Your Guide to Tennis Elbow Surgery and Recovery

Your Guide to Tennis Elbow Surgery and Recovery


Tennis elbow is a repetitive injury that specifically impacts where the tendons in your forearm attach to the bone on the outside of your elbow. It can refer to inflammation or microtears in the tendon or surrounding muscles. While it’s coined as “tennis elbow,” the formal name for this painful repetitive action injury is lateral epicondylitis (LE).

However, pain is not limited to the elbow and can also spread to your wrist and forearm. While rest and over-the-counter (OTC) medications can often be enough to ease symptoms in most people, other individuals may need surgery to fully treat their tennis elbow.

Tennis elbow surgery can refer to one of three common surgical methods for treating LE. The type of surgery recommended can depend on the severity of a person’s injury, as well as their general health, and currently prescribed medications that might increase risks associated with surgery.

These surgeries are intended to remove damaged muscle tissue and restore the healthy muscle to the bone. It’s important to note that currently research suggests that patient outcomes are relatively the same regardless of which of the three surgical treatment methods is performed.

Open surgery

Open surgery, where an incision is made over the elbow, is the most common option. With this surgery, a scalpel is used to scrape away damaged tissue. Then the healthy tissue is reconnected using what’s known as a suture anchor before closing the incision with stitches. Typically, this is an outpatient procedure and you can go home the same day.

Elbow arthroscopy

Alternatively, elbow arthroscopy is less invasive and is achieved by making a small incision and relying on small scopes and instruments to visualize the injury on a screen and treat it. Along with a smaller incision site, arthroscopic elbow surgery tends to result in short recovery periods, less residual discomfort, and less joint stiffness.

Percutaneous surgery

Percutaneous surgery is similar to elbow arthroscopy in that a small incision is made over the elbow. However, hypodermic needles are used instead of arthroscopic tools. This type is also highly effective, with some studies reporting an “excellent outcome” in 48 percent of surgeries.

According to research, only roughly 10 percent of people diagnosed with tennis elbow are encouraged to consider surgery as a viable treatment solution. Tennis elbow surgery is usually the last treatment method recommended when traditional at-home solutions are not effective at remedying the condition.

In most cases, this treatment will not be recommended unless you have not seen improvement after trying other options for at least 6 to 12 months.

Other treatment options include:

While tennis elbow surgery can be an effective solution for good candidates, it’s not without a few potential risks.

Pro

  • improved range of motion
  • reduction in pain at the injury site

Cons

  • infection or fever
  • swelling that does not subside
  • reduced strength and flexibility
  • reduced range of motion
  • potential injury to nerves (ie, numbness or tingling in hand or fingers)
  • potential for long-term physical therapy
  • potential need for more surgery
  • scar that’s sore to the touch

According to the American Academy of Orthopedic Surgeons (AAOS), roughly 80 to 90 percent of tennis elbow surgeries performed were effective at improving range of motion and reducing pain associated with the condition. However, there is a smaller percentage of people that do require additional surgery to further treat the pain.

The cost of tennis elbow surgery can vary widely depending on where in the United States you live and if you’re insured. It is frequently covered by insurance or Medicare, though your plan may require your doctor to deem it “medically necessary” before covering it.

Without health insurance, this surgery can run from $10,000 to $16,000 — though of course prices can vary between surgeons and locations.

With health insurance, the price will frequently be 30 percent of what it would be if you were paying for it yourself — plus the cost of copays. It’s best to contact the clinic or medical professional you’re interested in for an estimate if you have concerns about cost.

While elbow arthroscopy offers short recovery periods, anyone undergoing tennis elbow surgery — regardless of the surgical method recommended — should be prepared for both an initial recovery period and extended recovery time to regain full range of motion and joint strength through physical therapy.

Initial recovery

  • Immediately following surgery, expect to spend 7 to 10 days with your arm in a sling to keep it immobile so the injury and incision can heal. During this time, you’ll need to keep the wound clean and routinely change the bandages to promote proper healing. And you may need to use an OTC or prescribed pain medication as well as ice therapy to ease.
  • After the initial week to week and a half after surgery, you’ll return for a checkup to confirm that your wound is healing properly and to have your stitches removed. You might also transition from a sling to a splint which will allow for more mobility but must be potentially worn for up to 2 additional weeks.
  • In the first month postsurgery, expect to have someone assist you with tasks around the home as you won’t have full use of your injured arm. Additionally, you may need to consider planning to take time off from work during this period if your job requires the use of both arms.

Extended recovery

Once you transition to a splint, you’ll need to begin physical therapy to rebuild your elbow’s range of motion, as well as boost arm and hand strength.

This process to regain range of motion and strength can take an additional 6 to 8 weeks. For most people who have tennis elbow surgery, returning to their typical activity levels can take around 12 weeks. However, sports and lifting heavy objects may need to be delayed an additional 4 to 10 weeks.

Recovering from surgery is a process that takes time. You should not expect to feel back to “normal” immediately following surgery. However, there are tips you can incorporate to boost recovery efforts and regain range of motion as well as arm and hand strength.

  1. Rest when you need to. Trying to engage in too much activity, too quickly, can cause setbacks. Be sure to get adequate rest as your body uses resting periods to heal.
  2. Focus on gentle activities Such as low intensity walks around your neighborhood or in a park.
  3. Ask a friend or relative to help you manage tasks While your arm is in a sling and splint to avoid moving your injured arm too much and experiencing a recovery setback.
  4. Ice and elevate your arm to ease swelling and discomfort. But be sure to keep ice packs wrapped in a towel or cloth to avoid direct contact with your skin.

Post-tennis-elbow-surgery exercises for recovery

usually, postsurgery exercises start small and gentle to minimize overuse and the risk of additional injury to the wound site. This can include simple arm and shoulder stretches or gentle finger and wrist flexing or bends to boost recovery and ensure that you can transition to more intensive therapies later on. These are known as passive rehabilitation exercises.

As you progress through recovery, exercises will become progressively more intensive to boost strength and mobility. More intensive exercises can include:

  • hand-squeezing, such as with a ball or sponge
  • static arm cycles
  • wrist extension or flexion exercises and shoulder rotations to build upper limb mobility
  • training with wrist weights and light dumbbells
  • hydrotherapy

Make sure to follow the exercise program your doctor or physical therapist lays out for your recovery and discuss any additions you’d like to make with them before trying it. Otherwise, you could damage the healing tissue.

While most people diagnosed with tennis elbow can recover without the need for surgical interventions, roughly 10 percent of people will need to have surgery to regain range of motion and strength in their arm or hand.

Although individual success stories depend on a person’s health before surgery as well as adhering to physical therapy and recovery guidelines, most people who undergo tennis elbow surgery experience significant improvements and can return to previous activity levels.

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