Only tennis players get tennis elbow, right? Nope. Medically known as lateral epicondylitis, tennis elbow plagues athletes and anyone who engages in repetitive arm, elbow, and wrist movements. It’s a form of tendonitis that causes pain and tenderness on the outside of the elbow, stemming from overuse of the forearm muscles. So, how do you recognize it, and what can you do about it?

Symptoms to Watch For

Pain & Tenderness

• Localized Pain: The most common symptom is pain on the outside of the elbow, where the tendons of your forearm muscles attach to the bony prominence (lateral epicondyle). This pain may also radiate into the forearm.

• Tenderness: The area around the lateral epicondyle may be tender to the touch.

Pain Exacerbated by Specific Movements

• Gripping Motions: Pain can increase when gripping objects, even light weight ones, making it difficult to hold a coffee cup, turn a doorknob, or shake hands.

• Wrist Movements: Extending or flexing the wrist, especially against resistance, can aggravate the pain, including lifting, using tools, or even basic wrist movements.

Stiffness

• Elbow Stiffness: You may experience stiffness in the elbow, especially in the morning or after periods of inactivity, making it difficult to extend your arm fully.

Weakness

• Forearm Weakness: There might be a noticeable weakness in the forearm, affecting your ability to perform tasks that require gripping or lifting.

• Reduced Grip Strength: You may find it harder to grip objects firmly, impacting daily activities and work tasks.

Other Symptoms

• Numbness or Tingling: Although less common, some individuals may experience numbness or tingling sensations extending from the elbow down to the fingers, particularly the ring and little fingers.

While symptoms of tennis elbow can impact your ability to perform daily activities, they typically do not cause night pain. However, the severity of these symptoms can vary from person to person, ranging from mild discomfort to severe pain that limits even simple tasks.

At-Home Management Strategies

While severe cases of tennis elbow may require professional medical intervention, many find relief through at-home exercises and tips. Here are several strategies to manage tennis elbow effectively:

1. Rest

Rest is crucial for healing tennis elbow because the condition is caused by overuse and strain of the forearm muscles and tendons. Continuing to engage in the activities that caused the condition can lead to further damage and prolonged recovery.

• Activity Modification: This doesn’t necessarily mean complete immobilization of the arm but instead avoiding or modifying the activities that exacerbate the pain. For instance, if playing tennis is causing pain, you should take a break from the sport or reduce the intensity and frequency of play.

• Ergonomic Adjustments: For those whose work involves repetitive hand and wrist motions, ergonomic adjustments can help. This might include using a more supportive mouse or keyboard, adjusting the height of your chair and desk, or using tools designed to reduce strain on the forearm.

2. Cold Therapy

Applying ice to the affected area is a tried-and-true method for reducing inflammation and numbing pain. The cold helps decrease blood flow to the area, which can reduce swelling and inflammation.

• How to Ice: Use an ice pack, a bag of frozen peas, or a towel soaked in cold water and wrung out. Apply the ice pack to the outside of your elbow and forearm, covering the sore and tender area.

• Duration and Frequency: Apply ice for about 15-20 minutes. You can do this several times daily, especially after activities that aggravate your symptoms. Place a protective layer (like a thin towel) between the ice pack and your skin to prevent ice burn.

• Combination with Other Treatments: While icing, you can gently stretch or massage the area (unless it increases pain) to help alleviate symptoms. However, it’s best to consult a healthcare professional or a physical therapist for specific guidance tailored to your condition.

3. Stretching

Stretching exercises are an essential part of the rehabilitation process for tennis elbow. These exercises help improve flexibility, reduce stiffness, and increase the range of motion in the affected arm:

Wrist Extensor Stretch

• Extend your affected arm in front of you with your palm facing down.

• Use your other hand to gently press down on the fingers of your extended hand so your wrist bends towards you.

• Hold this position for 15 to 30 seconds, feeling a stretch on the top of your forearm.

• Relax and repeat 2 to 3 times.

Wrist Flexor Stretch

• Extend your affected arm in front of you, but this time with your palm facing up.

• Use your other hand to gently pull back on the fingers of your outstretched hand so your wrist and fingers point up towards you.

• Hold this position for 15 to 30 seconds, feeling a stretch on the inside of your forearm.

• Relax and repeat 2 to 3 times.

Elbow Bend

• Stand straight and lower your arm to one side.

• Slowly bend your arm upwards until your hand touches your shoulder.

• Hold this position for 15 to 30 seconds.

• Relax and repeat 2 to 3 times. This helps to stretch the muscles and tendons around the elbow gently.

Wrist Turn

• Extend your arm in front of you with the elbow straight and palm facing up.

• Slowly turn your wrist until your palm faces down.

• Hold each position (palm up and palm down) for 15 to 30 seconds.

• Repeat 2 to 3 times. This exercise helps increase the flexibility of the wrist muscles.

Towel Twist

• Hold a towel with both hands shoulder-width apart, and extend your arms in front of you at shoulder height.

• Twist the towel by moving your hands in opposite directions as if you were wringing out water. Perform the twist with both hands so each hand gets the movement of both inward and outward rotation.

• Hold each twist for a few seconds, then relax and repeat several times. This exercise simulates the action of wringing, which stretches the forearm muscles differently.

