Q. My daughter has been watching what she eats and has really been paying close attention to her body fat over the past couple of months. She is a track and cross-country athlete who doesn’t have much fat to begin with, could this be destructive?

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Tennis elbow and golfer’s elbow are generic terms giving to tendonitis or epicondylitis of the elbow. For the sake of this article, I will apply the terms to a right-handed individual for a more simple explanation. The term “ tennis elbow” is commonly used for a lateral tendonitis or epicondylitis and the term “golfer’s elbow” refers to medial tendonitis or epicondylitis. These terms were derived from the motion most frequently used in their respective namesake sports. For example, when a right-handed person goes to hit a one-handed backhand shot in tennis, they drive the racquet through the range of motion using primarily the wrist or forearm extensor muscles. Most of these muscles commonly attach on the outside, or lateral side, of the elbow causing point tenderness and pain at that site. With the golfer’s elbow, when a right-handed individual goes to hit a forehand shot in tennis or in the downward motion of the golf swing, they primarily use the muscles that attach on the inside, or medial side, of the elbow. There is one other type of tendonitis at the elbow, known as posterior tendonitis, that usually follows a sudden severe strain to the triceps where it attaches to the back of the elbow. This is very rare and usually not the case in a chronic overuse injury, such as the others.

Both of the former diagnoses, lateral and medial epicondylitis, are usually a result of consistent activity for a prolonged period of time. And it is usually not during, but after the activity that the pain surfaces, after significant internal strain to the tendon fibers. This is common not only is sports such as tennis and golf, but also baseball and swimming and overuse skills of painting, carpentry, gardening, and surgery. Ice and NSAID’s (ibuprofen and naproxen sodium) are a simple fix for decreasing the pain and some stubborn cases may need iontophoresis, which is an electrical delivery of an anti-inflammatory steroid. Ultimately, limiting your activity, stretching, and cross-friction massage may be needed for several days before adding back some strengthening exercises to help prevent reoccurrence.

If the pain has been present for more than a few days or even weeks, I encourage you to see a sports medicine professional to help discern the direction of your treatment. As with any overuse injury, after the pain subsides, gradually add back the motion that causes the discomfort in moderation until you are able to resume full activity.

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