DEAR DR. DONOHUE: I am 50 and took up tennis only last year. I love it, but it doesn’t love me. I am headed again this year for tennis elbow. Why does this happen, and what is the best way to treat it? – B.P.

ANSWER: Tennis elbow is a bad name. Only about 10 percent of those with tennis elbow are tennis players. It can happen to carpenters, plumbers and anyone required to perform repetitive arm motions.

To make sure we are on the same page, stand with your arms at your sides and with palms facing forward. With your good arm and hand, feel for the small, bony prominence at the side of your elbow – the side not touching the body. That’s the lateral epicondyle, and that’s where the trouble lies.

From the epicondyle come tendons to the forearm muscles, the ones that bend your wrist so the palm faces forward. Those muscles are the ones used when hitting a backhand stroke. Overuse of those muscles produces small tears in the tendon attaching them to the lateral epicondyle. Added to overuse is improper hitting technique. The tennis player is holding the racquet too tightly and is hitting a backhand stroke improperly.

The battered tendons are not getting enough time to heal. A person with tennis elbow not only has to hang up the racquet but has to enter into a program that fosters tendon healing.

If the pain is only a day or two old, then application of ice to the lateral epicondyle will relieve pain and keep inflammation to a minimum. After two days of icing, switch to heat. Apply heat three times a day.

You can use a heating pad or submerge your elbow in warm water.

Take anti-inflammatory medicines if you have no contraindications for taking them, such as stomach pain or previous ulcer.

If faithfulness to this program brings no progress, you should see your doctor, who can inject cortisone into the painful area.

To prevent tennis elbow, invest in some lessons with a pro. A change of technique can be the best way to prevent recurrences. Adopting a two-handed backhand is another way to protect the elbow.

DEAR DR. DONOHUE: I am a 75-year-old woman with a friend who takes Pilates exercise classes. She’s been trying to talk me into taking them, too. I haven’t exercised for 30 years, and I wonder if I could get any results from these exercises. My doctor says I can safely join the class. What do you think? – R.M.

ANSWER: You wonder what I’m going to say? I say take the class. Your doctor has given you permission, so your age and lack of exercise are not contraindications to your participation.

For readers unfamiliar with Pilates exercises, they are a group of 500 exercises during which participants change from one exercise position to the next with slow, fluid movements. Not all 500 exercises are done in one session.

These exercises keep your joints limber and increase strength. They strengthen bones by warding off osteoporosis. That, in turn, prevents broken hips. They also restore a sense of balance, something that evaporates with time.

A class with an instructor is perfect for a beginner. The instructor can spot any deviations from proper technique and provide the stimulus to keep at it.

Another selling point is that these exercises are not too strenuous for a 75-year-old woman who has not exercised for 30 years.

DEAR DR. DONOHUE: I take a three-mile walk at least three times a week. I do not have breakfast until after the walk. Is not eating defeating the purpose of walking, since my metabolism rate is not working? – S.R.

ANSWER: Your metabolism works fine without food in your stomach. Furthermore, the metabolic rate stays elevated for quite some time after exercise. You are covered on that front, too. If you think you cannot burn calories without food in the stomach, stop worrying. We all have plenty of fuel for exercise in calories stored as carbohydrate and fat.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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