I'm 55 and still do competitive wrestling & racquetball so I am familiar with what happens to highly trained athletes as they age. You may need to implement a specific warm up routine that is different and LONGER in duration than what you used to do when you were 20 or 30 years. Your elbow may be suffering from hyperextension and you may need to look into your technical form a bit more.

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Brief Answer:
Tennis player inury

Detailed Answer:
I understand.

The most likely cause of your problem as you've described is an overuse syndrome which will involve the tendons, ligaments, and the articular joint of the elbow. The swelling from this overuse is what is likely causing the intense pain and restriction in your play. The most common mechanism of injury in this setting is that of OVERUSE/HYPEREXTENSION. Although you may not feel this to be directly in the elbow joint; in point of fact it is the limitation of that joint which leads to all the other pains and discomforts you're feeling which do involve other tissues as you've correctly pointed out.

However, if there are things other than that involving physical damage such as a tear etc. then, you would need to get either imaging studies of the elbow such as an MRI/CT scan of the arm/elbow/forearm region itself or be physically examined by a doctor for more definitive localization of the problem. In most cases imaging studies are really not necessary if the patient will simply rest, ice, and take proper steps to do an adequate warm up before playing full out.

In addition to the standard icing that we recommend of the affected area which should be for 20-30 min. using bags of crushed ice, followed by a minimum rest period of 24-72hrs until the pain and soreness have resolved there are agents such as ibupropen, paracetamol, and acetaminophen that can be taken. After several days of this initial icing regimen- heat should be applied for the same 20-30 minutes at a time both prior as well as after play.

I also have used a neoprene elbow wrap/protector when playing racquet ball and suffering similar symptoms with excellent results since the heat generated in the arm/elbow/forearm can be recirculated into the affected muscles, ligaments, and tendons and becomes almost a mode of therapy while actually playing. You should find such a device through any retail outlet that sells sporting goods. Some pharmacies may even carry such items.

However, your key will be to discover what changes you need to make to your playing style to AVOID such injury. For example, is your follow through on the swing using far too much BRUTE FORCE as opposed to allowing the body motion to carry the joint through so that you are not overexerting a joint that cannot be hyperextended but which you are doing without even realizing? Of course, I'm not a tennis player to speak to specific style and technique but that's an example of one question that could be asked of an expert who can analyze what you're doing during play to bring this on.

In other words, prevention in this case would be preferable to trying to cure.

Plus if you have to play XXXXXXX Claus for your kids this year you'll need that arm to carry the big bag of gifts...not to mention having to crawl up and down the chimney! LOL....

I hope these suggestions will provide the more specific guidance you are looking for in order to get your play and comfort back on track.

Regards for a wonderful holiday season and please keep me informed as to your progress.

If this information has provided you with useful information then, your brief note of feedback as well as STAR RATING would be greatly appreciated. Also, if there are no further questions to pose on this topic would you please close the consult on your end so that the computer will properly credit the transaction and archive the case for future reference?

The total time spent on reviewing the questions with research and compilation of response for patient envoy is 35 minutes.

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Brief Answer:
Appropriateness of waiting to Close Query Based on Outcomes

Detailed Answer:
Thank you very much for your partially positive and encouraging reply.

I believe your appreciative comments based upon the response I last gave are sincere and genuine. My fear is that the comment of wishing to wait until outcomes are known before closing the query or rating the case suggests that you are not considering the finer nuances of the practice of CLINICAL medicine which often requires the passage of time for a problem to fully declare itself along with the adequate titration of an intervention so that it is appropriate to the individual patient. This is in contradistinction to ACADEMIC or what I have come to term, INTERNET MEDICINE, which tends to generate "right" and "wrong" answers through a series of isolated symptoms and complaints and checking them against THE FACTS to finally come up with "What's right and wrong to do" without really taking THE PATIENT into account. I do not not subscribe to that style of practicing medicine.

In the hallways of the most elite Medical schools of the world it is said, "Diseases don't read books." Simply stated, more often than not books and scrolls as well as SAGACIOUS MENTORS tell us what's SUPPOSED to happen- not WHAT ACTUALLY happens. However, this should never be interpreted as a failure in treatment or diagnosis but rather a sign that modifications are necessary in order to get things under better or best control.

This describes the process of healing. It's rarely if ever a case of "2 steps forward and NEVER 1 back..." If that were to be the standard of measurement as to success or failure of a treatment then, the suggestion would be that anything less than perfection is of little value. I believe this to be an error in thinking for we are dealing with human diagnosticians and human patients...both of which are inherently flawed but both of which also are inherently driven to succeed given the proper circumstances and the proper amount of time.

I believe that not wishing to validate what's been offered as my best medical advice effectively sets a bar of measurement to an unreasonably high standard although I do not waver in the least from all that I've previously said and certainly do hope you improve on the basis of implementing what I've written in exacting detail with much self reflective thought and experience both as an active athlete as well as coach of highly trained and accomplished men on a varsity team at a university which consistently places itself at the Top of its conference and in its Division at the National Tournament each year.

In other words I have the utmost faith in my suggestions as stated to treat a person in a perfect world.

I firmly believe that the time and effort put forth on your behalf should be judged on its merits and enthusiasm independently of outcomes.

Feel free to close this query at your leisure but please do me the favor of giving what I've said its full due course of consideration. I believe other physicians would stand in agreement with what I've said as well as many scores of patients I've counseled and whose comments you are free to read on my webpage (bit.ly/drdariushsaghafi).

I would love to hear for good or otherwise, how you fare in the future with your condition and if you are able to successfully discover what may be at the root of having developed this overuse syndrome either by your observations or by those of a tennis professional. I may give this final piece of advice and that is to SHARE my MEDICAL recommendations with them as this may give them insight into what could be going on with your technique based upon how I view the medical remediation of your problem. An astute pro will be able to extrapolate one set of circumstances to the other rather quickly if you choose someone of repute.

Cheers and a very Happy Holiday Season to you and Yours.

This response took 88 minutes to read, research, and compile for patient envoy.

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