Lateral Epicondylitis: What to Do About Tennis Elbow


What is it?

Lateral epicondylitis, also known as tennis elbow, is the general term for lateral pain in the elbow caused by overuse of the muscles and tendons. The name is deceiving because very few people actually get this injury from playing tennis. Some of the more common causes include yard work, prolonged use of a computer mouse or keyboard, construction work, or any other activity that involves repetitive gripping, lifting, and twisting. Pain is typically located in the meaty part of the lateral forearm or over the bony prominence at the elbow.

Once this pain is recognized, it is important to act quickly and seek physical therapy. This condition is notorious for becoming a chronic issue, which can last up to six months to a year if left unaddressed and untreated.

What can I do about it?

The first step in recovery is to cut back on the aggravating factor; in other words, back off of the activity that caused your pain in the first place. If swelling is present, ice and anti-inflammatories can help to ease the initial pain. You should always check with your physician to make sure anti-inflammatories will not interfere with any other medications you may be taking. Light stretching of the forearm extensors can be performed to decrease the tension of the muscles and tendons at the elbow. Seeking the attention of a physician or a physical therapist can help guide you the rest of the way.

What can physical therapy do?

Your physical therapist will perform range of motion, strength, and special tests to determine the precise muscles and tendons that are affected, and then they can prescribe the appropriate exercises for the stage of injury that you are in. Modalities such as ultrasound (to help improve blood flow to the injured tendons and muscles), electrical stimulation (for pain relief), and/or laser therapy (used to help increase intracellular metabolism to speed healing) can help speed along the healing process.

Your therapist will also perform soft tissue mobilization (massage) and possibly trigger point dry needling, which can be extremely effective for relieving muscle tension and improving pain and activity tolerance in a short amount of time. There can be multiple muscles involved, such as your extensor carpi radialis brevis and longus, extensor carpi ulnaris, extensor digitorum, and extensor digiti minimi. They all attach to the same bony prominence in the lateral elbow, which a skilled therapist can identify and treat.

Injury prevention is another area that your therapist can aid in. They can help examine and correct your form and mechanics during your sport or activity to alleviate the strain on your elbow. In the event of a computer-based mechanism of injury, an ergonomic assessment can be done to improve your workspace, remove the stress from your forearms, and correct overall posture. A timeline of return to sport or activity will be reviewed and established to make sure you do not re-aggravate the injury by ramping up too quickly. Weakness in the shoulder and back and wrist joint tightness or instability are other predisposing factors that can be addressed to decrease the amount of stress placed on the elbow.

Summary

Lateral epicondylitis is a very common and difficult injury to beat. No injury or person is the same, and attention needs to be placed on the specific causes and structures involved in each case. Physical therapy can be an effective way to speed healing time to get you back to the activities that you love, or back on the job as quickly as possible. Please contact your local Foothills Sports Medicine Physical Therapy location for any questions or to set up an appointment.


Michael Heidt

DPT | Civic Center Scottsdale Location