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Greg Bailen

That Elbow Pain You have? It could be Tennis Elbow




Many people talk about tennis elbow, it is a very common condition that can affect those that sit at a desk and use a keyboard frequently to those that do heavy lifting and everything in-between. Oddly enough, out of all of those that get tennis elbow, only about 10% are tennis players (so no you don’t have to worry about getting tennis elbow if you just started playing tennis or pickleball).


What is it and why did I get it?

Tennis elbow, or lateral epicondylitis (or lateral epicondylalgia) is a term that indicates there is pain and possible tendinitis of the wrist and finger extensors as they attach around the elbow. This condition, like all other musculoskeletal issues, lateral epicondylalgia results when the tissue’s (muscles and tendon in this case) capacity is exceeded by the load placed on it. It is not necessarily the result of a “bad tendon.”


How do I know if I have it?

To know for sure you should be evaluated by a professional. However, generally, those with tennis elbow will display symptoms on the meaty part of the outside of the elbow joint with activities that require heavy gripping, twisting (i.e. twisting jars, door knobs), pulling heavier objects, etc. Most of the time there is also an associated area that is tender to the touch as well.


When do I go in for it?

Generally speaking, with most non-urgent ortho injuries you don’t want to wait more than 7-10 days before getting treated. Waiting beyond that period of time can lead to more long-standing or chronic injuries that can become more difficult to treat.


What do I do to fix it?

A good place is to start with a tennis elbow strap as seen here. However, you also need to immediately manage your load. If you are working out in a gym setting, find ways to modify your exercises to keep you moving (the increased bloodflow of exercise can help injured tissues to repair) but take stress off of your grip and forearm. This is a condition that you should not try to “push through” as it could keep getting worse and worse.


What does PT do to fix it?

Again, tennis elbow is a LOAD issue, it is not an inherent issue with the tissue. So how do you fix it? The answer is a resounding progressive load. However, many people that come to us have such high levels of pain around the elbow they can’t do any lifting with that wrist/forearm. So our approach is then to “put the fire out” with various modalities like instrument assisted soft tissue mobilization (scraping), cupping and dry needling. From there we like to use blood flow restriction training to be able to induce the same positive tissue adaptations as lifting heavy weight without actually lifting heavy weights. Once the fire has been put out we will then turn to progressive loading/lifting to be able to build resiliency of the affected muscles and tendons and keep it from coming back.


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