Tennis elbow is an inflammatory and degenerative condition of the structures on the lateral side of the elbow. The bony prominence on the outside of the elbow is known as the lateral epicondyle which is why the formal term for tennis elbow is lateral epicondylitis. The elbow is made up of the humerus of the upper arm and the radius and ulna of the forearm. There are two main joints located near the elbow. The first one is the joint created by the articulation of the humerus and the ulna. This joint allows you to bend and straighten the elbow. The second joint lies between the radius and ulna and allows you to turn your palm up and palm down, motions known as supination and pronation respectively.

Many different muscles attach near the elbow in order to move the shoulder, elbow, forearm and hand. The muscles that extend or pull back the wrist and assist with gripping strongly attach at the lateral epicondyle and are implicated in the pain and weakness experienced with tennis elbow. Tennis elbow is considered an overuse condition in which the tendons of these extensor muscles become inflamed and may even chronically degenerate near where they attach to the bone. Tennis elbow usually occurs in those who repeatedly perform tasks that require gripping, rotating and extending the wrist whether it be for work or recreation. Some common triggers for tennis elbow include:

• Computer work and typing
• Frequent use of hand tools like screwdrivers or hammers
• Racquet sports like tennis or racquetball
• Using tools for decorating or work duties

Since not everyone who does these activities develops tennis elbow, we know that there are underlying factors that may predispose one to developing tennis elbow. Many of these factors can be targeted for treatment with physical therapy:

• Typing, playing sports or using hand tools with excessive wrist extension or poor grip strength
• Weakness in the muscles that perform these tasks or that help stabilize the wrist and elbow
• Pain, mobility limitations or weakness in nearby structures that may increase the stress and strain on the lateral elbow
• Degeneration and limited stiffness in the tendons of these muscles

If you decide to work with a physical therapist to help correct your tennis elbow issues, your entire treatment plan could consist of around 8-20+ different physical therapy for tennis elbow sessions that will each last 60-90 minutes. Once you complete your customized tennis elbow physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

PHYSICAL THERAPY TO ADDRESS TENNIS ELBOW

As mentioned above, physical therapy to address tennis elbow is a two-pronged approach. Providing symptom relief is a primary goal of physical therapy for this condition but in order to minimize the likelihood of recurrent bouts of tennis elbow, identifying underlying contributing factors and making a plan to address them is vital.

• Apply manual therapy techniques like instrument assisted soft tissue mobilization over the involved tendons to improve blood flow and encourage realignment of tendon fibers
• Perform soft tissue mobilization to stiff or tight muscles in the area to help improve their extensibility and provide symptom relief
• Use modalities like electrical stimulation or ultrasound for symptom relief and improving blood flow
• Start you on a progressive overload program for the tendons to help them heal and become more resilient against repeated forces
• Strengthen the muscles around the wrist and elbow to avoid excessive stress at the lateral epicondyle and help you return to activities without pain
• Observe how you perform the activities and movements that may have caused the tennis elbow and advise you on how to optimize or modify these movements to prevent a future episodes