Tennis/golfer's elbow
This is not medical advice.
Dr. Google defines tennis elbow as; “Lateral epicondylitis, or tennis elbow, is swelling or tearing of the tendons that bend your wrist backward away from your palm. It's caused by repetitive motion of the forearm muscles, which attach to the outside of your elbow.”
Golfer’s elbow is a similar condition, just on the inside of the elbow.
I disagree with some aspects of that definition. I don’t think it’s so much repetitive motion, as it is muscle attachment weakness, in relation to the forces acting upon the area.
We tend to take our bodies for granted. There is very little leverage at the wrist for extension, and the muscles that pull that motion are long and thin. Once you add an even longer lever arm (tennis or pickleball racket) away from the wrist, leverage decreases even more.
So yes, there is some repetitive motion going on, however I think it is the forces involved that is the problem.
Picture the ball hitting the racket as you perform a backhand swing. It’s 18-24 inches of a long lever arm, from where the ball hits the strings, to where your wrist extensors attach at the elbow. Some players are hitting the backhand swing with 40 pounds of force.
Professionals perform the most repetitions, with much more force, and do not develop the same level of problems because their wrists and forearms are stronger. Strengthening is the key.
It is difficult to do strengthening when there is inflammation and pain. Lets decrease some of the symptoms first. That’s hard to do if you keep playing and ignore the pain, like these people,
Massage
What does it do? Makes it feel better, decreases tension and guarding, increases healing blood flow to area, allows you to start strengthening sooner.
Ice
Icing is the go to matra that every arm chair doctor parrots. If you are really swollen and inflamed, this might be appropriate. However, ice also decreases inflammation, and inflammation is what heals our body. Every case is different. Something to consider.
Isometrics/strengthening
Isometric strengthening is when you contract the muscles, and the joints don’t move. There is some good evidence for isometrics with tendonitis. Sometimes people are able to complete these with less pain than traditional movement based strengthening. Many times with a backhand stroke, the contraction at the forearm is isometric, so you are mimicking the original muscle action.
Most people find these boring, and an unsatisfying muscle contraction. If that’s the case, you can perform wrist extensions. The forearm is stable on the arm of the chair, as seen in the picture below.
Overall, this is very specific strengthening to your arm, and we don’t work this way. We perform a symphony of coordinated muscle contractions, and balance. I like total body movements for strengthening; push ups, pulls ups, or variations from your knees to make it easier.
Taping and compression sleeves
There are some leukotape and kinesiotape jobs that may help decreases symptoms. They take some of the pulling pressure off the epicondyle.
Compression sleeves also help alleviate some of the pulling pressure on the epicondyle.
In both cases, you could make things worse if you continue to play with pain. The main focus should be on strengthening with a resistance low enough that symptoms do not get worse. As you get better, gradually increase the weight.
Shots for pain, or painful shots?
I think you get the picture. I’m not saying don’t do them, however that is a bumpy road. If you don’t get stronger, you are not addressing the root cause of the problem. Shots are not effective 100% of the time, and do have some drawbacks. If it's my body part, I am choosing massage and strengthening as much as possible before I go there.
Golfers elbow
This is basically the same problem, just on the inside of the elbow. Same rationale for healing applies.
