Common Sports Injuries and Their Care
Lateral Epicondylitis of the Elbow (Tennis Elbow)
Lateral epicondylitis, or Tennis Elbow, is a chronic condition seen in athletes that perform repeated forearm flexion and extension movements. The most common sports or activities associated with this injury are tennis, throwing a baseball or javelin, golf, swimming, and fencing.
It is caused from repetitive microtrauma to the insertion of the extensor muscle on the lateral epicondyle of the elbow. The primary action causing the irritation is excessive pronation of the forearm
Initially, the patient will complain of pain and tenderness on the area of insertion of the extensor muscle both during and after activity. Gradually the pain will become worse and grow to include weakness in the hand and wrist. Along with the tenderness over the condyle, the patient will experience pain and weakness with resisted wrist extension and full extension of the elbow. There will also be a decrease in elbow range of motion.
Follow the RICE (Rest, Ice, Compression, and Elevation) acronym for treatment during initial stages. If pain persists, take an anti-inflammatory such as Ibuprofen, Motrin, or Alleve for any inflammation. The patient may use a brace or neoprene sleeve to provide some relief during activity. Range of motion exercises and resistance exercises for the forearm and wrist should be done, as well as deep friction massage at the spot of pain. The athlete should also re-learn the proper technique for the skills they are performing in order to avoid injury recurrence.
If the pain persists, see your physician for further examination.
Achilles Tendonitis
Achilles tendonitis is a pathology seen in activities mostly involving running, cutting, and jumping. It is typically an overuse injury occurring when and activity is long in duration and/or high in intensity. It may also have an acute onset, such as a blunt blow to the tendon like being kicked. It may also occur due to improperly fitting footwear or poor running mechanics. Tight plantar fascia, or a rigid foot, may also be a predisposing factor.
The patient will present with pain radiating, often described as a burning sensation, along the length of the tendon. There may be some discoloration or edema visible as well. Sometimes the tendon on the affected side appears thicker than that of the other side. The tendon is painful to touch and may feel a sensation of crepitus or creaking with movement. The patient will feel pain, soreness, or crepitus with pointing the foot up and down. Stretching the Achilles will be sore or painful, which will cause a limited range of motion. Attempting calf raises may be painful as well as weak.
The initial treatment for Achilles tendonitis is rest and ice. Take time off from activity for 1-2 weeks. Using an anti-inflammatory, such as Ibuprofen, Alleve, or Motrin, at the recommended dosage should help decrease the inflammation and pain. Stretch the Achilles, calf, and plantar fascia at least 4-5 times per day. Once range of motion has increased and is pain free, begin strengthening with calf raises on two legs and then one. As long as those are pain free, start some light bouncing and hopping. In order to prevent re-injury when returning to activity, make sure to begin with an intensity and duration that is less than before sustaining the injury.
If the pain persists, try new footwear or use a heel cup or heel lift in your shoe to alleviate tension on the achilles. Also, see your physician for further recommendations and advanced injury evaluation and treatment.
Achilles Tendonitis and Lateral Epicondylitis Reviews by:
Roger Dortch-Doan, LAT, ATC, CSCS
Assistant Athletic Trainer
DePauw Sports medicine