What Is Tennis Elbow?

Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow that occurs from overuse. The tendons that attach muscle to bone become overloaded from the repetitive motion of the arm and wrist, leading to inflammation, degeneration, and pain. While the condition does happen to tennis players, many other sports, activities, and professions also cause tennis elbow. What is tennis elbow, and how can it be treated to improve function and relieve discomfort?

Elbow Anatomy

To understand why tennis elbow occurs, it’s helpful to know a bit about the anatomy of the elbow.

The elbow is a hinged joint made up of three bones: your upper arm bone (humerus), and the two bones of your forearm (ulna and radius.) Muscles, tendons, and ligaments, support the elbow joint and hold it together.

The lateral epicondyle is the pointy bump that sticks out on the side of your elbow. Medically, tennis elbow is termed lateral epicondylalgia (or -it is, termed for the stress of muscles pulling on the lateral epicondyle.

Tennis elbow involves these muscles and tendons which support the wrist as you straighten the elbow. Think of a tennis player who repeatedly engages these muscles when they go to swing their racquet at a ball. Over time, repeated use of the same muscles for the same motion can lead to symptoms.

What Is Tennis Elbow Pain?

Tennis elbow is not usually caused by a single injury. The condition generally begins with mild pain that increases over a period of weeks or months. Burning or swelling on the outer part of the elbow and a weak grip are common with tennis elbow.

Some people with tennis elbow find that pain comes on or worsens at night or with forearm activity. Things like shaking hands or using a hand tool can bring on tennis elbow pain.

While symptoms are usually more noticeable in the dominant arm, both arms can be affected. The pain and grip weakness associated with tennis elbow can make it hard to do simple tasks like hold a cup or turn a doorknob.

Who Gets Tennis Elbow?

As noted above, tennis players aren’t the only people who get tennis elbow. Anyone who has a job or hobby that requires vigorous and frequent use of the forearm, or the extension of the hand and wrist can develop the condition.

Plumbers, electricians, painters, cooks, mechanics, factory worker are susceptible, as are people who play baseball, garden, sew, golf, and play musical instruments for work or recreation. Individuals who also increase activity unexpectedly can also develop tennis elbow, such as after a busy weekend painting a room or doing yardwork.

Do I Need Surgery?

Most patients with tennis elbow do not need surgery. An estimated 80%-95% of patients with the condition respond well to nonsurgical treatments including ice, rest, wearing a brace, exercise, and physical therapy. Local corticosteroid injections, and extracorporeal shock wave treatments (ESWT) also offer good results for lateral epicondylitis symptoms.

How to Relieve Tennis Elbow Pain

Physical therapy is shown to reduce pain and improve grip strength in patients with tennis elbow.

For a mild case of tennis elbow, rest, and non-steroidal anti-inflammatory drugs (NSAIDS) offer noticeable relief. But they may not be enough for severe lateral epicondylitis. If you don’t feel better after a few weeks of home treatment for tennis elbow, your doctor may prescribe physical therapy.

A physical therapy treatment plan for tennis elbow consists of specific exercises to strengthen and stretch the forearm muscles and improve range of motion. These exercises are often used in conjunction with manual therapy, and other therapies to heal damaged muscles and tendons.

Every patient and every physical therapy program are unique. The length and duration of your treatments will depend on the severity of your tennis elbow and how quickly you respond to therapy.

4 Exercises to Relieve Elbow Pain

In addition to physical therapy and at-home treatments, your therapist may recommend exercises to build strength or improve mobility in the muscles affected by tennis elbow. Here are a few safe and easy exercises you can do at home to prevent elbow pain:

1. Grip: Hold a small object like a stress ball or small rolled towel in your hand. Squeeze the object continuously for 5 minutes two to three times a day. Repeat on both hands.
2. Towel Twist: Start in a seated position. Hold a small, rolled towel in both hands. Keep your shoulders relaxed. Twist the towel with both hands as if you are wringing out water. Do this 10 times, change the direction of your hands, and repeat 10 more times.
3. Wrist Extension: Start in a seated position. Hold a two-pound weight in your hand. Rest your elbow on your knee and turn your palm to face down. With your palm facing down, relax your wrist down toward your body and then curl it up towards the ceiling. All of the motion should occur in the wrist. Try to isolate the arm as much as possible. Return to the starting position and repeat the curl 10 times. Do the same exercise on the other arm. (If you have any pain, you can do this without the weight.)
4. Wrist Flexor/Extensor Stretch: Start in a seated position. Extend your arm straight out in front of you with the palm facing the floor. Use your other hand to bend your wrist down to the floor until you feel a gentle stretch in the top of the forearm. Hold this for 15-20 seconds and repeat 3-5 times. Next, flip the palm up towards the ceiling. Use your other hand to bend the wrist back towards the floor until a gentle stretch is felt on the inside of the forearm. Again, hold for 15-20 seconds and repeat 3-5 times.

Tips for Prevention

If your job or your favorite sport or hobby requires the frequent use of your hands, wrist, and forearm, it’s wise to take a proactive approach to prevent tennis elbow.

Here are some practical tips to protect these muscles and prevent elbow pain and inflammation:

• Lift weights to build strength in your wrists and arms.
• Before starting an activity, take a few moments to stretch and warm up your arms and wrists.
•  If you have symptoms, wear a brace to keep them from getting worse.
• Get guidance from a coach, trainer, or physical therapist to improve your technique for sports activities that involve repetitive motions.
• Listen to your body. Pain is a sign that something is wrong. See a doctor or physical therapist if you have persistent elbow pain.

A bout of tennis elbow doesn’t have to keep you from doing what you enjoy forever. Most people respond well to physical therapy and other conservative treatments. If at-home care doesn’t help your elbow or wrist pain, talk to your doctor about physical therapy to improve your symptoms. Find a physical therapy clinic near you.