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Recognizing and Rehabilitating Tennis Elbow

Posted by Romano Sulit, PT, FCAMPT, CGIMS on 10 August 2015
Recognizing and Rehabilitating Tennis Elbow

The majority of everyday tasks and sport activities require us to use our wrists and hands. Certain activities such as turning doorknobs, lifting groceries, or playing sports such as tennis require adequate arm strength and proper technique.

Occasionally, the outer part of the elbow becomes painful and tender, usually as a result of a specific strain, overuse, or a direct bang. Sometimes no specific cause is found. 

We'll discuss the details on 'tennis elbow', or Lateral Epicondylitis, and the factors that contribute to this pain as well as the rehabilitation for this condition.

How Do I Know If I Have Tennis Elbow?

  1.     Recurring pain on the outside of the upper forearm just below the bend of the elbow; occasionally, pain radiates down the arm toward the wrist.
  2.     Pain caused by lifting or bending the arm or grasping even light objects such as a coffee cup.
  3.     Difficulty extending the forearm fully (because of inflamed muscles, tendons and ligaments).
  4.     Pain that typically lasts for six to 12 weeks; the discomfort can continue for as little as three weeks or as long as several years.

How Does Lateral Epicondylitis Occur?

Although called tennis elbow, lateral epicondylitis is much more common in people who are over-using their arm doing something else.

The most common cause is over-use of the muscles which are attached to the bone at this part of the elbow. These are the muscles which pull the hand backwards (the wrist extensors). All the extensor muscles of the hand attach to the elbow at the outer part (the lateral epicondyle). If they are strained or overused they become inflamed, which means they are swollen, painful and tender to touch.

Sometimes the inflammation is caused by a direct injury or bang. Sometimes, especially when the cause is direct injury or strain, the muscles are actually partially torn.

The problem can occur partly or completely due to a neck problem, which is causing pain in the elbow via the nerves from the neck.

What Can I Expect from Rehabilitation?

Lateral epicondylitis is a common and often lingering pathologic condition. It is critical, therefore, that you progress your rehabilitation only when you experience minimal or no pain.

As a general guideline, the more chronic or longer you have experienced the condition, the longer the recovery time is to be expected.

What Kind of Rehabilitation is Appropriate for Epicondylitis?

Phase 1  Decrease inflammation and pain, promote tissue healing, and retard muscle atrophy.
               (Education, RICE principle, Manual therapy and modalities)

Phase 2  Improve flexibility, increase strength and endurance, increase functional activities and return to function.
               (Stretching and Strengthening of forearm musculature)

Phase 3  Improve muscular strength and endurance, maintain and improve flexibility, and gradually return to prior level of sport or high level activity.
               (Progressive return to functional activities - sport, work, daily activities)

Your therapist can also provide information on bracing, taping and equipment modification.

Experiencing tennis elbow, or other chronic sports injuries? SEMI Sport Clinics provides a range of services for all of an athlete's needs - sports massage therapy, sports physiotherapy, kinesiotaping, and more! Contact us to see how we can help get you back to playing the sports you love!


Romano Sulit, BSc(Hons), MScPT

Printed: August 2006
Copyright ©2006 SEMI
Author: Romano Sulit, PT, FCAMPT, CGIMS
About: Physiotherapist
Tags: Treatment options Performance


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