Updated: Jan 12
It's important for us to start with a huge DISCLAIMER here. Please see a physician before starting any kind of exercise regimen. What I am listing below is a very general outline of what usually works for patients after a thorough evaluation to confirm the cause of their symptoms. It may not work for everyone or every case and you should seek a formal evaluation and assessment of your concerns. In general, any time you feel numbness and/or tingling in your face, head or jaw, down your arms, or have an upset stomach, abnormal bowel/bladder movements, please discontinue the exercise and seek professional advice.
Tennis elbow, medically known as lateral epicondylitis, is pretty common and typically happens with overuse from repetitive motions. But, as with runner's knee (you can read more about it here), I believe the diagnosis of tennis elbow is a blanket term to describe a symptom more than the cause.
There are so many different things that can be happening in the body anatomically to cause these symptoms which can make treating it a bit tricky. Often, people with tennis elbow are just told to rest the area. But what happens when you go back to your regular activities? It comes back. So check out what I believe to be the major causes of tennis elbow and my favorite exercises to prevent and alleviate the symptoms.
Where does tennis elbow come from?
Tennis elbow has a number of different causes and I'll break them down with an image from Essential Anatomy below:
1. Elbow joint is misaligned
2. Inflammation and repetitive use to the extensor tendons of the forearms and wrists
3. Faulty shoulder mechanics that change the angle and use of the elbow (No picture of this one because it's about the motion so enjoy this gif. You get the idea.)
4. Nerve pain down the neck and thoracic outlet
5. Pinched nerves in the forearm
So what are the common symptoms of tennis elbow?
Burning and pain down the forearm with use, numbness and tingling down the forearm/wrist, wrist cramping and/or popping and weakness with grip are all common symptoms of "tennis elbow". Another common indication is pain with quick motions such as hitting a ball with a tennis racket (hence the name).
What would we do about it in-office?
Here at Rehab and Revive, we like to work on the whole chain of movement beginning with proper ribcage alignment because it sets the structure for the shoulder and shoulder girdle.
A stable shoulder then yields more efficient elbow mechanics. Then we work on the elbow mechanics. What we do differently than most places is we treat down the chain (starting with the ribcage and shoulder) and work our way to the end of the chain (which leads us to the wrist and hand).
Tennis elbow isn't just about strength or lack thereof. It is about redistributing the forces to other joints in our bodies to disperse the stressors. That is the main thing we consider when looking at the mechanics.
Below are three of my favorite exercises for patients with tennis elbow pain!
Always start at the shoulder. Strengthening via stabilization is the key to being more efficient at the elbow. I always like to think of it like geometry. If you are off by one degree up at the shoulder, imagine how many inches or centimeters you are off down the line at the elbow.
Continuing to work on pronation and supination, this exercise is all about mobility and strengthens the muscles that help with those motions. This exercise inspired by Functional Manual Therapy really works well with helping the elbow joints pivot around an axis to reinforce smooth micromechanics.
The wrist is the other end of the chain as we target optimal upper body motion. The idea with this exercise is to keep all joints healthy for better grip, a stronger punch or more finesse in fine motor tasks.
These are just a few of my favorite exercises for my patients suffering from tennis elbow pain. No single program works for everyone, so even if these don't work for you, there may be many others that do! If you find yourself struggling with symptoms of tennis elbow, it may be worth it to see your local PT and get it checked out!
Remember, we can and we will get better together!
Dr. Justin C. Lin