Tennis elbow, or lateral epicondylitis, can be painful, annoying and can keep your from excelling in your everyday tasks and the leisure activities that you love. Getting rid of tennis elbow and getting you back to functioning at your best is a priority at Unpain Clinic. 

Tennis elbow doesn’t just affect tennis players, it can occur in people of all ages but is more common in those between the ages of 30-50 and people who perform repetitive movements with their elbows and wrists for periods over an hour at a time.  It is also slightly more common for men to develop this condition than for women. 

What causes tennis elbow?

Tennis elbow is typically caused by an overuse injury of the extensor muscles of the forearm. Some of the most common causative activities include playing racket sports, repetitive occupational movements including those involved with using a computer mouse frequently, and jobs in plumbing, carpentry, or butchery. With overuse the tendon can develop micro-injuries leading to inflammation and pain where the extensor tendons anchor on the outside part of the elbow and even into the forearm, wrist, and hand. With too much stress, the body cannot repair the injured tissue and structural alterations of the tendon can occur, leading to chronic pain and sometimes degeneration. 

Symptoms of Tennis Elbow

Symptoms of tennis elbow include: 

• Pain that can be constant or worsen with certain movements and is located on the outer part of the elbow or sometimes into the forearm or wrist. 
• Stiffness in the elbow or wrist and occasional pain with holding a coffee cup, turning doorknobs or shaking hands. 
• Pain may be accompanied by weakness in the hands, wrists, or elbows. 

If you have any of the above symptoms and your elbow is also hot, inflamed or swollen, looks deformed, cannot be bent, or you have suffered a traumatic injury to the elbow, seek immediate medical attention.  

Diagnosing tennis elbow is generally based on clinical history and an examination performed by a physiotherapist, chiropractor, or medical doctor and does not typically require special lab tests or imaging, however your healthcare practitioner may order such tests if they feel that they are warranted. 

Tennis elbow treatment 

Untreated tennis elbow can persist for weeks or even years in some cases, but with the right treatment, healing time can be significantly reduced.  If you suffer with this condition, there are a variety of therapies available to control pain and improve your function. At Unpain Clinic in Edmonton, we work with you to customize your treatment plan for great results. 

At home treatment options include: 

• rest and reduction or modification of aggravating activities
• using ice and elevation to control inflammation
• stretching, foam rolling, ball rolling or using self-massage to release the affected forearm muscles 
• at home strengthening exercises for tennis elbow 
• the use of pain relief or anti-inflammatory medications or topicals as directed by a pharmacist or medical doctor 

In-clinic options for treating tennis elbow can include: 

• manual myofascial release or massage therapy (including some special techniques like ART, Rapid NFR, Graston or gua sha) 
• dry needling or clinical acupuncture
• ultrasound, laser therapy or TENS  
• KT or kinesio taping for tennis elbow
• the provision of orthotic devices such as braces, straps, or splints 
• shockwave therapy  

At Unpain Clinic Edmonton we love shockwave therapy for tennis elbow

Your healthcare professional will work with you to create the best treatment plan and while we offer a variety of interventions including intensive manual therapy and exercise for those in need, we find many patients respond very well and relatively quickly to shockwave therapy for their tennis elbow. Shockwave works by speeding up the natural healing process or, in some cases, re-activating it after years of dormancy.   Your own stem cells are activated, old scar tissue is removed and replaced with healthy new collagen, and blood vessels grow rapidly to improve tissue health.  Your body does the healing work, we just help it along in relatively low risk way with shockwave treatment. 

FAQs

Do I need to use a tennis elbow brace or strap? 

Bracing or using a forearm strap can help to reduce the load on the affected tendon. Using a strap on the forearm, not right at the elbow, helps to reduce pain by moving the point of tension away from the affected tendon. While bracing can be helpful, it is not mandatory. If you choose to use a brace or strap it may be helpful to consult with a healthcare professional to select one that fits correctly, is comfortable and is suited to your activities and personal needs. 

Will I need surgery to correct my tennis elbow? 

If your tennis elbow is severe and non-responsive to more conservative types of treatment, you may need to be referred to an orthopedic specialist to discuss the possibility of injections, tenotomy or surgery to treat your pain.

Do I need to stop doing the activities that I normally do? 

Activity modification or cessation may be helpful for a period of time to reduce strain on the affected extensor tendon. Tennis elbow is an overuse injury and one of the best ways to heal it is to avoid over stressing the forearm muscles, but this doesn’t mean that you will never be able to do your job or the things that you love. Our healthcare professionals educate and offer advice to their patients to guide their return to full functional participation and make activity modifications to reduce strain and prevent further injury. 

What exercises are good for tennis elbow pain? 

There are many different exercises that can be used during tennis elbow rehab and physiotherapy but some common ones include:

Forearm Flexor Stretch

• Hold your arm comfortably out in front of you with your elbow straight, palm down
• Bend at the wrist and bring your fingers up to the ceiling with your palm away from you
• Use your other hand to pull your wrist closer to your body, keeping your elbow straight out in front of you
• Feel for a stretch in your forearm and at the affected area and hold for 30 seconds or more. 
• Perform this exercise one or more times per day as needed. 

 Forearm Extensor Stretch

• Hold your arm comfortably out in front of you with your elbow straight, palm down
• Bend at the wrist and bring your fingers down to the floor with your palm facing you 
• Use your other hand to pull your wrist closer to your body, keeping your elbow straight out in front of you
• Feel for a stretch in your upper forearm and hold for 30 seconds or more. 
• Perform this exercise one or more times per day as needed. 

 Eccentric Flexion 

• Hold a small weight or soup in your hand and hang your wrist over the edge of a table or support surface
• Keep your forearm on the table and your palm facing upwards but let your wrist hang toward the floor
• Bring your wrist toward the ceiling SLOWLY and then lower your wrist down again below the level of the table. Return to your start position and repeat. 
• Perform 10-20 repetitions of this exercise once per day. 

Eccentric Extension

• Hold a small weight or soup in your hand and hang your wrist over the edge of a table or support surface
• Keep your forearm on the table and your palm facing the floor; let your wrist hang toward the floor
• Bring your wrist toward the ceiling SLOWLY and then lower your wrist down again below the level of the table. Return to your start position and repeat. 
• Perform 10-20 repetitions of this exercise once per day. 

 

Ball Squeeze

• Hold a semi-soft ball or stress ball in the palm of your hand with the tips of your fingers on the ball too
• Squeeze the ball with your fingertips and hold for a few seconds then release and repeat. You can use all your fingers or alternate and try to use one or two at a time. 
• Perform 10-20 repetitions of this exercise once per day.