title: Tennis elbow, natural course and relationship with physical activities: an inquiry among physicians.
abstract: BACKGROUND
  The main purposes of the study were to answer the following two questions: is a restrictive therapeutic management in case of tennis elbow (TE) better or worse than a regular therapeutic approach and do racket sports and other physical activities influence the risk to get TE and to what extent.
  
  
  METHODS
  
  
  
  METHODS
  Cross-sectional study by means of a postal questionnaire. The impression was verified that physicians are reserved about medical interventions when treating themselves for tennis elbow. The frequency of therapeutic measures and their results were compared with data reported in literature. Physical activities of physicians who had TE were compared with those of physicians who never had TE.
  
  
  METHODS
  Physicians who attended postgraduate courses on diagnosis and treatment in orthopedic medicine from 1984 to 1992.
  
  
  METHODS
  72 physicians who had TE and 266 with no history of TE.
  
  
  METHODS
  The study is based on self-assessment of therapeutic approaches and their results, reported physical activities at the onset of TE and at the moment of the inquiry. By a team of experts the grade of grasping and/or dorsiflexion of the physical activities was classified.
  
  
  RESULTS
  Compared with patients in general practice, physicians treating themselves for TE were more restrictive to use NSAID's, ointments or local steroid injections or to consult a specialist. No-one was treated with surgery and no-one interrupted her/his work because of TE. In all but two of the 72 cases the TE resolved within two years. The odds ratio for TE for playing racket sports versus not playing racket sports was 2.8 (95% confidence interval 1.64-4.82). The odds ratio for activities with low-grade grasping and/or dorsiflexion versus "no sports or hobbies" was 0.11 (0.02-0.50).
  
  
  CONCLUSIONS
  Absence from work and therapeutic measures for TE are (in physicians) not necessary for a good result on the long term. Playing racket sports increases the risk to get TE by a factor of 2.8. Performing weekly activities with low grade grasping and/or dorsiflexion of the wrist may have a protective effect against developing tennis elbow.
authors.affiliation: Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Erasmus University Rotterdam, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Mens
authors.forename: R
authors.initials: R
authors.lastname: Stoeckart
authors.forename: C J
authors.initials: CJ
authors.lastname: Snijders
authors.forename: J A
authors.initials: JA
authors.lastname: Verhaar
authors.forename: H J
authors.initials: HJ
authors.lastname: Stam
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D013716:Tennis Elbow / Q000628:therapy*; D016896:Treatment Outcome