Rehabilitation of Lateral Epicondylitis

Posted On: April 15, 2020

“Tennis Player Preparing toServe” by meridican, flickr is licensed under CC BY 2.0

Lateral epicondylitis or “tennis elbow” is a common cause of lateral elbow pain in middle aged individuals. The reason that the prevalence is higher in this age group is that the muscle most involved in this problem, the extensor carpi radials brevis, atrophies with age.

Individuals in this age group will often continue to try to perform tasks that they could do when they were younger. This can easily lead to micro tears in the tendon of the weakened and atrophied muscle.

Over the years I have treated weekend warriors from Lake Forest, tennis professionals from Highland Park, and golfers from Wilmette. It spares few individuals. I have even seen plumbers and electricians with this condition.

Rehabilitation is simple but not always easy. It consists of: relative rest, anti-inflammatory measures, wearing a counter force brace, manual therapy, stretching and strengthening.

Relative rest does not always mean totally quitting the activity. If, for instance, it only hurts during a player’s back swing, they can often still work with a pro to develop their footwork, work on forehands, and eliminate spin on their back hand while wearing a counter force brace.

My favorite anti-inflammatory is ice. With the elbow you should ice ten minutes on and off through a cotton barrier like a tee shirt. If your elbow hurts after activity do this every day for about a half hour. In the early more inflamed phases, it may require that you do it even as often as an hour a day.

Massage techniques professionally applied (transverse friction and myofascisal release) can be useful in helping to organize tissue into a stronger and more pliable muscle tendon unit.

Stretching of the wrist extensors is key. You have to perform this type of stretch 3-5 x 30 seconds per day. This can be done by holding the affected limb straight in front of your body palm down. Then pushing on the back of your hand with the other hand fully flexing the wrist.

Strengthening the wrist extensors is the ultimate remedy. Working to rebuild the atrophied muscles with palm down reverse wrist curls or using a tool like the Theraband FlexBar is crucial. The problem that slows down recovery is often times how involved the tendon is. If a person has had a long-standing unaddressed issue, it will take longer. People that have less damaged tendons will take less time and those with more damage will take longer.

One should always see a physical therapist or a chiropractor who is experienced in orthopedics and sports injuries to establish the diagnosis and direct care.

Stay well and stay active.

Dr. J

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