Looking For A Tennis Elbow Cure?

Tennis elbow aka lateral epicondylitis can be one of the most frustrating injuries you can get with a common pattern of recovery anywhere between 3 months and 2 years. Pain is located on the outside of the elbow (the lateral epicondyle hence the lateral epicondylitis).  

Now whether you have 3 weeks to be able to serve pain free to win a million bucks in a Grand Slam Tennis Tournament or whether you just want to get back in the gym because the kg’s are piling on OR it is so bad you cross the street to avoid shaking your best mates hand. The management doesn’t change. It can be distilled into a few key areas

Ironically it’s actually very rare to see the dreaded tennis elbow in a tennis player.

It’s more common in a bloke (less so in women) in his 30’s to 50’s who picks up screaming kids in unorthodox positions, who sits as a desk for a profession but decides to paint the house in 48 hours, land scape the back yard or put together a house load of ikea furniture “amateurishly” 

Tennis Elbow Symptoms

It can be so annoying that if you have your arm bent for a while then try and straighten it can be really painful. People describe being asleep and getting woken up when trying to straighten their elbow. 

If you have tennis elbow and someone attempts to shake your hand, you look at them with shear terror knowing the pain you are about to receive.  Opening doors, picking up a bag or around 99,000 other activities that involve gripping with your wrist. Did I mention you can also get it from tennis? Mostly the back hand or serve if anyone is interested.

Tennis Elbow Cause

So what causes it? You can nearly always trace it to a sudden overload of something involving excessive gripping of the wrist. For example, if you decided to get on the power tools for a weekend on a background of minimal power tool use, that could do it. Or, if you were down two sets to love and decided you would keep playing tennis until you won a set. That could do it too.

Sometimes it becomes mildly uncomfortable but over a series of weeks it continues to get worse.

Actually, it normally involves the tendon of the muscles that extend your wrist. It particularly affects a little muscle called extensor carpi radialis which is designed to lock your wrist into place while you do things with your wrist. 

If the load is too much for the tendon then the tendons structure starts to change, abnormal blood vessels grow into it and the collagen makeup begins to change.

Interestingly this is also a part of the aging process and some people have it on ultrasound imaging but don’t even know they have it!

So what does that mean? In order to get better you don’t necessarily have to fix the structure of the tendon. Simply restore your pain free grip strength and mobility. 

So what is the tennis elbow cure?

Now whether you have 3 weeks to be able to serve pain free to win a million bucks or whether you just want to get back in the gym because the kg’s are piling on OR it is so bad you cross the street to avoid shaking your best mates hand. The management doesn’t change. It can be distilled into a few key areas

 Exercise

We know that one of the key ingredients to this puzzle is exercise. I know what you're thinking “but exercise actually got me into this predicament in the first place!”

The exercises we prescribe need to be pain free and start slowly. I’ve included 3 of my favourite exercises below.

Exercises should definitely not be painful. We call this good load. Bad load is when it hurts. 

Exercise 1: Isometric grip strength: This exercise must be pain free. I would recommend starting with your elbow bent in this position. Aim for 30 seconds. If this is easy, try 1 minute. The most I would recommend is 3 x 1 minute.

Here is a progression

I’d recommend doing this x 1 per day. If you are finding that is just too much try it every second day. 

Exercise 2: This is another great exercise to try but you must be able to do the first exercise pain free before progressing. Use a hammer or something similar. Do this with the arm bent at 90 degrees. Don’t attempt until you can do 3 x 1 isometric full extension and probation holds. Again, the first exercise must be 100% pain free before attempting the next one.

Exercise number 3: This is another great exercise. You can pick up one of these flex bars from the clinic. Do 2 x 6 to 8 slowly. 

You Need To Offload The Tendon

Every time you go to bend or straighten your elbow it can hurt. Normally if you were to pick something up with your elbow straight, palm down in a grip type motion it will hurt the most.

Modifying your pick up position with a bent elbow and hand in neutral will help. There are also good braces and “secret” physio taping tricks.

Braces

I’d also recommend wearing a brace like this if you have to use your elbow. This is how to apply it. We actually do a great taping in the clinic. We can teach you how to tape which is more effective in the first few weeks so if you live in the area of Sydney come in.

Is it just the elbow that’s involved?

Believe it or not there is a lot of scientific evidence to show a direct correlation in tennis elbow and pain or stiffness of the neck, shoulder and trunk!

So if your posture permanently looks like you are a security guard for mid tantrum toddlers, you walk like the tinman, or your posture “used to be” awesome but ain’t that great now you need some help.

It is also possible have a nerve get caught around your outside elbow called your radial nerve. If there is occasional burning, or a deep ache then I would consider this to be a potential nerve entrapment. 

We also use Physio techniques called MWM’s (Movement with Mobilisations) which have been shown in several studies to reduce your tennis elbow pain. 

I’d highly recommend you come and see us in our Bondi Physio or the Sydney CBD Physio clinics and we can help you with this. If you don’t live in Sydney shoot us a message and I can recommend someone else in our international Physio community.

So there you have it. You can get started on the basics of managing your tennis elbow. If you want to stop avoiding alpha hand shakes, or get back to the gym without punching out some 1kg bench presses, simply click the contact us button if you have a question OR to get rehabbing that elbow and begin the road to the French Open/Gym click the BOOK IN button!