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What is Tennis Elbow?

Tennis elbow is a condition that commonly results in pain around the outside of your elbow joint. It is now commonly known as lateral elbow tendinopathy.

Tennis elbow occurs when there has been a change in the use and demand on the tendons that extend your wrist. The tendon itself changes in its structure and is no longer able to withstand the forces that everyday life puts upon it.

What are the signs and symptoms of Tennis Elbow?

Pain. Tennis elbow presents with pain on the outside of your elbow. This pain can increase with gripping or rotation of the wrist and forearm e.g. opening a jar or a door. You may experience constant pain which could occur at rest and can affect your sleep. The pain can travel down your arm from your elbow towards your wrist.

Weakness. Weakness in your wrist or reduction in your grip strength

Stiffness. Tennis elbow can cause stiffness and a general restriction of your movement

Tingling. Sometimes tingling and numbness can also be experienced.

Over use activities at home

• Gardening/DIY/painting/raquet sports

Over use activities at work

• Computer work and typing/manual labour

• Administrative work e.g. filing

Trauma: Tennis elbow can also occur as the result of a single, forceful injury.

What are the treatment options for tennis elbow?

Modifying your activities

You should try to modify movements and activities that bring on your symptoms as much as possible. Consider adapting how you perform a task for example sitting at the correct height at your computer with elbows relaxed at a right angle on the desk and wrists in a neutral position. You may need to take regular breaks from recreational activities for example those that require repetitive gripping or for you to use a power grip. If your symptoms are affected by your work it may be helpful to discuss with your occupational health department.

Exercises

When treating any tendinopathy we use a traffic light system to monitor pain levels or the numbered pain chart. It is really important to monitor pain scores before, during and after your exercises. This will help to tailor your exercise programme as symptoms begin to improve. Whilst exercising and for the first 24 hours after completing your exercises we recommend a pain score of no greater than 4-5/10 or amber on the traffic light system. Please pick either isometric, eccentric or concentric exercises to start with. You could trial an exercise from each section and pick the exercise where your pain does not exceed 5/10. Once this is becoming more comfortable move onto phase 2 exercises.

Phase 1

Isometric exercises: Pick one of the exercises below. Either hold the weight/band in your hand and keep the wrist in an extended position against resistance. Or use your other hand to resist wrist extension. Hold the position for…………… Repeat ……………...

Eccentric exercises: If your elbow is feeling to sore to hold the wrist in extension for a minute. Try the eccentric exercise below. Place your arm, palm side down, on a table with your hand over the edge holding a free weight / dumbbell.

Start by using your unaffected hand to lift up your affected hand and free weight. Hold this position with your affected hand as you release your unaffected hand.

Next, use only the affected hand that is gripping the free weight to lower the free weight as you bend at the wrist.

Return to starting position by lifting with your unaffected hand again and repeat.  Repetitions…………..Sets……………     

Phase 2 exercises:

Pronation punches

Exercise 1: Begin by holding a small weight or resistance band in your hand. Start with your arm at a right angle by your side with your palm facing up towards the ceiling holding a weight. Then punch forwards rotating your forearm so your palm faces down. Repetitions………...Sets……...

Exercise 2: An alternative exercise is using kettlebell to perform an overhead press as demonstrated in exercise 2 below. Repetitions…………….Sets……………..

Alternative grip strengthening exercises: You could use a grip strengthener, towel or putty to improve your symptoms: Repetitions………………. Sets……………….

Press ups - If your Physiotherapist recommends progressing to press ups. Please follow the link below to work through the press up exercise guidance.

Push-Ups Guide (darebee.com)

Repetitions…………….Sets………………..

Pull ups: If your Physiotherapist recommends progressing to pull ups. Please follow the link below to work through the pull up exercise guidance.

Pull-Ups Guide (darebee.com)