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A Comprehensive Physical Therapy Guide to Tennis Elbow (Lateral Epicondylitis)

Introduction

Tennis elbow, medically known as lateral epicondalgia, lateral epicondylopathy, previously lateral epicondylitis and more recently lateral elbow tendinopathy, is a common and often painful condition that affects millions of people each year. This article serves as a comprehensive guide to help you understand what tennis elbow is and how physical therapy can play a crucial role in your recovery. Whether you're a tennis enthusiast, a DIY home improvement enthusiast, or simply someone looking for relief from this condition, this guide has got you covered.



The Role of Physical Therapy

Tennis elbow is what we call a “tendinopathy”, where the driver of the pain is the tendon (the structure that joins muscles to bones). This is usually caused by a mismatch between the load on the tendon and the capacity to deal with this load. If you would like to learn more about tendon pain then check out this podcast episode Tokyo Living Podcast - Extrasode - Tendon Pain. This may occur in the form of an acute incident (e.g. a weekend of DIY involving hammering, twisting, painting etc.) or an excessively rapid increase in load (e.g. going from working out at the gym 2 times a week to 6 times a week). Physical therapy for tennis elbow focuses on restoring this balance. This may be in the form of bracing/taping, technique/ergonomic advice and activity modification to offload the tendon, and then specific graded exercise to improve the capacity of the area. We may also use manual therapy or specific exercise for pain reduction. As surgery for tendon problems is rarely effective, physical therapy is usually the first line non-surgical management.

Keywords: strength, flexibility, 


Diagnosis and Evaluation

A physical therapist can make a tennis elbow diagnosis through a thorough interview and clinical evaluation. While in some medical systems other healthcare professionals may be in charge of the diagnostic process, in our clinic this is carried out by a physical therapist. In most cases the diagnosis is straightforward and imaging is rarely necessary. However there are a number of other conditions that may cause pain on the outside of the elbow, and the management of these will differ. 


Tailored Treatment Plans

Physical therapists create personalized treatment plans to address each patient's unique needs and condition. 


Exercise and Rehabilitation

The cornerstone of physical therapy for tennis elbow is exercise. As mentioned earlier in the article, specific tennis elbow exercises will load the injured area, and this is the crux of the rehabilitation process. It is also important to include exercise to optimise the strength, endurance, flexibility and mobility in other areas of the body to help offload the tendon. 


Home Exercises

Following your sessions, your home exercise program will be provided to you (in our clinic we use the physitrack program with detailed videos and explanations of the different elements of your program. You should also be given self-care strategies to handle pain and flare ups. 


Preventing Future Episodes

Prevention is key to avoiding future bouts of tennis elbow. Even after you have safely returned to your desired level of activity, we continue to monitor activity loads and complete a very low volume of maintenance exercises for recurrence prevention. As well-know tendon expert Jill Cook famously says “A tendinopathy isn’t just for christmas”. This is something you may have to manage going forward. 


Tennis elbow can be a stubborn and frustrating condition to deal with. If you or someone you know is experiencing elbow pain, book in to see your physical therapist today!


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