Posts Tagged ‘tennis elbow’

Takeaways from the Hand, Wrist & Elbow Live Chat

hand-wrist-elbow-emailThanks to everyone who joined us Tuesday, April 26, for our live online chat on “Hand, Wrist & Elbow Pain and Treatment” hosted by Emory orthopaedic surgeon, Dr. Michael Gottschalk.

We had an awesome turnout for the chat, and we were able to answer a lot of really great questions that were submitted prior to and during the chat. Below you can find some of the highlights. You can view the full chat transcript here.

Question:I have carpal tunnel and arthritis in my hands and my wrist is very painful I can’t use my hands. What can I do for this?

Dr. Gottschalk: Currently there are several suggestions and recommendations for carpal tunnel syndrome. I always like to first make sure that this is indeed what you have. Carpal tunnel syndrome is a pinching of the median nerve at the wrist. It can cause pain, numbness and tingling to the hand and especially the thumb, index, middle, and half of the ring finger. If your carpal tunnel is severe or has been going on for a long time it can also cause weakness or wasting of the muscles to the thumb. Often times we might order an electrical test to confirm you have carpal tunnel syndrome or perform certain physical maneuvers to confirm this in the office. Once we have confirmed you have carpal tunnel syndrome I will normally make the following suggestions.

1) Wear a wrist brace at night that keeps the wrist straight (the brace does not need to be tight)

2) Try anti-inflammatory medications such as Ibuprofen or Aleve, make sure to check with your primary care doctor first as these medications can have side effects and cause kidney/stomach issues

3) Injections: I normally reserve injections for patients I am either confirming the diagnosis or for a patient that has a temporary reason for carpal tunnel (e.g. pregnant women)

4) Surgery: This is normally a last resort and I often recommend this for patients who have failed 1 and 2.


Question: My wrist hurts when I bend it backwards (as if I were telling someone to stop) and if it bears any weight (like shifting my weight in a chair). If I make a fist and keep my wrist straight it doesn’t hurt at all to bear weight on it. There’s also a slightly tender knot on the ulna side of my wrist). This has been happening for approximately 3 weeks. Any thoughts?

Dr. Gottschalk: This can be a common problem. Hyperextension or bending the wrist backwards (e.g. like for pushups) can cause significant stress on the wrist joint. There are several possibilities as to why this may be painful. One possibility is a wrist sprain where the ligaments are injured but not torn. Other possibilities include inflammation within the wrist joint (synovitis), ligament tears (more severe than a sprain), and possibly even a broken bone.

If these symptoms do not subside I would recommend seeing a physician for x-rays. It is possible that they may recommend NSAIDs, bracing, or an injection. I would also recommend cessation of activities that make it worse at least until it improves.


Question: Tell me a bit about golfers elbow.

Dr. Gottschalk: Golfer’s and Tennis elbow are very similarly related. They’re often repetitive overuse injuries. They normally occur where the tendon attaches to the bone near the elbow. Treatments often start with stretching exercises, inflammatory medication and sometimes bracing. If these are ineffective, I would normally recommend injection or other advanced therapies. Surgery would be the last resort option.

If you missed out on this live chat, be sure to check out the full list of questions and answers on the chat transcript. You can also visit Emory Sports Medicine Center for more information.

Also, if you have additional questions for Dr. Gottschalk, please feel free to leave a comment in our comments area below.

About Dr. Gottschalk

gottschalk-michaelDr. Gottschalk grew up in Dallas, Texas as the youngest of three boys. He went on to graduate from JJ Pierce High School in the top 10% of his class and as an AP Scholar with Distinction. Dr. Gottschalk received an academic scholarship to attend the Business Honors Program at the University of Texas at Austin. After graduating from UT Austin, he then went to complete medical school at the University of Texas Health Science at San Antonio. Upon completion of medical school, Dr. Gottschalk completed his Orthopaedic Surgery Internship and Residency at Emory University. While in his training, Dr. Gottschalk received multiple accolades and awards for his outstanding research and was elected as a resident leader to the esteemed American Orthopaedic Association.

