Dr Gautam Tawari is an accredited orthopedic sports surgeon from The Royal College of Surgeon in the UK. Now practising as a Orthopedic Doctor & Surgeon in Mumbai. He has a Diploma in Sports & exercises Medicine (Dip.SEM) from the college and is a Fellow of the Sports & Exercise Medicine Society of the UK.
He has worked as a Consultant Orthopaedic Surgeon in the UK and specialises in advanced elbow joint arthroscopy & Sports related injuries to the elbow joint.
The common sports related injuries he treats surgically include – Tennis Elbow, collateral ligament ruptures, Elbow instability and elbow pain from cartilage damage requiring intervention using elbow Arthroscopy. Sports related elbow fractures / trauma and ligament injuries..
Tennis elbow is a chronic degenerative condition of the tendon on the outside of the elbow. It is also known as ‘lateral epicondylitis’
Cause
Extensor Carpi Radialis (ECRB) tendon is most commonly affected, and it is usually precipitated by repetitive strain. This tendon is involved in extending the wrist joint and is also active when gripping with the wrist extended (as in tennis). Any activity that twists and extends the wrist can lead to tennis elbow.
Presentation
Tenderness and pain when pressure is applied to the outside of the elbow. Pain when the wrist or hand is straightened (wrist extension) or when lifting a heavy object.
Pain is typically localised over the bony bump on the outside of the elbow (lateral epicondyle) and may extend down to the hand. This area is usually very tender to touch.
Treatment
The type and duration of the treatment depends on the severity of the condition
- Elimination of the activities that cause the pain (tennis, golf, Gym)
- Pain killers medications relieve the pain.
- A tennis elbow clasp can be worn just below the elbow to limit the stress on the ECRB tendon.
- Physiotherapy focussed on the eccentric exercises helps to release the tendon inflammation and retrain the muscles.
- Injections are second line of treatment. Steroid injections should be avoided, they have a detrimental overall effect on the tendon.
- More recentlyPlatelet Rich Plasma (PRP) injections have shown to be more effective than steroid injections, but are more expensive.
Surgery
For very severe cases and those that fail to improve after injections surgery may be necessary. The surgery is usually performed as day case surgery. This may be performed by an open approach, percutaneous or arthroscopically (keyhole).
Prevention
To prevent tennis elbow from reoccurring, it is important to make sure the muscles are kept strong by exercise, warming up before starting to use the muscle may also help to prevent the condition.