Tennis and golfers elbow
Tennis elbow (lateral epicondylitis) occurs when the tendon which joins your forearm muscles to the outside of your elbow thickens and swells or develops small tears. It causes pain and tenderness.
It typically affects the dominant upper extremity and is associated with repetitive and forceful activity. Pain is often most debilitating with wrist extension.
Golfer’s elbow (medial epicondylitis) causes pain and inflammation in the tendons which connect the forearm to the elbow. The pain revolves around a bony bump on the inside of your elbow and may radiate into the forearm.
Golfer’s elbow is often caused by overusing the muscles in the forearm that allow you to grip, rotate your arm, and flex your wrist.
To find out more watch Mr. Ali Noorani’s lecture on tennis elbow treatment.
Despite the names, tennis elbow and golfers elbow are usually a result of everyday activities. Although, we see a significant number of people that have elbow pain due to sporting activities.
You may experience pain in your forearm and in the back of your hand. Symptoms can range from a mild discomfort to severe pain that can be felt even when the joint is not active.
What treatments does The Regenerative Clinic offer?
Our renowned medical team provides a range of treatments, from the traditional to the innovative:
This day case treatment is exclusively offered to our patients. It uses the pioneering procedure of Lipogems®, a pioneering procedure that uses your body’s own adipose (fat) cells to treat pain and inflammation. Injections using Lipogems® are minimally invasive and are carried out under ultrasound guidance. Altogether the procedure takes about an hour to perform with a minimal recovery time of around three hours. As well as being a potential alternative to surgery, Lipogems® can also aid post-surgery recovery.
This is an effective and well-researched procedure that’s a potential alternative to surgery. It takes advantage of the blood’s natural healing properties to reduce pain and improve joint function. It uses a specially concentrated dosage of platelets prepared from your own blood to repair damaged cartilage, tendons, ligaments, muscle and bone. Patients usually see their symptoms improve in one to two weeks of having the injections. Read more clinical evidence supporting PRP here.
This treatment involves a selective filtration of your blood which harnesses Monocytes and their reparative properties for sporting injury and soft tissue damage.
In the degenerated tendons, Monocytes contribute to the repair of the damage by promoting the release of enzymes that help remove the damaged parts and consequently help the formation of a new matrix to promote the healing of the tendon. They perform a similar function in muscle injuries and promote the repair of damaged muscle fibres as a result of injury. There is some evidence to show these cells reduce inflammation in joints and have a beneficial effect in inflammatory forms of arthritis. Read more.
Bone Marrow Aspirate Concentrate (BMAC) is a non-surgical, minimally invasive, regenerative treatment that harnesses the natural ability to heal the body through the assistance of biological growth factors. BMAC utilises the regenerative stem cells collected from bone marrow to aid in the acceleration of healing moderate to severe osteoarthritis and tendon injuries. Read more here.
Are you at risk?
Most people at risk of the injury tend to be office or manual workers and it is usually due to the overuse syndrome caused by repeated forceful wrist and finger movements resulting in excessive use of the forearm extensors (for tennis elbow) or the forearm flexors (for golfers elbow). Playing racket sports or golf does increase your risk, although the condition is often a result of prolonged rapid activities like playing the piano or typing.
We do know that smoking, high body mass index (BMI), certain medications, genetics and poor diabetic control play an important role in the presentation of lateral and medial epicondylar tendinopathy.
- 15% of people are likely to experience tennis or golfers elbow
- men and women between the ages of 30 and 50 are more at risk
- it can last for over two years and it can often reoccur
How do we diagnose tennis or golfers elbow?
Are X-rays required?
Treatment of tennis and golfers elbow
Rest, medication and supports
Injections can help with symptoms of tennis/golfers elbow. Injections of local anaesthetic (or local anaesthetic patches) can temporarily help relieve the symptoms.
Steroid injections are not recommended as they have been used too often in the past and there is overwhelming evidence that suggest that they cause significantly more harm than good. In the short term, steroids can reduce the inflammation and pain, however, they don’t aid in the healing process and can further degenerate the tendon leading to long term complications and the prolongation of symptoms
Minimally-invasive regenerative treatments
The use of biologics including Platelet Rich Plasma (PRP) or Plasma Rich in Growth Factors (PRGF), are a very effective way of treating tennis elbow when physiotherapy and rehabilitation has failed.
PRP/PRGF concentrates growth factors from your blood and injecting them in the area affected by tennis or golfers elbow helps the healing process. There is overwhelming evidence, supported by randomised control trials, that proves PRP/PRFG is a more effective way of treating tennis and golfers elbow as opposed to the use of steroid injections.
At the Regenerative Clinic, patients often ask whether AMPP® (Activated Mesenchymal Pericyte Plasma) can be used to treat tennis and golfers elbow. The biologics of this treatment normally contains a small dose of PRGF, as well as adipose-based pericytes harvested with Lipogems®. Theoretically AMPP® is superior in regeneration and healing. You may have AMPP® in conjunction with the treatment of other joints, the results of which have been very positive.
Our Regenerative Clinic treatments effective in treating these conditions, include:
Platelet Rich Plasma (PRP) therapy, also known as autologous conditioned plasma, takes advantage of the blood’s natural healing properties to repair damaged cartilage, tendons, ligaments, muscle and bone. It can reduce pain, improve joint function and helps you quickly return to normal activities. PRP supports your body’s self-healing processes by using your own cells. Blood is mostly liquid (called plasma) but also contains solid component including red cells, white cells and platelets. The platelets are important for clotting blood but they also contain proteins called growth factors which are important in the healing of injuries. With a higher concentration of growth factors than typically found in blood, PRP injections support the restoration of injured tissue and inhibit painful inflammatory processes. This treatment is widely researched and supported in clinical papers. See our PRP evidence section.
Find out more about tennis elbow
Watch Mr. Ali Noorani our upper limb surgeon discuss the benefits of using injections for treatment of tennis elbow.
“PRP has become an increasingly popular treatment option for professional athletes as well as those who have strained their outer elbow tendons”.