Medically known as lateral epicondylitis, the condition better known as tennis elbow is painful. Usually caused by overuse of the elbow joint, it’s a specific muscle and tendon combination in your forearm that causes the pain when microscopic tears create inflammation. Not only is overuse a culprit, this muscle also rubs against some bone surface in your forearm, creating a slow wear-and-tear process over time.
There are many non-surgical treatment options that can improve tennis elbow, and indeed, up to 95% of patients see results without resorting to surgery. Sometimes a few weeks of rest are all you need, but physical therapy, anti-inflammatory medications, and braces may help prevent recurrence. If you’re actually a tennis player with tennis elbow, try a racquet with more stiffness, or re-string at a lower tension.
For those unlucky few who need surgery to fix tennis elbow, getting back in the game is the important thing. Here are some tips to speed up your recovery.
Be prepared to wait
For the first week to 10 days after surgery, you’ll be in a splint; but then that will be removed, along with the stitches from surgery. However, you’re not out of the woods yet. The usual goal of tennis elbow surgery involves removing diseased portions of your forearm muscle, then reattaching healthy portions of tissue to the bone. The precise approach depends on your unique case, but since muscle tissue is removed, you’ll need time to regain capacity.
Once the splint comes off, exercises to stretch and restore elbow flexibility begin. About two months after surgery, strengthening exercises get added to the mix. These will start out slowly to gradually build back strength without damaging your surgical repair. Your return to pre-surgery activity may be four to six months after your procedure, depending on how your recovery progresses.
The type of surgery you have matters
Not only does the target of surgery depend on your individual case, it also dictates the surgical options open to you. Typically, tennis elbow surgery can be performed with open surgery techniques, arthroscopically, or with a procedure called percutaneous tenotomy. The preferred method for this type of soft tissue injury is usually arthroscopy, but there are times when open surgery provides better access. Percutaneous tenotomy is performed with ultrasound guidance and involves a small puncture site.
Arthroscopic methods are minimally invasive, as is percutaneous tenotomy. These procedures require smaller incisions or penetrations of the skin and they disturb less adjacent tissue when compared with open surgery. Therefore, your recovery time will be faster whenever open surgery can be avoided. With percutaneous tenotomy a return to activity at an average of 12 weeks as opposed to 4-6 months.
Patients who have a partial tear or a degenerative tendon condition and want to try the least invasive option may be candidates for platelet-rich plasma therapy (PRP). PRP uses your own blood to trigger a healing response at the site of degenerative tendon and is the least invasive option since it involves just a needle stick. The treatment options are usually determined after an MRI is obtained to visualize the extent of degenerative tearing. Surgical options are only discussed after the patient has failed at least 4-6 months of conservative treatment including injection, bracing, modification of activities, and therapy.
No matter what type of procedure you undergo, all surgery carries a risk of complications. You can minimize these by following my recommendations for aftercare. These, too, vary from patient to patient, but some of the more common tips apply to most situations.
- Take your meds – in some cases, your pain medication is also anti-inflammatory, so it aids your recovery, even if you’re not hurting at the time.
- Keep your incision clean and dry – keep your splint and arm out of water.
- Watch for swelling – redness, puffiness, increased pain, feelings of hotness around incisions, pus, and fever are all indications of infection, so contact my office immediately or seek urgent medical attention outside office hours.
Patience is key when recovering from any surgery, and particularly from tennis elbow surgery. People who suffer from tennis elbow are often on-the-go active types, so resting may not come easily. Take it slow, or your recovery may be in jeopardy.