GENERAL INFORMATION ON REHABILITATION EXERCISES FOR
TENNIS ELBOW (LATERAL EPICONDYLITIS)

Note: Do not follow this program until you have discussed this with your osteopath
 

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Research suggests that many non-traumatic complications with the elbow result from a combination of poor posture (especially upper body/limb) and an abnormal amount of repetitive strain. This stress can eventually develop into structural changes which can manifest as joint degeneration, shortening or lengthening of support ligaments and muscles together with wear and tear on cartilage. All of these changes can lead to pain
Commonly the tissues in the elbow will withstand strain (without symptoms) until the tissues fail past its pain threshold. Tennis elbow is particularly sore because this area has a lower pain threshold than other areas of the body. This is also theorised to be the reason for its repetitive pain cycles.
 
How can we reduce pain and restore function?
An important factor in stimulating repair is to enhance blood/nutrient and nerve supply. The key elements to achieving this are:
 
  1. Appropriate body structure will assist with good function: Learning and practicing appropriate posture and body mechanics during everyday activities will reduce strain and enhance healing elements to the damaged areas. 
  2. Regular exercise: Stretching, Strengthening and general aerobic exercise
  3. General Health Maintenance: including elements of a healthy balanced diet, relaxation, and appropriate management of pre-existing health issues.
Using good body mechanics during everyday activities. Important things to remember:
How tasks are performed each day can have an impact on your recovery. Don’t place unnecessary stress on the muscles and joints of your elbow.
Here are some tips to reduce the stress on your upper body and elbow:
  • Change your posture frequently throughout the day.  
  • Assume the upright stress free posture for short periods regularly throughout the day (this will slowly train your body to be comfortable in a better position).  
  • Carry lighter weights. Prevent the strains of unnecessary or sudden increases in weight.
  • Rotate work chores. Joints and muscles like activity but not to excess.
  • Change from one task to another if you notice that you are experiencing increased discomfort with that task. The modifications that can be the most useful are often the simple commonsense ones.
  • Gradually increase your activity and increase tolerance.

 

ELBOW EXERCISE PROGRAM
 
  • Please ensure correct full body posture when performing any exercise. The whole body is connected and repetitive strain in a new area can cause further complications and reduce the recovery time.
  • Please cease exercises with the onset of any abnormal discomfort or sharp pain. 
  • It is important to avoid painful & high impact exercises whilst you are building up your elbows to normal strength. 
  • Remember to breathe through your exercises.
  
 
Stretches (Minimum 3 Times Per Day)
Please refer to here for images and instructions for upper body stretches: Stretches for the Elbow, Wrist and Hand. Elbow stretches should be performed along with finger, shoulder, neck and upper body stretches. Never stretch a muscle in 1 plane/direction. Always provide a gentle change in direction once you feel a muscle has been stretched in one direction. 
 
Active Resisted stretching: Incorporate resistive muscle activation (i.e. stretch the muscle and then activate the muscle against that resistance. Hold for 3 seconds → stretch for 3 seconds → then activate muscle again → repeat 3 times
  
 
 
Strengthening (Minimum 3-5 x Sessions Per Week)
PLEASE CHOOSE 2-3 OF THE FOLLOWING STRENGTHENING EXERCISES TO PERFORM 2-4 TIMES PER WEEK
 
Note: Please ensure your whole body posture is correct whilst performing these exercises. Please stop if any painful symptoms are reproduced.
 
(1) Weight Strengthening (Elbow flexion, extension, and rotation out and in): Use 500grams → progress to 1kg
Make sure your elbow is supported whilst performing these exercises (i.e. rest it on the edge of a table with your wrist hanging over the edge). Perform each exercise slowly and to end range and hold for 3 seconds then return to opposite direction and hold. 
 
(2) Towel-wringing Exercise 
Roll up a hand-towel and, with your arms straight, grasp the towel. Wring the towel slowly so that your wrist is fully bent forwards. Hold for 10 seconds, and then reverse the wringing to extend your wrist and hold for 10 seconds. Gradually, increase the time by 5 seconds until you can hold for 60 seconds. 
 
(3) Ball Squeeze
Place a rubber ball or tennis ball in palm of hand, squeeze and hold for 3 seconds then release. Repeat 25 times. Rest for 1-2 minutes and repeat. If pain is reproduced squeeze a folded sponge or piece of foam.
   
(4) Elastic Band
Place a rubber band around all five finger tips. Bend your elbow at 90° close to your body. Spread fingers, hold for 3 seconds, and then retract. Repeat 25 times. Rest for 1-2 minutes and repeat. If you experience pain when doing this exercise then straighten your elbow and try again. If you want to add resistance you can use an extra rubber band.