What should I do first?

Remember: This information is not intended to replace the advice of a doctor.

The hardest part was understanding what I had done to my elbow and what I should do. The sites I found said "ice it," but I wasn't sure where to ice it, how long, and what I should use to ice it with. The basic concept that seems to work is: Use heat on the forearm (to relax the forearm muscles) and ice directly on the sore elbow area (to reduce inflammation in the elbow).

The following info is from WebMD.com:

If you have tennis elbow, follow these simple steps to reduce pain and start tendon healing. A rehabilitation program such as this will prevent further injury by making your arm muscles stronger.

• Rest your fingers, wrist, and forearm muscles to allow your tendon to heal. Stop any activity that you think may be causing your elbow pain and soreness. Depending on the severity of tendon damage, you may have to avoid this activity for weeks to months.

• Ice your elbow 3 times a day for 10 minutes each time, or according to your health professional's instructions. Use an ice pack, cold pack, or even a bag of frozen peas.

• Wear a "counterforce" brace during activities that require grasping or twisting arm movements. A counterforce brace is a strap worn around your forearm just below your elbow. This brace relieves pressure on the tendon and distributes it throughout the arm. Wrist or elbow splints also may help reduce pain. Talk to you doctor before trying a splint. These braces are not a substitute for rehabilitation exercises.

• Try elevating your elbow to help ease pain and reduce swelling in your wrist or forearm.

• Take nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and any inflammation.

• Do simple warm-up and stretching exercises with your fingers and wrist to prevent stiffening of your tendons. If you have any pain, stop the exercises.

My take on what to do first if you have tennis elbow:

Realize that you have done something that has somehow damaged the connection of the tendons that connect your forearm to your elbow. Try to become aware of all the ways during the day that you put stress on that area of your arm. I was surprised how much I was clinching my arm during the day, which put stress on the elbow. Even the movement of using a mouse can add to the stress.

I remember thinking that this was never going to go away. And, I wanted to play tennis so much, it was driving me crazy. I tried to get as much information as I could so that I could play again.

Now, throughout the day, I will stretch out my arm and do some gentle rubbing of the muscles in my forearm for maybe 20 seconds or so. Then I will stretch my arm using the stretches from WebTennis' CD. It only takes a small amount of time to do the stretches and in the beginning I was icing my elbow for up to 20 minutes. That wasn't the best thing to do. You should probably ice the elbow for up to 1 minute is all.

It is going to be a process to repair the damage to your elbow. But, you will get better if you care for your elbow and take the time to learn about the best way to heal the tendon, strengthen the damaged tendons and then do what you can to prevent future injury.