Tennis Elbow: How Can it be Treated?
By Kyle Bailey, SPT
What is Tennis Elbow?
Lateral epicondylitis, or tennis elbow, is one of the most reported complaints of elbow pain. The cause of tennis elbow and treatment options are unique to each patient.
Tennis elbow is pain or discomfort coming from the common extensor tendon in the lateral portion of the elbow. This is the tendon in the outside of your elbow that connects all the muscles that straighten your fingers and extend your wrist and hand to the bottom part of your humerus/upper arm. The onset of this pain, especially with athletes, can come from overloading these extensor muscles eccentrically, meaning overloading and resisting the muscles as they work to relax and let the fingers and wrist be flexed. More commonly, the onset of pain may come from highly repetitive actions that involve gripping or working with loads over 20kg for more than 2 hours.
How Can it be Treated?
The treatment of tennis elbow is not clear cut. Much research needs to be done to solidify an approach that works on the majority of patients, however, there is an abundance of research that provides methods in which a physical therapist can personalize treatment to a given patient. Most patients presenting with symptoms of tennis elbow, or any musculoskeletal issue for that matter, will present in a slightly different manner or have deficits that affect their ability to properly recover in different ways.
Manual Therapy for Tennis Elbow
A physical therapist can use techniques called manual therapy as a part of the program created to treat tennis elbow. These techniques can include, but are certainly not limited to:
- Radial nerve stretching and gliding
- Joint mobilizations
- Myofascial release
- Deep Transverse Friction
- Muscle Energy Technique
- Trigger Point Release
These techniques alone can aid in the treatment of tennis elbow, but alone will not be enough to eliminate the presenting symptoms. They will, however, provide relief and aid in promoting full range of motion to the elbow so that strengthening exercises can be performed as efficiently as possible.
Exercises
There are far too many exercises that will help to regain overall strength to the affected area to list them all out here. Three types of exercises that have received positive clinical evidence for being effective at reducing pain and increasing strength are:
- Eccentric Contractions
- Gyroscopic Exercises
- Flexbar Exercises
Eccentric contractions may seem counterproductive seeing as it is a potential reason for developing tennis elbow, but research shows that by adding stress to the extensor tendons through exercise, it can stimulate the body to strengthen the region, making the tendon more resistant against overload. Gyroscopic exercises have shown to improve strength and reduce pain symptoms in not only tennis elbow, but also shoulder impingement. A handheld device is used to provide rotational forces that the patient must continue, which can provide grip strength and stability. The flexbar has been shown to have similar effects in that these exercises can help to reduce pain and increase strength when used concentrically, eccentrically, in pronation, and supination (flexion, extension, rotating inward, and rotating outward with the wrist and forearm).
Capital Area Physical Therapy provides analysis and treatment for all types of elbow, shoulder and tendonitis pain and injury. Contact us at 518-289-5242 to make your appointment at one of our clinic locations.
