Treatment and Prevention Strategies for Tennis Elbow

Tennis elbow, or lateral epicondylitis, is a common condition that affects the tendons outside the elbow. It is often caused by repetitive motions that strain the forearm muscles and tendons, leading to pain and tenderness around the elbow joint. Although it’s called tennis elbow, it can affect anyone who performs repetitive arm movements, not just tennis players. At Twin Boro Physical Therapy, we focus on preventing and treating this condition to help our patients maintain an active, pain-free lifestyle.

What is Tennis Elbow?

Tennis elbow involves inflammation or micro-tearing of the tendons that join the forearm muscles to the outside of the elbow. The pain primarily occurs when the tendons of the forearm muscles attach to a bony bump on the outside of the elbow (lateral epicondyle). Pain can also spread into the forearm and wrist, leading to weakness and decreased function.

Causes and Risk Factors

The primary cause of tennis elbow is repetitive stress and overuse of the forearm muscles, which can occur during various activities, including:

• Tennis and other racquet sports
• Weightlifting
• Painting
• Typing or using a computer mouse
• Carpentry

Several risk factors can increase the likelihood of developing tennis elbow, including age (most common between ages 30 and 50), engaging in activities with repetitive arm motions, and poor technique or equipment use in sports.

Tennis Elbow Treatment Strategies

If you develop tennis elbow, several treatment options can help manage the symptoms and promote healing:

1. Rest and Activity Modification:

• Rest: To allow the tendons to heal, give the affected arm a break from repetitive activities. This may involve taking a break from sports or modifying your work activities.
• Activity Modification: Adjust your activities to reduce stress on the elbow. This could include using the opposite hand for specific tasks or employing tools designed to minimize strain.

2. Physical Therapy:

• Manual Therapy: Techniques such as massage, myofascial release, and mobilization can help reduce pain and improve mobility.
• Exercise Therapy: A physical therapist can design a personalized exercise program to strengthen the forearm muscles and improve flexibility. This might include eccentric exercises, which involve lengthening the muscle under tension, as these are particularly effective for tendon healing.
• Modalities: Various modalities, such as ultrasound, ice, and electrical stimulation, can reduce pain and inflammation.

3. Bracing and Support:

• Elbow Brace: Wearing a counterforce brace can help alleviate stress on the tendons by distributing pressure away from the affected area.
• Wrist Support: A wrist splint can limit wrist movement, reducing strain on the elbow tendons.

4. Medication and Injections:

• NSAIDs: Non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain and reduce inflammation.
• Corticosteroid Injections: In some cases, corticosteroid injections may be recommended to provide short-term pain relief, although these should be used cautiously as they can weaken the tendon over time.

5. Surgical Intervention:

• Surgery: If conservative treatments fail to alleviate symptoms, surgery may be considered. Surgical options typically involve removing the damaged tendon tissue and reattaching the healthy tendon to the bone.

Rehabilitation and Recovery

Recovery from tennis elbow can vary depending on the severity of the condition and the treatment approach. A structured rehabilitation program is essential to ensure a full recovery and prevent recurrence. At Twin Boro Physical Therapy, rehabilitation includes gradually returning to activity by slowly reintroducing activities that involve repetitive arm movements. This approach ensures that the tendons are adequately prepared for the increased demand.

Ongoing strengthening and flexibility exercises are also crucial; these exercises help maintain strength and flexibility in the forearm muscles, promoting healing and preventing future injuries. Regular follow-up appointments with your physical therapist or healthcare provider are also essential to monitor progress and adjust your treatment plan as needed. These follow-ups help ensure that the rehabilitation is on track and addresses any emerging issues promptly, facilitating a smoother and more effective recovery.

Tennis Elbow Prevention Strategies

Preventing tennis elbow involves several proactive measures, particularly for those at risk due to their activities or occupations. Twin Boro physical therapists recommend the following preventative strategies:

1. Proper Technique and Equipment:

• Technique: Ensure proper technique in sports and activities to reduce stress on the tendons. For example, using a proper grip and swing in tennis can significantly decrease the risk.
• Equipment: Use appropriate equipment that matches your strength and skill level. For instance, a lighter racquet with an appropriately sized grip can help reduce strain on the forearm muscles.

2. Strengthening and Stretching Exercises:

• Forearm Strengthening: Regularly perform exercises to strengthen the forearm muscles. Exercises such as wrist extensions, flexions, and forearm pronation and supination can build resilience in the tendons.
• Stretching: Incorporate stretching exercises to maintain flexibility and prevent tendon tightness. Simple stretches like wrist flexor and extensor stretches can be effective.

3. Ergonomic Adjustments:

• Workstation Setup: Adjust your workstation to ensure proper ergonomics. This includes setting up your computer, keyboard, and mouse at appropriate heights and angles to minimize strain.
• Tool Use: Use ergonomic tools and take frequent breaks to avoid repetitive stress injuries.

4. Warm-Up and Cool-Down:

• Warm-Up: Always warm up before engaging in repetitive arm movements. Gentle stretching and light aerobic exercise can prepare the muscles and tendons for activity.
• Cool-Down: After the activity, perform cool-down exercises to help relax and elongate the muscles.

5 At-Home Exercises

Here are a few exercises that can help prevent and treat tennis elbow:

1. Wrist Extension Stretch:

• Extend your arm in front of you with your palm facing down.
• Use your opposite hand to gently pull your fingers back towards your body until you feel a stretch in your forearm.
• Hold for 15-30 seconds, then relax. Repeat 3-5 times.

2. Wrist Flexor Stretch:

• Extend your arm in front of you with your palm facing up.
• Use your opposite hand to gently pull your fingers back towards your body until you feel a stretch in your forearm.
• Hold for 15-30 seconds, then relax. Repeat 3-5 times.

3. Towel Twist:

• Hold a rolled-up towel with both hands.
• Twist the towel in opposite directions, like wringing out water.
• Perform 10-15 repetitions in each direction.

4. Eccentric Wrist Extension:

• Hold a light weight (1-2 pounds) in your hand with your palm facing down.
• Use your other hand to help lift the weight, then slowly lower it back down on your own.
• Perform 3 sets of 10-15 repetitions.

5. Forearm Pronation and Supination:

• Hold a light weight or a small hammer in your hand with your elbow bent at 90 degrees.
• Rotate your forearm so your palm faces up (supination), then rotate it so your palm faces down (pronation).
• Perform 3 sets of 10-15 repetitions.

Get Back in the Game

Tennis elbow is a common but manageable condition with the proper prevention and treatment strategies. Twin Boro Physical Therapy is committed to helping patients achieve optimal health and functionality through personalized care and evidence-based practices. Focusing on correct technique, strengthening and stretching exercises, ergonomic adjustments, and a comprehensive treatment approach, Twin Boro can help prevent and treat tennis elbow, allowing you to continue enjoying your favorite activities without pain. For more information or to schedule a consultation, please call 1-866-407-2144 or complete an appointment request form here.