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Repetitive overhead throwing imparts high valgus and extension loads to the athlete’s elbow, often leading to either acute or chronic injury or progressive structural change. Tensile force is applied to the medial stabilizing structures with compression on the lateral compartment and shear stress posteriorly. Common injuries encountered in the throwing elbow include ulnar collateral ligament tears, ulnar neuritis, flexor-pronator muscle strain or tendonitis, medial epicondyle apophysitis or avulsion, valgus extension overload syndrome with olecranon osteophytes, olecranon stress fractures, osteochondritis dissecans of the capitellum, and loose bodies. Knowledge of the anatomy and function of the elbow complex, along with an understanding of throwing biomechanics, is imperative to properly diagnose and treat the throwing athlete. Recent advantages in arthroscopic surgical techniques and ligament reconstruction in the elbow have improved the prognosis for return to competition for the highly motivated athlete. However, continued overhead throwing often results in subsequent injury and symptom recurrence in the competitive athlete.

Your treatment choices will depend in part on whether elbow pain affects your job or livelihood. It also depends on whether you are willing or able to change habits or activities that are causing your elbow pain.

Nonsurgical treatment is usually started if the injury is:

• A result of overuse.
• A sudden (acute) injury that doesn't have large tears in the tendon or other severe damage in the elbow.

Most cases of tennis or golfer’s elbow respond to rest, ice, rehabilitation exercises, pain medication and splints. This injury does take from 6 months to 12 months to heal. Patience helps.

Surgery is considered as a last resort when:

• The injury is from a sudden (acute) injury that left large tears in the tendon or other severe damage in the elbow.
• The injury is from chronic overuse, and 6 to 12 months of tendon rest and rehabilitation haven't relieved elbow pain. (If the tendon is very weak, surgery may not improve your situation much.)
• Pain continues despite other treatment, such as corticosteroid shots or acupuncture.

Recovery of lateral epicondylitis surgery varies patient to patient. Most patients are able to return to daily activity within 3 to 6 weeks. It is very important to realize that just because your arm no longer hurts, it is not safe to engage in heavy activity or sports for 12 or more weeks. It takes a long time for the tendons to completely heal. Straining them by subjecting them to strong forces may cause delay healing, if not cause permanent damage.