Elbow Pain Keeping You From The Sports You Love? Find Out More Here.

If you experience pain on the outer part of your elbow, particularly intensified during activities like tennis, pickleball, padel, or weightlifting, you might be dealing with lateral epicondylitis, also known as tennis elbow.

What exactly is tennis elbow?

Lateral epicondylitis involves the wrist extensor mass attaching to the outer side of your elbow. It is characterized by tenderness or pain around the bony prominence on your lateral elbow (the lateral epicondyle of the humerus), along with discomfort in the tendon that connects beneath it. Moreover, you might feel pain above or below the elbow joint, where the wrist extensor muscles reside. These symptoms can worsen with racket sports, prolonged gripping activities, wrist stretches, and direct pressure on the elbow joint, such as during a side plank position.

Why does this occur?

Tennis elbow most commonly arises as an overload condition affecting the extensor tendons. The tendons can become irritated due to rapid, elastic movements like swinging a racket. Engaging in such activities for numerous hours daily and multiple times per week without sufficient recovery or cross-training can lead to these symptoms. Scientifically, the tendons and ligaments in your body consist of collagen. With overuse, collagen can break down faster than your body can regenerate it for proper tendon healing. This situation places the tendon in a state of disrepair, potentially progressing to a “degenerative tendinopathy” marked by minor micro-tears in the tendon. You might wonder, “But I only play tennis for 2-4 hours weekly. How could that be excessive?” This could result from the tendon lacking the necessary resilience to withstand load due to inadequate physical preparation before starting a new sport. Other factors like poor nutrition, poor technique, stress, and insufficient sleep could contribute to this as well.

How can we address this issue?

Ideally, we educate you about load management, which involves ensuring sufficient rest between racket sport sessions and adjusting your weightlifting technique. Technique modification is also a large part of reducing the risk of reoccurrence. Tennis elbow is often seen in racquet sports when a person is not adequately dispersing forces throughout the entire body during the swinging motion.  A proper racket swing is a full body movement. If the person is only relying on their arm to produce the force needed to hit the ball instead of incorporating the larger muscles of the torso and legs it can cause a severe over accumulation of force at the elbow.  End result? Pain at the elbow.

If caught early, we can modify the stress placed on your lateral elbow, provide initial treatment, and expedite your return to beloved activities. However, in most cases, this condition is a gradual process that can take several weeks to months to fully recover. This is because we need to structurally adapt the tendon, enhancing its resilience through a four-phase loading protocol. While individual variations exist, the protocol generally comprises these four phases:

1. Isometric loading (symptom management and load reduction)

2. Isotonic loading (heavy slow training, load increase)

3. Elastic loading

4. Return to sport/full function

Seeking appropriate physical therapy treatment for this condition is vital to prevent it from becoming a chronic concern. Generally, the longer an individual experiences a specific impairment, the more time it takes for resolution.

To initiate your recovery journey, click here to schedule an initial evaluation with one of our skilled Doctors.