Tennis Isn’t the Only Thing that Can Cause Tennis Elbow

Tennis Elbow PDFTennis elbow is a condition that is caused by over using the wrist. This type of injury occurs when the tendon that connects the wrist to the elbow gets inflamed or tears.

In a recent interview with the team at CNN, Emory Sports Medicine physician Dr. Amadeus Mason was asked to speak about Tennis Elbow and answers questions such as:

  • What is Tennis Elbow?
  • What types of professions are most likely to cause Tennis Elbow?
  • How can you prevent Tennis Elbow?
  • How is Tennis Elbow treated?

Check out Dr. Mason’s full interview in the video below:

Hand and Upper Extremity Live Online Chat

hand-upper-caloutDo you have hand, wrist or elbow pain that is keeping you for your daily activities? If so, join Emory Orthopaedic Surgeon, Dr. Claudius Jarrett on Tuesday, July 23 for an online web chat to discuss various topics related to hand and upper extremity conditions in the hand, wrist and elbow such as:

  • What is the difference between a fracture and a sprain?
  • What are the most common injuries that occur from falling down on an outstretched hand?
  • What is carpal tunnel syndrome?
  • What types of hand and wrist problems need surgery?
  • How do you treat arthritis in the hand?
  • What does it mean if it have numbness and tingling in my hands at night?
  • Is Emory involved in any research regarding new treatments of hand and upper extremity conditions?


Understanding & Preventing Tennis Elbow

Tennis Elbow PDFLateral epicondylitis, or Tennis Elbow, is marked by pain over the bone on the outside of the elbow. The piece of bone that can be felt on the outside of the elbow is called the lateral epicondyle. When the tendons attached to this bone are overused, they can deteriorate and become irritated and painful. This damages the forearm extensor muscles, which are active when something is gripped, such as a tennis racquet. However, the condition is not restricted to tennis players. In fact, only a fraction of people who suffer from Tennis Elbow actually play tennis.

So what causes Tennis Elbow? Aside from playing tennis, some of the conditions or activities that can cause tennis elbow include:

  • Improper technique of hitting tennis ball
  • Improper size of tennis racquet or tension of racquet strings
  • Use of a racquet that is too heavy
  • Repetitive arm motions in activities such as golf, tennis, raking, pitching, rowing, painting and using a hammer or screwdriver
  • Improper golf swing technique
  • Insufficient stretching
  • Advancing age
  • Work that requires repetitive gripping

When it comes to Tennis Elbow preventive measures, there are a few steps you can take to avoid injury.

  • Appropriately warm up and stretch before practicing or competing in any sport.
  • Ensure proper equipment (tennis racquet, golf club, etc.) fit
  • Use proper technique when swinging the racquet. Consult with a coach or specialist if you need guidance on proper technique.
  • Maintain appropriate conditioning, including:
    • Wrist and forearm flexibility
    • Cardiovascular fitness
    • Muscle strength and endurance
  • Wear a tennis elbow (counterforce) brace

If you suspect you have Tennis Elbow, treatment would be provided by a hand and upper extremity orthopedist, or sports medicine specialist, who may recommend treatments ranging from a rest/heat/ice regimen, to eccentric strengthening exercises, or the prescription of anti-inflammatory medications or injections. In extreme cases, your physician may recommend outpatient surgery for Tennis Elbow.

For more information, you can download our Tennis Elbow PDF, which includes details on Tennis Elbow prevention, risks, treatment options and more.

About Dr. Claudius Jarrett
Claudius Jarrett, MDClaudius Jarrett, MD is an assistant professor in the Department of Orthopedic Surgery. He started practicing at Emory after completing an orthopedic hand, microsurgery, and upper extremity fellowship at Allegheny General Hospital in Pittsburgh, Pennsylvania. After finishing medical school at Northwestern University, he completed his orthopaedic residency here at the Emory University Hospitals. His clinical practice and research interests focus on addressing hand, wrist, elbow, and shoulder injuries.

Related Resources:

Tennis Elbow & PRP (Platelet Rich Plasma) Therapy – Is it Right for Me?

