Tennis Elbow Management and Prevention

Tennis elbow, also known as lateral epicondylitis.

** Make sure to consult with your physiotherapist, massage therapist or naturopathic doctor to properly diagnose this condition **

Lateral epicondylitis is a common condition that affects people who perform repetitive activities involving the wrist and forearm. While it is commonly associated with tennis players, it can also occur in people who perform repetitive strain activities with the upper extremity. The condition causes pain and tenderness on the outer side of the elbow and can make it difficult to grip or perform everyday activities.

Fortunately, there are effective treatments for tennis elbow that can help patients alleviate their pain and get back to their daily activities. In this blog post, we will discuss the current best guidelines for the treatment of tennis elbow based on research.

Exercise therapy

The goal of exercise therapy is to strengthen the forearm muscles and improve flexibility. Studies have shown that exercise therapy is effective in reducing pain and improving function in patients with tennis elbow (1).

Research based exercises

• Wrist extensor stretch: Start by holding your arm out in front of you with your palm facing down. Use your other hand to gently pull your fingers back towards your wrist until you feel a stretch in the muscles on the back of your forearm. Hold the stretch for 15-30 seconds and then release. Repeat 2-3 times on each arm.

• Eccentric wrist extension: Hold a light weight (such as a small dumbbell or a can of soup) in your hand with your palm facing down. Slowly lower the weight towards the floor, using the muscles on the back of your forearm to control the movement. Return to the starting position and repeat for 10-15 repetitions on each arm.

• Forearm pronation/supination: Hold a light weight (such as a small dumbbell or a can of soup) in your hand with your palm facing up. Slowly rotate your forearm so that your palm faces down, then rotate back to the starting position with your palm facing up. Repeat for 10-15 repetitions on each arm.

• Isometric wrist extension: Hold a small towel or resistance band in your hand with your palm facing down. Keeping your elbow bent and your wrist straight, press your hand up against the resistance of the towel/band for 5-10 seconds, then release. Repeat for 10-15 repetitions on each arm.

It is important to note that the specific exercises included in an exercise program for lateral epicondylitis may vary depending on the individual patient’s needs and goals. It is always recommended to work with a qualified healthcare professional who can create an individualized exercise program for your specific condition.

Manual therapy

Manual therapy, which includes techniques such as massage, mobilization, and manipulation, is another treatment option for tennis elbow. Manual therapy can help reduce pain and improve function by releasing tension in the muscles and improving blood flow to the affected area. Studies have shown that manual therapy can be effective in reducing pain and improving function in patients with tennis elbow (2).

Corticosteroid injections

Corticosteroid injections are a common treatment for tennis elbow. However, recent research has shown that corticosteroid injections may not be as effective as previously thought and may even have negative long-term effects on tendon health (3). Therefore, corticosteroid injections should be used with caution and only after other conservative treatments have been tried.

In summary, tennis elbow is a common condition that can be effectively treated with a combination of exercise therapy, manual therapy, and corticosteroid injections. However, corticosteroid injections should be used with caution and only after other conservative treatments have been tried. If you are experiencing pain and tenderness on the outer side of your elbow, it is important to consult with a therapist who can create an individualized treatment plan for you.

Sources

1. Bisset L, Coombes B, Vicenzino B. Tennis elbow. BMJ. 2015;350:h1212.
2. Pienimäki T, Tarvainen T, Siira P, Vanharanta H. Progressive strengthening and stretching exercises and ultrasound for chronic lateral epicondylitis. Physiotherapy. 1996;82(9):522-30.
3. Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Lancet. 2010;376(9754):1751-67.