DEAR DOCTOR K:

I'm an avid tennis player. Unfortunately I've developed tennis elbow. What can I do to treat this problem? And how can I make sure it won't return?

DEAR READER:

"Tennis elbow" is one of the many minor maladies of man that have not been studied as seriously as they should be.

So what is tennis elbow? Let's start with a little anatomy. Hold your right arm out in front of you, with the palm up. Now with your left hand, grab underneath your right elbow. The fingers of your left hand should feel a hard, bony, round bump on the outer part of your right elbow. That's where the pain is, right?

Tendons from muscles that move your right wrist and fingers attach to that hard, bony bump. Tendons are tough, flexible, fibrous bands of tissue that connect muscles to bones. When tendons become inflamed or suffer tiny tears, the condition is called tendonitis. Many cases of tendonitis (like yours) are caused by repeating a particular body motion too often. People who play racquet sports often injure the tendons in this part of the elbow.

As you've experienced, tennis elbow causes pain on the outer side of the elbow joint, possibly extending down to your forearm and wrist. Your elbow may also feel weak.

I tell my patients that they need to rest the injured area. For sure, that means no tennis for at least a month, and often more. Sometimes the pain is caused by simple everyday activities (not just tennis). If so, patients often benefit from a brace or splint to protect the injured area from more injury.

To relieve pain and swelling, I suggest ibuprofen (Advil, Motrin), aspirin or another nonprescription anti-inflammatory medication, possibly for up to several weeks. For more serious cases, a corticosteroid drug or local anesthetic can be injected into the affected tendon.

Your doctor may also refer you to a physical therapist for more specialized treatments, such as deep heat to the elbow. This therapist may also prescribe a rehabilitation program to help you to regain strength, motion and function.

Once your tennis elbow has healed, take the following steps to make sure it doesn't return:

-- Always warm up before beginning strenuous exercise.

-- Change to a racquet with a larger head (but make sure the new racquet is not heavier than the original). This cuts down on vibrations to the arm and may help to prevent re-injury.

Back to our anatomy lesson: When you grabbed underneath your right elbow, the palm of your left hand probably also felt a hard, round bump on the inner surface of the elbow. Tendons from other muscles that move your wrist and fingers attach there. This spot is often injured by playing golf too much. That's called "golf elbow."

Tennis elbow and golf elbow can be caused by repeated arm activities besides playing tennis and golf. Whatever the cause, there are treatments to ease the pain and return you to a sport you love. Just be patient.

(Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.AskDoctorK.com.)

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