Definition Tennis elbow is soreness or pain on the outside (lateral) side of the upper arm near the elbow.Alternative NamesEpitrochlear bursitis; Lateral epicondylitis; Epicondylitis – lateralCauses, incidence, and risk factorsThe part of the muscle that attaches to a bone is called a tendon. Some of the muscles in your forearm attach to the bone on the outside of your elbow.When you use these muscles over and over again, small tears develop in the tendon. Over time, this leads to irritation and pain where the tendon is attached to the bone.This injury is common in people who play a lot of tennis or other racquet sports, hence the name “tennis elbow.” Backhand is the most common stroke to cause symptoms.However, any activity that involves repetitive twisting of the wrist (like using a screwdriver) can lead to this condition. Therefore, painters, plumbers, construction workers, cooks, and butchers are all more likely to develop tennis elbow.This condition may also be due to constant computer keyboard and mouse use.SymptomsElbow pain that gradually worsensPain radiating from the outside of the elbow to the forearm and back of the hand when grasping or twistingWeak graspSigns and testsYour doctor or nurse will examine you.The exam may show:Pain or tenderness when the tendon is gently pressed near where it attaches to the upper arm bone, over the outside of the elbow.Pain near the elbow when the wrist is bent backwards.X-rays may be done.advertisementTreatmentThe first step is to rest your arm and avoid the activity that causes your symptoms for at least 2 – 3 weeks. You may also want to:Put ice on the outside of your elbow 2 – 3 times a day.Take nonsteroidal anti-inflammatory medications (such as ibuprofen, naproxen, or aspirin).If your tennis elbow is due to sports activity, you may want to:Ask about any changes you can make in your technique.Check any sports equipment you are using to see if any changes may help. If you play tennis, changing your grip size of the racket may help.Think about how often you have been playing and whether you should cut back.If your symptoms are related to working on a computer, ask your manager about making changes to your work station or have someone look at how you chair, desk, and computer are set up.An occupational therapist can show you exercises to stretch and strengthen the muscles of your forearm.You can buy a special brace for tennis elbow at most drug stores. It wraps around the upper part of your forearm and takes some of the pressure off the muscles.Your doctor may also inject cortisone and a numbing medicine around the area where the tendon attaches to the bone. This may help decrease the swelling and pain.If the pain continues after 6 – 12 months of rest and treatment, surgery may be recommended. Talk with your orthopedic surgeon about the risks, and whether surgery might help.Expectations (prognosis)Elbow pain may get better without surgery. However, most people who have surgery have full use of their elbow forearm afterwards.Calling your health care providerCall for an appointment with your health care provider if:This is the first time you have had these symptomsHome treatment does not relieve the symptomsReferencesRegan WD, Grondin PP, Morrey BF. Elbow and forearm. In: DeLee JC, Drez D Jr., Miller MD, eds. DeLee and Drezs Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier;2009:chap 19.Schmidt MJ, Adams SL. Tendinopathy and bursitis. In: Marx JA, ed. Rosens Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 115.Review Date:8/11/2012Reviewed By:David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc., and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery.
October 8, 2001The construction crew, September workshoppers and volunteers poured the stairsleading to the second floor of Phase V of the East Crescent Construction.[Photo by: Tomiaki Tamura] Since it was a small quantity pour, the group used the small mixer and carted it up to the formwork by hand.Pictured: Yeonsook bringing buckets of concrete up the stairs.[Photos and text by: Jennifer Thornton] Construction Crew Leader Ray Shong, smooths the concrete into the formwork Habitat Manager David Tollas, and the Construction crew, hosted a barbeque in Phase Five to celebrate the completion of thefirst floor which is the culmination of over a year of hard work by Arcosanti staff, volunteers and workshoppers.Pictured: Aldo fires up the BBQ while people check out the new stairs (back).
Sky Deutschland has made significant inroads with its value-added services. The German pay TV operator has announced subscriber growth for its HD and DVR services, while use of its multiscreen platform has also increased.Sky ended the first quarter with 508,000 Sky Plus DVR customers, up from 81,000 a year earlier, while Premium HD customers increased from 664,000 to 1.017 million.Sky’s multiscreen service Sky Go has grown in popularity, with 6.231 million viewer sessions during the quarter, compared with 4.562 million a year earlier.Overall, Sky attracted 360,000 new customers in the 12 months ending March 31. It ended the quarter with a total of 3.866 million.“Germany and Austria are amongst the highest potential markets for pay-TV across Europe, and the acceleration of demand across our full product range, as well as outstanding customer satisfaction and recommendation levels, underline the strong momentum in the business. The recent acquisition of the full Bundesliga rights, along with extended rights for other important sports competitions, major Hollywood studio renewals, the forthcoming launch of Sky Atlantic HD, and the milestone agreement with Unitymedia and Kabel BW, give Sky a unique long-term perspective and provide a significantly enhanced opportunity for growth and innovation,” said Brian Sullivan, CEO of Sky Deutschland.Sky increased first quarter revenues by 18% to €318 million.