sports involving overuse of the shoulder and occupations requiring frequent overhead reaching are other potential causes of irritation to the rotator cuff or bursa and may lead to inflammation and impingement.

Signs of these conditions include slow onset of pain in the upper shoulder or upper arm and difficulty sleeping on the shoulder. Tendinitis and bursitis also cause pain when the arm is lifted away from the body or overhead. If tendinitis involves the biceps tendon (the tendon located in front of the shoulder that helps bend the elbow and turn the forearm), pain in the front or side of the shoulder is common and may travel down to the elbow and forearm.

Diagnosis of tendinitis and bursitis includes a physical exam and various tests. Treatment includes rest, ice, and anti-inflammatory medicines. In some cases physical therapy is prescribed. Gentle stretching and strengthening exercises are added. If there is no improvement after 6 to 12 months, arthroscopic surgery may be used to repair damage and relieve pressure on the tendons and bursae.

Frozen Shoulder (Adhesive Capsulitis)

A frozen shoulder, also called adhesive capsulitis, is an inflammatory condition that causes limited, or reduced motion range of motion in the shoulder joint. It can be caused by injury or disease. Pain results in decreased motion in the joint, which then lead to stiffness. Risk factors for frozen shoulder include diabetes, stroke, accidents, lung disease, and heart disease. The condition is uncommon in those under 40 years old, except in impact injuries.

Signs and Symptoms

The shoulder joint becomes painful, then tight and stiffthat is worse at night.

Treatment

First line treatmetn includes the use of medication to reduce pain and inflammation . Next, joint movement is restored with gentle stretching exercises. Finally, manipulation of the shoulder under general anesthesia may be used, but is rare. Surgery is necessary in some very rare cases.

Tendinitis of the Wrist

What Is Tendinitis of the Wrist?

Tendonitis of the wrist is an irritation and swelling of the tissue or 'tunnel' which surrounds the tendons of the thumb. Pain in the front of the wrist is a common symptom of tendonitis. Bending and extending the wrist is usually painfulh; there may be swelling in the wrist. If the hand is made into a fist with the thumb tucked inside and the pain gets worse the diagnosis is likely tendonitis.

Tendonitis of the wrist can be caused by biomechanical problems, injury to the arm, overuse, poor equipment and overuse. Inflammation of the wrist tendons happens often when someone starts a new activity or exercise.

If treated early, tendonitis can improve quickly. Steroid injection or anti-inflammatory medications can be used in most cases. More serious tendonitis may require surgery.

If you experience symptoms, the first thing to do is to alter the activities which caused the symptoms and let the wrists rest and recover.

Achilles Tendonitis - Causes and Treatment for Achilles Tendonitis

The Achilles tendon is the largest and most vulnerable tendon in the body. It joins the gastrocnemius (calf) and the soleus muscles of the lower leg to heel of the foot. The gastrocnemius muscle crosses the knee, the ankle, and the subtalar joints and can create stress and tension in the Achilles tendon. Tendons are strong, but not very flexible so they can only so far before they get inflammed and tear or rupture.

Achilles Tendonitis Causes

Achilles tendonitis is a chronic injury that occurs primarily from overuse. It tends to come on gradually over time until pain is constant and exercise or activity too painful to continue. The biggest cause of chronic Achilles tendonitis is ignoring early warning signs and pushing through pain. If the Achilles tendon is sore, or aches, you need to pay attention and rest it immediately.

Another major contributor in the development of Achilles tendonitis is tight of weak calf muscles. If this muscle is weak and becomes fatigued, it will tighten and shorten. Overuse also causes muscle fatigue. The bottom line with Achilles tendonitis is that the more fatigued the calf muscles are (regardless if it is from weakness or overuse), the shorter and tighter they will become. This tightness increases the stress on the Achilles tendon, and a tendonitis can develop. Sudden increases in training, hill running or a lot of speedwork can also lead to Achilles tendonitis.

Achilles Tendonitis Treatment

At the first sign of Achilles tendon pain, cut back and reduce your training. Stop speed training and hill running, and begin gentle calf stretching after exercise when the muscle and tendon is still warm and flexible. Post-exercise ice may also help. Be carful to avoid excessive stretching that could aggravate the problem. Strengthening the calf muscle can help reduce the stress on the Achilles tendon. Toe raises, and balancing on your toes, and wall stretching are useful exercises.It is not necessary to stop activity completely (you may consider cross training) as long as you pay attention to muscle soreness and reduce activity accordingly.

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