If you've been watching the Proteas smash the Aussies down under, you are probably becoming pretty familiar with that pesky little injury called 'tennis elbow'.

With skipper Graeme Smith almost constantly at the mercy of his lateral epicondylitis (as it is known by those bearing stethoscopes), the injury has piqued the interest of even the most sedentary South Africans.

So, what's it all about? And why are cricketers being plagued by an injury that, by its very name, belongs on the courts of Wimbledon?

What is it?

Tennis elbow is something of a misnomer, for while tennis players are prone to having a little elbow trouble, they are by no means the only ones.

Tennis elbow has a prevalence rate of about three percent in the general population and 15 percent in high risk groups. Alongside tennis players, those falling into high risk groups include cricketers, golfers, rowers, labourers, plumbers, carpenters, painters, gardeners and domestic workers.

Most patients with tennis elbow are between the ages of 35 and 65; however this is obviously not always the case with professional sportsmen and women.

The injury is caused by overusing (generally through repetitive actions) the forearm extensor muscles. The muscles, which extend the wrist, are active when you grip something.

Overusing these muscles leads to deterioration or tearing of the tendons attached to the outside of the elbow. The pressure caused by the inflammation of the injured area can result in a disruption of blood flow and the pinching of the radial nerve (one of the major nerves controlling muscles in the arm and hand).

Tennis elbow is often a recurring problem, because after the initial injury heals, the same area often tears again, leading to the formation of rough granulated tissue and calcium deposits within the surrounding tissue.

Symptoms

• Pain on the outside of the elbow, which is worsened by grasping objects.


• Pain when lifting objects, shaking hands or turning doorknobs.


• Pain radiating down the forearm.


• Pain caused by lifting or bending the arm.


• Pain caused by pressing on the outside of the elbow.


• Difficulty in extending the forearm fully.

The onset of pain can be gradual or sudden and generally lasts for between six and 12 weeks. The resulting discomfort can last for as little as three weeks or as long as several years depending on the severity of the injury.

Treatment

Rest is imperative in the treatment of tennis elbow. The injury will not heal (as is the case with Graeme Smith) unless you stop doing the exercise which caused the injury completely.

Ice should also be applied to the elbow (although not directly) in 15 to 20 minute stints to reduce any inflammation. Anti-inflammatory medication, as directed by your doctor, can also be taken to reduce inflammation and pain.

Alternative treatment strategies include elbow bands (worn on the forearm below the elbow), splints, acupuncture, ultrasound, laser therapy, shock-wave therapy, deep massage and, in more severe cases, surgery.

Once the pain has been alleviated, it is important to do regular stretching and strengthening exercises to prevent future re-injury.

Prevention