Tennis Elbow

Tennis elbow or lateral epicondilitis is a very common injury of the elbow. It is most commonly caused by repetitive gripping or lifting objects while the palm is facing downward. The injury predominantly effects the extensor muscles of the forearm which travel from the elbow attaching to the lateral epicondyle which is generally the point of extreme tenderness for the injury and extends down to the fingers.

Over time the extensor muscles tighten from overuse as they are loaded again and again with lifting or gripping. Without the proper stretching or rehabilitation exercises this muscle tightness begins to produce excessive pressure at the tendon. Over time this tendon will begin to degenerate and thats when pain is developed secondary to the inflammatory process.

Another common way to develop the injury is from a trauma to the area either from a sudden jerk in motion such as trying to catch a heavy object as it falls or by being hit directly on the extensor muscles which may cause a tear. The tear then changes the mechanics of the muscle and again the tendon is overloaded.

For many athletes this may significantly limit their ability to train as the ability to grasp simple objects becomes increasing difficult and upper limb strength may quickly diminish.

There are however several stretches which can quickly manage the symptoms of tennis elbow to limit the injuries progression and are the ideal prehab exercises in maintaining elbow health.

The simplest of the exercises are forearm stretches. There are two specific ones. One for the extensor muscles and one for the flexor muscles. I recommend holding for 30 seconds at a time. If you feel an injury coming on or pain at the elbow doing this multiple times throughout the day is ideal.

If the injury has begun the degenerative process around the tendons attachment point at the elbow further care will be required. At Elite our providers use a range of modalities in managing this as well as functional assessment of the entire upper limb as this injury may occasionally be secondary to another older injury and be loaded up from a compensation.

The modalities used in the treatment of this injury range from soft tissue management most commonly with active release technique, dry needling, strapping, joint mobilisation, neural mobilisation and rehabilitative exercises.

After the first week of treatment and the soft tissues have been released the next protocol in managing tennis elbow is to rehabilitate the degenerated tendon. There is strong evidence in the literature showing that eccentric exercises while loading the tissue with light weight is most effective. The providers are at Elite are well trained in this and will help tailor a rehab program suited with the patient's training and work habits. The video below is an example of one such exercise.

Treatment can range from 2-6 weeks depending on how chronic the condition is. In some chronic cases a referral for ultrasound guided cortisone injection is required however this is uncommon and most cases can be managed conservatively.