Stretching Tips

• Gentleness: Stretch gently and slowly; the stretch should feel tension but not pain.

• Consistency: Perform these stretches regularly, ideally 2-3 times daily, especially before and after any activities that could strain your forearm.

• Breathing: Breathe normally while stretching. Do not hold your breath, as this can create muscle tension.

• Progression: As your symptoms improve, gradually increase the duration and intensity of the stretches, but always within a comfortable and pain-free range.

4. Strengthening

Strengthening the forearm, wrist, and elbow muscles helps support the tendons, reducing pain and preventing future injuries. Start the exercises when the acute pain subsides to avoid aggravating the condition. Here are several effective strengthening exercises for tennis elbow:

Wrist Extension

• Sit at a table with your forearm resting on the table, palm down, and wrist just beyond the edge.

• Hold a light weight (like a small dumbbell or a water bottle) in your hand.

• Slowly lift the weight by extending your wrist upwards, then lower it back down.

• Perform 2-3 sets of 10-15 repetitions. Increase the weight as the exercise becomes easier and pain permits.

Wrist Flexion

• Similar to the wrist extension exercise, but with the palm facing up.

• Hold a light weight, bend your wrist upwards, then slowly lower it.

• Perform 2-3 sets of 10-15 repetitions. Gradually increase the weight as your strength improves.

Grip Strengthening

• Use a soft tennis ball or a similar stress-relief ball.

• Squeeze the ball in your hand as hard as possible without causing pain.

• Hold the squeeze for a few seconds, then release.

• Repeat 10-15 times, and do 2-3 sets. This exercise helps to strengthen the muscles involved in gripping.

Pronation & Supination

• Sit with your elbow bent at 90 degrees and your forearm pointing upwards, holding a light dumbbell or a hammer with your hand.

• Without moving your elbow, turn your forearm so that your palm faces down and then up.

• Perform 2-3 sets of 10-15 repetitions. This exercise strengthens the muscles that rotate the forearm.

Elbow Extension

• Stand or sit with your arm bent in front of you, holding a light weight in your hand.

• Slowly straighten your arm, lifting the weight towards the ceiling.

• Slowly lower the weight back to the starting position.

• Perform 2-3 sets of 10-15 repetitions. This exercise targets the muscles around the elbow, improving their strength and flexibility.

Important Tips

• Warm-Up: Always start with a warm-up, including gentle stretching, to prepare the muscles for exercise.

• Pain-Free: Perform all exercises within a range of motion and with a weight that does not cause pain. If an exercise causes pain, stop immediately.

• Progress Slowly: Increase the weight and the number of repetitions gradually to avoid overloading the muscles.

• Consistency: Regularly performing these exercises, ideally daily or every other day, is crucial to building strength and preventing the recurrence of tennis elbow.

• Cool Down: Finish with gentle stretching exercises to cool down the muscles and improve flexibility.

5. Use of a Brace or Strap

Wearing a brace or strap can alleviate the symptoms associated with tennis elbow. They are designed to reduce the strain on the affected tendons and muscles, providing support and stability to the elbow area during activities. Here’s a deeper look into how these braces or straps work and tips for using them:

Types of Braces for Tennis Elbow

• Counterforce Brace: A counterforce brace is a strap that wraps around the forearm just below the elbow. It works by applying pressure to the muscles of the forearm, distributing forces away from the tendon’s point of attachment to the lateral epicondyle, thus reducing strain on the tendons.

• Elbow Sleeve: Some people may prefer an elbow sleeve, which provides compression and warmth to the entire elbow area. A sleeve can help reduce pain and swelling, though it may not specifically target the muscles and tendons affected by tennis elbow as precisely as a counterforce brace.

Tips for Using a Brace or Strap

• Proper Placement: A counterforce brace should be placed about 1-2 inches (2.5-5 cm) below the elbow on the forearm. The placement can vary slightly depending on where you feel the most relief.

• Adjustment: The brace or strap should be tight enough to apply pressure but not so tight that it cuts off circulation or causes numbness. Adjust the tightness depending on the activity or level of discomfort.

• Wear During Activities: Wear the brace during activities that could aggravate your tennis elbow. However, please don’t wear it constantly to avoid dependency or weakening of the forearm muscles.

• Complement with Exercises: While a brace can help relieve symptoms, use it with other treatments, such as stretching and strengthening exercises, to manage tennis elbow effectively.

• Consult Healthcare Professionals: Consult a healthcare professional or physical therapist before using a brace or strap. They can advise on the appropriate type of brace and ensure it fits correctly.

Considerations

• Duration of Use: The length of time you should wear the brace each day will depend on your specific situation and the advice of your healthcare provider. Generally, use the brace during periods of activity that strain the elbow, but don’t wear it all day.

• Skin Care: Ensure the area under the brace stays clean and dry to prevent skin irritation.

• Limitations: A tennis elbow brace or strap can be valuable in managing symptoms and aiding recovery. It’s most effective, though, when combined with a comprehensive treatment plan, including physical therapy, exercises, and modifications to activities that may contribute to the condition.

Tennis elbow can be frustrating and painful, but with the right management strategies, many people can find relief and prevent recurrence.

If you are experiencing tennis elbow, please reach out to us to see how we can help. We can develop a personalized treatment plan that meets your needs and enables you to get back to living your life to the fullest.