Tennis elbow, also known as lateral epicondylitis, is caused by inflammation of the forearm muscles that attach to the elbow. It is usually the result of inflammation of the extensor carpi radialis brevis tendon.
Tennis elbow is an overuse injury caused by repetitive activities. Although it is common in racquet sports, it can also be seen in workplace injuries, particularly among painters, carpenters and plumbers.
The American Academy of Orthopedic Surgeons states that weak grip strength and pain and burning on the outside of the elbow are common signs of tennis elbow.
The onset of symptoms may be gradual, worsening over several weeks or months. Non-surgical treatment includes:
- rest
- ice
- nonsteroidal anti-inflammatory drugs (such as Advil or Aleve)
- exercise
- ultrasound
- reinforcement and compression
- steroid injections
Tennis elbow treatment:
“To heal a tendon you will eventually have to move and load it,” says Kelly Starrett, DPT, performance consultant at Hyperice and founder of The Ready State.
This will likely cause some discomfort as you begin to restore movement and tissue function in your elbow, and Starrett says that’s to be expected.
Starrett explains that tendons must be able to do three things: load eccentrically (absorb force), load isometrically (remain in a position under tension), and load concentrically (transmit force).
So, the first thing to do in tennis elbow, she says, is to start applying those forces to the elbow tissue. This is the goal of treating tennis elbow.
Be sure to consult your doctor or physical therapist to determine when you are ready to begin therapeutic exercises.
Exercises for tennis elbow:
1. Fist clench:
Poor grip strength is a common symptom of tennis elbow. Improving your grip strength by developing your forearm muscles can help improve your ability to perform daily activities.
Necessary equipment: table and towel
The thumb and fingerlong flexor tendons were among the muscles used.
Place your forearm on the table as you sit down.
Take hold of a ball or towel that has been rolled up.
Take a handful of the towel and hold it there for ten seconds.
Release and repeat 10 times. Repeat with the other arm.
2. Supination with a dumbbell:
The supinator muscle is a large muscle in the forearm that attaches to the elbow. It is responsible for raising the palm of the hand and is often involved in movements that can cause tennis elbow.
For all the supination exercises listed below, it is recommended to first practice isometric supination without weights: with the elbow fixed, rotate the palm of your hand upwards and hold it for about 30 seconds.
Equipment needed: Table and 1-pound dumbbell
Muscles worked: supinator muscle
Sit in a chair, holding a 2-pound dumbbell vertically in your hand, with your elbow resting on your knee.
Let the weight of the dumbbell help you rotate your arm outward, turning your palm up.
Rotate your hand in the opposite direction until your palm is facing down.
Repeat 20 times on each side.
Try to isolate the movement from the lower arm, keeping the upper arm and elbow still.
3. Wrist extension:
The wrist extensors are a group of muscles responsible for flexing the wrist, such as when making the hand signal for “stop.” These small muscles that connect to the elbow are often subjected to overuse, especially during racquet sports.
Equipment needed: Table and 2-pound dumbbells
The muscles worked: wrist extensors
Sit in a chair, holding a 2-pound dumbbell in your hand, palm down. He rests his elbow comfortably on his knee.
Keeping your palm facing down, extend your wrist by bending it towards your body. If it’s too challenging, perform the movement without weight.
Return to starting position and repeat 10 times on each side.
Try to isolate the movement from the wrist, keeping the rest of the arm still.
4. Wrist flexion:
The wrist flexors are a group of muscles that work opposite to the wrist extensors. These small muscles that connect to the elbow are also subject to overuse, which can cause pain and inflammation.
Equipment needed: Table and 2-pound dumbbells
Muscles worked: wrist flexors
Sit in a chair, holding a 2-pound dumbbell in your hand, palm facing up. He rests his elbow comfortably on his knee.
Keeping your palm facing up, flex your wrist and bring it towards your body.
Return to starting position and repeat 10 times on each side.
Try to isolate the movement from the wrist, keeping the rest of the arm still.
5. Towel twist:
Necessary equipment: towel
Muscles worked: wrist extensors, wrist flexors
Sit in a chair, holding a towel in both hands, with shoulders relaxed.
Rotate the towel with both hands in opposite directions, as if you were wringing out water.
Repeat 10 times, then repeat 10 more times in the opposite direction.
Precautions:
Always consult a doctor before starting an exercise program. It is important to get a complete evaluation to rule out a serious injury such as a torn muscle or tendon.
Do not begin activities until the inflammation has subsided, as activity can aggravate the condition. If pain returns after activity, rest and ice your elbow and forearm, and consult a physical or occupational therapist to ensure you are performing the exercises correctly.
Often, changing the way you do a daily activity can help reduce symptoms. Your therapist can help you determine which movements may be causing pain.
Physical therapy for tennis elbow:
“Tennis elbow is common among athletes who participate in racquet sports, such as tennis and squash, due to the high, repetitive forces these sports place on the wrist extensor muscles,” says Rami Hashish, PhD, DPT.
Hashish is the founder of the National Biomechanics Institute and the founder and chief technology officer of pareIT. He says the basic goal of physical therapy is to help restore function by managing inflammation and pain.
“The approach is to use exercise to help improve the strength, flexibility and endurance of the affected muscles and tendons,” he says. Other techniques, such as ice massage, electrical stimulation, or bracing, can also help control pain and inflammation.
According to Hashish, strengthening exercises that help treat tennis elbow include some of the moves listed above, such as weight-bearing wrist extension, weight-bearing wrist flexion, and weight-bearing wrist rotation, as well as ball squeezes and the twisting of the towel.
Additionally, stretching the wrist extensors and flexors also improves the flexibility of these muscle groups.
According to Hashish, for weighted wrist flexion and extension, you need to keep your elbow at about 90 degrees, hold a weight in your hand, raise your hand, and then slowly lower it.
In the case of wrist extension, you rotate the palm of your hand downwards, while in wrist flexion, you rotate it upwards.
Weighted wrist rotation has a similar setup, but instead of raising your hand, Hashish says, you now rotate your wrist from a position where your palm faces down to a position where your palm faces up.
The bottom line:
If you’ve had tennis elbow in the past or are recovering now, try these exercises to strengthen your forearm muscles and improve their function. Strengthening your muscles and avoiding repetitive movements can go a long way in helping you avoid this problem in the future.