DEAR DR. DONOHUE: I love to play tennis, but my elbow doesn’t share my love of the game. I’ve been playing since I was a teen and never had any trouble, until three years ago. For the past three years, I have gotten tennis elbow and have not been able to play more than once a month. I am 36 now. How should this be treated, and how do you prevent it? – L.M.

ANSWER: Lots of things cause elbow pain, so let’s make sure you truly have tennis elbow. Stand and let your racket-holding arm dangle at your side with the palm of the hand facing forward. With a finger of your other hand, feel the bony projection at the outer side of your elbow. That’s the lateral epicondyle, and that’s the site of pain in tennis elbow. It’s the place where the tendons of the forearm muscles attach. Those muscles are the ones that bend the wrist backward.

Constant use creates tears in the attaching tendons, and those tears are painful. That’s tennis elbow. It happens to players of all racket sports, and it happens to people who never lift a racket. Carpenters often get it.

For prevention, put warm packs on your elbows before playing. An elbow brace or a forearm brace can soften the shockwave that travels up the arm and hits the lateral epicondyle when racket meets ball. An awkward backhand swing, one where the elbow leads the arm, leads to tennis elbow.

Treatment is to rest until you’re free of pain. If you do come down with it, ice the elbow for the first day or two of pain, and then switch to hot packs. Anti-inflammatory medicine – aspirin, ibuprofen or naproxen – eases pain and reduces inflammation. A cortisone injection in the area of pain almost always brings immediate relief, but be careful: If you use the arm soon after an injection, you’ll continue to damage the tendon, and you’ll end up in worse shape than you were at the start.

DEAR DR. DONOHUE: My husband is 62. He commutes home every weekend from his job. During the week he eats in restaurants. He is about 25 pounds too heavy. He has always battled his weight.

Recently he was diagnosed with atrial fibrillation and is now on a blood thinner and heart pills.

He has stopped his exercise program. I can hardly get him to walk the dog when he’s home. He said he’s afraid to exercise.

Can he safely resume his activities? I am worried that he will gain more weight. – J.H.

ANSWER: I can’t give you a definite answer. Your husband has to ask his doctor.

I can tell you that most heart patients, including those who have had a heart attack, are encouraged to exercise. And the same goes for people with atrial fibrillation.

Inactivity does many bad things to the body and the heart. Weight gain is one thing. With weight gain comes resistance to the action of insulin. That, in turn, makes a person likely to develop diabetes. Inactivity can also lead to a rise in blood pressure. Your husband’s fear is not doing him any good unless his doctor has specifically said not to exercise.

DEAR DR. DONOHUE: My husband is 47 and has had diabetes for the past 12 years. The doctor has him on two diabetes tablets, to be taken twice a day. My husband takes only one and a half tablets. His fasting blood sugar is 235 (13 mmol/L). In the evening his sugar is 395 (22). He also takes blood pressure medicine but won’t have his pressure checked. He drinks 12 or more beers daily.

His doctor wants him to go on insulin, but my husband will not. He tells me he cannot and won’t give himself shots. He is very depressed. He has said more than once that he wants to die. I need to know what damage he has done to himself and if it is reversible. – D.R.

ANSWER: Your husband is on the fast track to a catastrophe. I can’t tell you the damage he has suffered, but I can tell you that the damage he will suffer will lead him to an early and unpleasant death.

He has to get his sugar controlled. Complications of diabetes include kidney failure, blindness, heart attack, stroke and nerve damage. The risk for those complications comes close to being eliminated with strict adherence to medicines, diet and exercise. I don’t want to belabor a point that should be self-evident.

I’d like to address your husband directly. Depression is not a matter of shame or of personal weakness. It occurs because of a glitch in the production of brain messenger chemicals. Without help, the neglect of your illnesses – diabetes, high blood pressure and depression – is going to bring irreversible changes that all but guarantee you a painful and early death. Medicines and talking with a professional can pull you out of this depression. Your family doctor can recommend one. Get in touch with the doctor today.

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. Readers may also order health newsletters from www.rbmamall.com