An Overview of Tennis Elbow Symptoms & Treatment
Tennis elbow is a painful condition of the arm that occurs when the tendons in the elbow become overloaded or inflamed. Also known as lateral epicondylitis or epicondylopathy, tennis elbow is a condition that affects many people – and is not just associated with playing tennis.
Any person, athlete or otherwise, who performs repetitive or stressful activities with the hand or arm is at risk for developing tennis elbow. Certain people, like plumbers, carpenters, butchers, painters, house cleaners, and even baristas who use their arms in specific ways for extended hours during the workday, are especially prone to this condition.
In this article, we will talk more in-depth about tennis elbow and ways to manage this common but uncomfortable condition.
Why is it Called Tennis Elbow?
Tennis elbow is the common phrase for lateral epicondylitis when the tendons that attach to the bony prominence at the elbow become inflamed or suffer microtears. Tennis players, when performing a backhand stroke, experience forces that place the tendons of the elbow in a position of strain. Indeed, tennis players commonly experience symptoms of lateral epicondylitis, so often that the painful condition became known as “tennis elbow”. As stated, however, there are many more daily or work activities that can cause this condition.
What are Tennis Elbow Symptoms?
Most of the time, tennis elbow symptoms begin with pain at the outside of the elbow that sometimes radiates into the forearm or wrist. Some people describe a feeling of weakness that accompanies the pain. Often a person will feel discomfort in everyday activities like turning a doorknob or picking up a gallon of milk. Pain can range from a mild dull ache to a burning sharp pain and tends to get worse over time without intervention. Additionally, using a forceful grip in any activity can reproduce symptoms of tennis elbow. Opening a tight jar, for example, can cause this associated pain.
How is Tennis Elbow Diagnosed?
Tennis elbow diagnosis usually occurs after a thorough history and physical exam by a medical professional. Outer elbow pain and tenderness are the hallmark symptoms, and when combined with a history of repetitive activity, tennis elbow certainly comes to the forefront of possible diagnoses. Patients rarely need X-rays or MRIs for diagnosis unless symptoms are atypical or not responding to activity modification or treatment.
What Are Some Tennis Elbow Treatments?
There are many effective tennis elbow treatments that can improve symptoms and allow a return to normal daily activities and sports.
Following here are some of the most common:
Stretches for Tennis Elbow
There are two main stretches for tennis elbow, with the first one pinpointing the involved tendon of tennis elbow. Do both stretches, if possible, to maintain balance in the surrounding musculature, but if either causes increased pain, stop, and see a professional.
Wrist Extensor Stretch
Fully extend your arm, with the elbow outstretched straight in front of you and your palm facing down. With the opposite hand, apply gentle pressure on the back of your outstretched hand, causing your wrist to flex. You should feel a pulling across the top of the forearm, possibly all the way up to the elbow. Hold for 15 seconds and repeat 3 times.
Wrist Flexor Stretch
Again, fully extend your arm with the elbow straight, but this time start with your palm up, and gently push fingers down with your opposite hand, extending your wrist until you feel a stretch in the top of the forearm. Hold the stretch for at least 15 seconds and repeat 3 times.
Exercises for Tennis Elbow
Wrist Curls
Sit at a table with your hand resting over the side and holding a small weight in your hand (1 or 2 lbs. is fine). Start with your palm up. Slowly raise your hand, curling at the wrist, moving through your full available range. Lower slowly and repeat 10 times.
Wrist Extension
Similarly, you will want to work the muscles opposite the flexors in the forearm by doing the same exercise as above but starting with your palm facing down. Holding the dumbbell, slowly extend your wrist back towards the arm, then lower gently allowing the wrist to move through its full range of motion. It will end in a flexed down position. Repeat 10 times, moving slowly and monitoring for any sharp pain.