Tennis Elbow PDFEmory Sports Medicine Center orthopedist, Dr. R. Amadeus Mason, recently spoke with the team from CNN about a study involving people with tennis elbow and the effectiveness of the treatment options. Check out this story to see what Dr. Mason recommends for treating tennis elbow.

Another treatment option available for chronic tendinitis like tennis elbow is Plasma Rich Platelet therapy, also know as PRP. The Emory sports medicine physicians use PRP to treat patients with chronic tendinitis or arthritis symptoms. Typically the patient will have tried other treatment options such as physical therapy, medications, and refraining from activity before being considered for PRP.

Dr. Mason explains, “PRP treatment is innovative because it takes a patient’s own blood and targets a specific area and harnesses its healing ability and allows us to treat specific types of injuries that otherwise would not be able to treat effectively.”

Typically during a PRP injection, a patient’s blood is drawn from his arm and transferred to a centrifuge machine where it spins the blood for about 15 minutes. The spinning separates the platelets from the other components of the blood. Using an ultrasound machine, the platelets are injected back into the patient into the damaged, painful area of the body.

Dr. Ken Mautner adds, “For the first time we can do a non-invasive, non-surgical procedure where we are just drawing blood from your arm and injecting right to the area of damage and actually get the body to heal itself without the need for a scalpel or any significant bed-rest or downtime.”

Watch this short video of Beth, an Emory Sports Medicine patient with tennis elbow. Beth tried several treatment options but in the end, PRP therapy allowed her to again be pain free and get back to the active lifestyle she wants to live.

Related Resources:

About R. Amadeus Mason, MD
Dr. Amadeus MasonDr. Mason is an assistant professor in the Orthopaedics and Family Medicine departments at Emory University. He is board certified in Sports Medicine with a special interest in track and field, running injuries and exercise testing. He has been trained in diagnostic musculoskeletal ultrasound, and Platelet Rich Plasma (PRP) injection. Dr. Mason is Team Physician for USA Track and Field and the National Scholastic Sports Foundation Track and Field and Cross Country meets, Tucker High School, and Georgia Tech Track and Field.Dr. Mason is a member of the American College of Sports Medicine, the American Medical Society for Sports Medicine, the America Road Racing Medical Society, and the USA Track and Field Sports Medicine and Science Committee. He has been invited to be a resident physician at the US Olympic Training Center, a Sports Medicine consultant in his homeland of Jamaica and the Chief Medical Officer at multiple USA Track and Field international competitions. He has also been a frequently featured guest CNN’s fit nation commenting on a wide variety of topics related to athletics and running injuries. Dr. Mason attended Princeton University and was Captain of the track team.

Dr. Mason is an active member of the Atlanta running community. He attended Princeton University and was Captain of the track team. His other sports interests include soccer, college basketball and football, and the National Hot Rod Association (NHRA). A Decatur resident, he is married with three children.

About Ken Mautner, MD
Ken Mautner, MDKen Mautner, MD is an assistant professor in the Department of Physical Medicine and Rehabilitation and the Department of Orthopedic Surgery. Dr. Mautner started practicing at Emory in 2004 after completing a fellowship in Primary Care Sports Medicine at the American Sports Medicine Institute in Birmingham, Alabama. He is board certified in PM&R with a subspecialty certification in Sports Medicine. Dr. Mautner currently serves as head team physician for Agnes Scott College and St. Pius High School and a team physician for Emory University Athletics. He is also a consulting physician for Georgia Tech Athletics, Neuro Tour, and several local high schools. He has focused his clinical interest on sports concussions, where he is regarded as a local and regional expert in the field. In 2005, he became one of the first doctors in Georgia to use office based neuropsychological testing to help determine return to play recommendations for athletes. He also is an expert in diagnostic and interventional musculoskeletal ultrasound and teaches both regional and national courses on how to perform office based ultrasound. He regularly performs Platelet Rich Plasma (PRP) injections for patients with chronic tendinopathy. Dr. Mautner also specializes in the care of athletes with spine problems as well as hip and groin injuries.