Complaints & connections · borters.ch
Not from tennis but from repeated loading — patience is part of the treatment here.
Also known as: epicondylitis · tennis elbow · golfer’s elbow · repetitive strain elbow · epicondylopathy · lateral epicondylitis
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
An overload irritation where the forearm tendons attach at the elbow: on the outside “tennis elbow” (extensors), on the inside “golfer’s elbow” (flexors). Typical is pain over the bony bump, worse on gripping, lifting or holding — often from repetitive strain (work, mouse, sport). Diagnosis is clinical. Treatment: adjust load, eccentric strengthening, sometimes a brace/strap; stubborn but usually settles over weeks to months. Cortisone injections relieve short-term but often worsen the long-term course — used sparingly.
Complete rest makes the tendon weaker. Better: change heavy grips, tools with a thicker handle, lift with the palm turned up instead of down.
Lower the wrist slowly against a small weight and bring it back with the other hand, three sets of fifteen on most days. Over eight to twelve weeks this is the most effective treatment.
Two to three finger widths below the painful point, not above it. It takes tension off the insertion and helps for the hours when gripping is needed — worn permanently it weakens.
After an injection things are better for weeks, but after a year worse than without. That is unusually clearly studied and the reason it is used sparingly today.
Some stubborn elbow pain comes from the neck or from an overloaded shoulder. If twelve weeks of training achieve nothing, that belongs looked at.
The course is self-limiting: with or without treatment, the great majority are symptom-free after one to two years. Steroid injections help in the first weeks and worsen the result at one year — one of the few cases where the quick fix lengthens the long road.
Anti-inflammatories help in the first weeks — in a long-standing tennis elbow there is hardly any inflammation but a remodelling of the tendon, and there they no longer work. A cortisone injection takes the pain away for six to twelve weeks and does worse at one year in comparisons than waiting. What remodels the tissue is measured load: eccentric training over twelve weeks. Untreated, eight in ten improve within a year.
The pain can be pointed to with one finger exactly on the bony bump on the outside and runs from there into the forearm. This pinpoint location is characteristic.
Lifting the coffee cup, opening a bottle, shaking hands, turning a key — activities with a firm fist and a straight arm. The elbow itself moves freely.
With a straight arm, press the middle finger upwards against resistance: pain on the outside of the elbow confirms the picture — without a device and without imaging.
The majority come from handiwork, mouse and keyboard, cooking, gardening or a new activity in the weeks before. The question of what changed leads further than the name does.
Complaints at tendon insertions heal more slowly and return more often with a raised sugar. That explains stubborn courses that otherwise stay puzzling.
An underactive thyroid encourages complaints of tendons and bursae. The value is worthwhile when several places are affected at the same time.
The most surprising point: complete rest worsens the course. What works is slow, controlled loading — lowering the weight over three to four seconds, daily, over twelve weeks. It hurts in the first weeks and is nonetheless the route with the best result.
Sensible only together with the exercise and at the right interval before it — about an hour, because the building blocks are then in the blood when the pull comes onto the tendon. Taken alone no effect is shown.
Belongs here honestly because it is so often wished for: after six weeks it is better with it than without, after a year worse than without — measured that way several times. The injection buys weeks and costs months; knowing that changes the decision.
The cortisone injection works markedly in the first weeks — and after a year those injected do worse than those without. That is one of the clearest examples that fast relief and a good course are not the same thing.
The tendon heals through slow remodelling, and that needs pull. This is why eccentric training over 12 weeks is the treatment with the best numbers — rest alone does not heal a tendon.
Tendon problems are markedly more common in diabetes and heal more slowly, because sugar attaches to collagen. That explains stubborn courses better than the loading alone.
Slow eccentric training is the best-documented treatment for tendon insertion pain.
At the outer elbow, exactly where the tendon attaches. Point and site of pain coincide here.
In TCM the point for tendons in general — it sits on the leg and is named for tendon complaints anywhere in the body. What actually heals the tendon is eccentric training over 12 weeks.