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Tennis Elbow (Lateral Epicondylitis) #Elbow pain


Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse. Tennis elbow is inflammation or, in some cases, microtearing of the tendons that join the forearm muscles on the outside of the elbow.

The pain of tennis elbow occurs primarily where the tendons of your forearm muscles attach to a bony bump on the outside of your elbow. Pain can also spread into your forearm and wrist.

The forearm muscles and tendons become damaged from overuse. Despite its name, athletes aren't the only people who develop tennis elbow. People whose jobs feature the types of motions that can lead to tennis elbow include plumbers, painters, carpenters and typing-job.


Symptoms of Tennis Elbow

The symptoms of tennis elbow develop gradually. In most cases, the pain begins as mild and slowly worsens over weeks and months. There is usually no specific injury associated with the start of symptoms.

Common signs and symptoms of tennis elbow include:

  • Pain or burning on the outer part of your elbow
  • Weak grip strength


Risk factors of Tennis Elbow

Factors that may increase your risk of tennis elbow include:

  • Age. While tennis elbow affects people of all ages, it's most common in adults between the ages of 30 and 50.
  • Occupation. People who have jobs that involve repetitive motions of the wrist and arm are more likely to develop tennis elbow. Examples include plumbers, painters, carpenters and cooks.
  • Certain sports. Participating in racket sports increases your risk of tennis elbow, especially if you employ poor stroke technique.


Physiotherapy Management of Tennis Elbow:


Initial/Acute Phase Decrease Pain, Edema, or Spasm Immobilization.

Rest the muscles by immobilizing the wrist in a splint such as a cock-up splint, where the elbow and fingers are free to move.

Avoid provoking activities. Instruct the patient to avoid all aggravating activities, such as strong or repetitive gripping actions.

Cryotherapy. Use ice to help control edema and swelling.

Activity modification. It may be necessary to modify the patient’s activity or technique before returning to the stressful activity.

For example, it may require taking tennis lessons to correct improper tennis techniques, adapting use of a hammer or other equipment if used.


Patient Education:

It includes advice and techniques on prevention, recognition of provoking factors, and identification of warning symptoms.


Develop Soft Tissue and Joint Mobility Multiple-angle muscle setting (low-intensity isometrics).


Strengthening exercise technique for wrist extensor muscles.

Patient position and procedure: Sitting with the elbow flexed, forearm pronated and resting on a table, and the wrist in extension. Begin with gentle isometric contractions with the wrist extensors in the shortened position. Resist wrist extension, hold the contraction to the count of 6, relax, and repeat several times; then move the wrist toward flexion and repeat the isometric resistance. Do not move into the painful range or provide resistance that causes a painful contraction. When full wrist flexion is obtained without pain in the lateral epicondyle region, progress by placing the elbow in greater degrees of extension and repeat the isometric resistance sequence to the wrist extensors. Progress until gentle resistance can be applied to the wrist extensors in the position of elbow extension and wrist flexion. It may take several weeks to reach this position.


Treatment/Exercise for tennis elbow 

1. Rest: rest from activities that provoke pain; sustained gripping actions and avoid repetitive wrist movements. 

2. Icepack application on Outer/lateral aspect of elbow.

3. Compression alone or compression along with ice pack has proven useful.

4. Forearm extensor stretch 3reps 20s hold; stretch should be comfortable not provoking pain. 

5. Forearm flexor stretch 3reps 20s hold; stretch should be comfortable not provoking pain. 

6. AROM wrist flexion and extension 1-2 sets 20-40 reps

7. Wrist extensor isometrics 1-2 sets 5-10reps 3-6s hold

8. Eccentric strengthening(using dumbbells or resistance bands) for wrist extensors 5-10reps 1-2sets

9. Wrist extensor Eccentric and concentric exercise (using dumbbells or resistance bands) for wrist extensors 5-10reps 1-2sets


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