Beyond the Baseline: Understanding Tennis Elbow

Prairie Doc Perspective Week of September 28th, 2025
Beyond the Baseline: Understanding Tennis Elbow
By. Andrew Ellsworth, MD


A few years ago, I was helping with my son’s baseball team. One day, for a routine practice, my role was to hit fly balls for the boys to catch. While I was confident at hitting fly balls, to make things easier for me, I was handed a racquet that, with a fairly easy swing, would launch the baseballs out to the boys. However, after 20 minutes, my elbow was getting sore. More groups of boys needed to rotate through and catch fly balls, so I kept at it. I swung the racquet and the baseballs flew to the outfield over and over. In the end, after less than an hour, my elbow was shot.  


I was experiencing lateral epicondylitis, or tennis elbow.  It hurt on the lateral, or outside, part of my elbow, and while it did not hurt that bad, it was almost debilitating for certain movements. I took some ibuprofen, avoided certain activities, and needed to give it time to heal. 


Lateral epicondylitis, which now could also be called “pickleball elbow” with the big increase in pickleball players, is an over-use injury of the tendons at the elbow. Caused by any repetitive use of the forearm muscles, microscopic tears can form which cause pain at the insertion where the tendons attach to the bone at the elbow, known as the lateral epicondyle. The cause is not just limited to sporting activities. Manual laborers, painters, gardeners pulling weeds, musicians, and anyone doing an activity repetitively and more than their body is used to doing, can be susceptible to this injury.  Golfers can experience a similar injury, but one that affects the inside part of the elbow, causing medial epicondylitis. 


One of the keys to recovery is paying attention to your body and avoiding activities that cause the pain. Pushing through may make it worse and make recovery last longer. Non-steroidal anti-inflammatories such as ibuprofen may help with the pain, as well as icing, stretches, and physical therapy. Some people may find benefit from using a brace wrapped around the forearm muscles, taking pressure off of the tendons. Rarely, steroid injections or an injection of plasma-rich protein may be used, although these are not without some risk. Other treatments can also include ultrasound and shock wave therapy. 


Thankfully, most cases will subside on their own with time. However, it can take a lot of time, oftentimes several months and possibly up to two years. In very rare cases, surgery to remove damaged tissue may be an option.  


In my case, the pesky elbow pain lingered for at least six months. This was all because of less than an hour of using a racquet that I refuse to ever use again. I am happy to hit fly balls and I still do, but give me the baseball bat, please. 


Dr. Andrew Ellsworth is a Family Medicine Physician at Avera Medical Group Brookings in Brookings, SD. He serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and  streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).