Tyler Twist
This exercise requires the use of a Theraband Flexbar and is clinically proven through research to reduce tennis elbow pain and dysfunction. Begin with your affected elbow at your side, forearm pointing forward, and wrist extended. Grasp one end of the Therabar so that it is pointing upward. With your other palm facing away from you, wrist extended, thumb pointing down, grasp the top side of the Therabar. As you stabilize the Therabar with your affected hand, twist with your upper hand forward so that your knuckles line up. Fully extend both arms so you are holding the Therabar directly in front of you. Slowly (at a count of four seconds) allow the Therabar to uncoil by rolling your affected wrist. When the bar has completely uncoiled, release it with the unaffected hand and reset. Perform as directed. Allow 30-60 seconds of rest in between each of the three sets. This exercise is a little more involved and should be monitored by a professional.
Rotator Cuff and Scapular Muscle Strengthening
For most patients with tennis elbow, one of the root causes is weakness of the muscles of the shoulder or rotator cuff and of the muscles that control the scapula or shoulder blade. This weakness leads to overuse of the forearm musculature when using the arms and hands and causes excessive stress on the extensor tendons. Therefore, in most cases patients will also need exercises that target strengthening of these particular muscle groups. There are many different types of exercises that include free movement patterns, therabands for resistance and even kettlebells.
Kinesiology Tape for Tennis Elbow
Kinesiology, or KT tape can be a helpful additional treatment for tennis elbow providing comfortable support and decreasing pain in the injured area. Kinesiology tape is great for athletes because it allows for excellent range of motion but gives cues to the body to help minimize potentially harmful positions. Non-athletes also can see benefits from kinesiology taping with no known side effects, so it can become an important part of your treatment plan for tennis elbow recovery.
Your chiropractor or medical professional can apply kinesiology tape in between treatments to help with symptoms and promote healing. It is difficult to do yourself, especially positioning the tape properly for optimal benefit, so see your chiropractor if you want to find out more about this intervention.
Myofascial Release for Tennis Elbow
It is natural to guard a painful area, perhaps not moving as much when you are injured, but this response itself can lead to further tightening of the body’s tissues, formation of scar tissue and decreased blood flow. Deep tissue massage or myofascial release can help loosen tight structures surrounding the elbow, improve blood flow and reduce the formation of scar tissue helping to relieve symptoms of tennis elbow. Active Release Technique (ART) and Instrument-assisted soft tissue mobilization have both shown to be very effective in treating tennis elbow.
Active Release Technique (ART) for Tennis Elbow
Active Release Technique (ART) is a state-of-the-art soft tissue method that focuses on relieving tissue tension via the removal of fibrosis/adhesions which can develop in tissues as a result of overload due to repetitive use. It is very effective in treating tendinopathies such as tennis elbow and is a vital tool in full recovery. Typically the treatment is done prior to doing exercise to decrease fibrosis or scar tissue and to increase blood flow to promote healing.
Instrument-Assisted Soft Tissue Techniques
A specialized form of myofascial release can treat tennis elbow by using a soft tissue tool, or instrument. Using these specialized tools, your chiropractor can apply deep, targeted pressure, often in a scraping motion, to release muscles and fascia that are resistant to deep tissue massage alone. Most people who have heard of this technique have heard it called Graston Technique, named after the original founder. It significantly increases blood flow and can sometimes be even more helpful in the reduction of scar tissue formed by repetitive microtrauma. Again, consult with your doctor to see if you are a candidate for this intervention.
Acupuncture for Tennis Elbow
In certain cases, acupuncture or dry needling can provide some relief and improve blood flow to the sore and tight muscles of the elbow. Consult with your chiropractor to see if this service is offered and appropriate for your case.
Tennis, anyone?
When tennis elbow strikes there are many effective interventions that can position you back on the road to recovery. By consulting with your chiropractor, you can make a customized plan on how to best treat your symptoms and discuss any activity modifications you may need to make, at least temporarily.
Don’t let the arm pain and tightness persist. With some simple exercises and stretches, as well as customized professional interventions, your tennis elbow symptoms can resolve as you get back to enjoying your everyday activities without pain.
If you feel you need to see a professional about your tennis elbow pain and are in the New York City area, schedule a consultation with one of our Chiropractors in Brooklyn, NY. Just give us a call or start by filling out the form below.