Tennis Elbow Surgeons Near Pittsburgh, PA

Elbow Pain Treatment for Ruptured or Distal Bicep Tear 

Tennis elbow is a common name for the elbow condition lateral epicondylitis. It is an overuse injury that causes inflammation and microtears of the tendons that attach to the lateral epicondyle. Tennis elbow is a painful condition occurring from repeated muscle contractions at the forearm. The condition is more common in sports activities such as tennis, painting, hammering, typing, gardening, and playing musical instruments. The signs and symptoms of tennis elbow can include:

• Elbow pain that gradually worsens.
• Pain to the outside of the elbow that radiates to the forearm and wrist with grasping objects.
• Weak grip.
• Painful grip.
• Pain that is exacerbated in the elbow when the wrist is bent back.

Golfer’s elbow, also called medial epicondylitis, is a painful condition occurring from repeated muscle contractions in the forearm that leads to inflammation and microtears in the tendons that attach to the medial epicondyle. Golfer’s elbow and tennis elbow are similar, except that golfer’s elbow occurs on the inside of the elbow and tennis elbow occurs on the outside of the elbow. Both conditions are a type of tendonitis, which refers to the inflammation of the tendons. The signs and symptoms of golfer’s elbow can include:

• Elbow pain that appears suddenly or gradually.
• Achy pain to the inner side of the elbow during activity.
• Elbow stiffness with decreased range of motion.
• Pain that radiates to the inner forearm, hand or wrist.
• Weakened grip.
• Increased pain while gripping objects.
• Increased pain in the elbow when the wrist is flexed or bent forward toward the forearm. 

An elbow sprain is an elbow ligament injury, causing damage to the soft tissues of the elbow. It is caused due to stretching or tearing (partial or full) of the ligaments that support the elbow joint. Elbow sprains are graded depending on the severity of the symptoms as I (mild), II (moderate), and III (severe). Severe elbow sprains can lead to elbow dislocation or joint instability. Sprained elbow symptoms can include:

• Pain, swelling, tenderness and bruising around the elbow.
• Restricted movement of the elbow.
• Pain at the elbow joint while stretching.

The biceps tendon that attaches the muscle at the elbow is known as the distal biceps tendon. A biceps tear can be complete or partial. Partial biceps tendon tears will not completely break the tendon while complete tendon tears will break the tendon into two parts. Tears of the distal biceps tendon are usually complete and the muscle is separated from the bone. Tears of the distal biceps tendon most often result from a sudden injury or lifting a heavy object.
The most common symptom of a biceps tendon tear is sudden, severe pain at the elbow. At times, you may hear a pop. Other symptoms may include swelling, visible bruising, weakness in the elbow, and trouble twisting the forearm. 

Treatment for soft tissue injuries to the elbow will vary depending on the severity of the injury. Treatment may include rest, ice, heat, physical therapy, and splinting or bracing. In some cases, surgery may be necessary to repair the injured tendon or ligament. The surgical options will also depend on the type of injury you have sustained. Your orthopaedic surgeon may recommend procedures such as:

• Tennis Elbow Surgery - If conservative treatment options fail to resolve the condition and symptoms persist for 6 - 12 months, your surgeon may recommend a surgical procedure to treat tennis elbow called lateral epicondyle release surgery. The goal of tennis elbow surgery is to remove the diseased tissue around the outer elbow, improve blood supply to the area, and alleviate your symptoms. Your surgeon will decide whether to perform your surgery in the traditional manner or endoscopically. Traditional surgery involves up to a 2” incision in the elbow area. The endoscopic surgery involves one or two ½” incisions to the outer elbow area, the lateral epicondyle and the use of an endoscope with a camera for viewing internal structures
• Golfer’s elbow surgery - Surgical intervention is necessary if you do not respond to conservative methods after about 6 months. Open surgery is usually performed to treat golfer’s elbow, although an arthroscopic technique may also be used. During this procedure, your surgeon detaches the common origin for tendons attached to the medial epicondyle. Damaged and degenerated tendon tissue is then removed without injuring the surrounding ligaments. Microfracture of the medial epicondyle is performed where numerous small holes are drilled into the bone to promote healing. Finally, the common origin for the tendons is reattached to the bone and the incision is closed.
• Distal Biceps Repair - Distal biceps repair is a surgical procedure to restore a ruptured or torn distal biceps and tendon, caused by an injury. The distal biceps is usually repaired through a single incision (front of the elbow) or a double incision (front and back of the elbow) technique. More serious injuries may need a graft (transplanted tissue) to repair the distal biceps.

If you think you have suffered a soft tissue injury to your elbow, it is important to see your orthopaedic specialist for an accurate diagnosis and treatment plan. Untreated injuries can lead to chronic pain and loss of function, so early intervention is the best course of action. 

Dr. Brian Kelly can help you determine the best route of treatment, as well as perform surgical procedures if necessary. Reach out to Brian J. Kelly MD for long-lasting pain relief from elbow injuries.