Top orthopaedic Elbow Specialist in Pittsburgh, PA
Tennis Elbow & Other Soft Tissue Injuries
The elbow joint is essential for bending or straightening the arm to 180 degrees and lifting or moving objects. The elbow is a complex joint formed by the articulation of three bones – the humerus, radius, and ulna – which are lined by articular cartilage. Articular cartilage is a thin, tough, flexible, and slippery surface that acts as a shock absorber and cushion to reduce friction between the bones. The bones of the elbow are supported by ligaments, tendons, muscles, nerves, and blood vessels.
When any of the structures that support the elbow joint are injured, it can cause elbow injury symptoms like pain, swelling, bruising, and loss of function. Elbow injuries can be caused by falls, direct blows to the elbow, overuse, or degenerative changes. Common soft tissue injuries around the elbow include tennis elbow, golfer's elbow, elbow sprains, and distal biceps tendon tears.
The elbow joint is essential to your arm movement, so it is important to seek treatment if you have sustained an injury. Dr. Brian Kelly, an acclaimed orthopaedic surgeon, is experienced in treating soft tissue injuries of the elbow and providing long-lasting pain relief for a variety of injuries.
When you visit the office of Brian J. Kelly MD, you will be welcomed by Dr. Kelly and his team of talented surgeons with a great reputation for providing the most skilled and compassionate care for their patients. If you are ready to recover from your injuries with the help of experts, schedule an appointment today with Brian J. Kelly MD.
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.
Frequently Asked Questions
What conservative treatment options can I try before tennis elbow surgery?
Before moving on to surgery, your orthopaedic physician will recommend conservative treatment options to treat the tennis elbow symptoms. These may include:
- Avoid activities that tend to bring on the symptoms and increase stress on the tendons.
- Splints or braces may be ordered to decrease stress on the injured tissues.
- Place ice packs on the elbow to reduce swelling.
- Anti-inflammatory medications and/or steroid injections may be prescribed to treat pain and swelling.
- Occupational therapy may be ordered for elbow tendonitis exercises (strengthening and stretching exercises) to the forearm once your symptoms have decreased.
- Pulsed ultrasound may be applied to increase blood flow and healing of the injured tendons.
Dr. Brian Kelly and his team members will make sure you are comfortable and have tried every option before deciding to proceed with surgical options.
How do I know if I need distal biceps tendon repair surgery?
The typical indications for distal biceps repair include:
- “Pop” or tear felt in the front of the elbow
- Severe pain around the crease of the elbow
- Bruising and swelling around the front of the elbow
- Weakness in bending of the elbow or twisting the forearm
- Warmth in the elbow and cramping in the arm
- Substantial pain and weakness of the entire upper extremity (shoulder to hand)
Brian J. Kelly MD can help you determine if surgery is the necessary choice for your treatment.
What does recovery from golfer’s elbow surgery look like?
After golfer’s elbow surgery, your orthopaedic surgeon may recommend post-operative measures such as:
- Keeping your arm supported by a splint.
- Doing light exercises, such as sponge squeezing, for the first few weeks following your procedure.
- Beginning resistance exercises after 6-8 weeks.
- Beginning to participate in sports after 6-8 months.
Even though your surgery has been completed, you will still receive care and support from your orthopaedic specialist. With consistent communication, recommendations, and check-up appointments, you will have someone by your side throughout your recovery.
How do I get started with an elbow specialist near me?
If you have sustained an elbow injury, don’t hesitate to seek treatment. Dr. Brian Kelly is ready to assist you with any problem you are facing. You can receive compassionate care from experienced orthopaedic specialists and rest assured that you will enjoy a successful recovery.
If you are ready to get back into the swing of things, schedule an appointment with a specialist at Dr. Kelly’s office today. You can contact us by phone at 412-262-7800, or visit our office at 725 Cherrington Pkwy, Suite 200, Moon Township, PA 15208.