How Is Tennis Elbow Treated?

All components of the condition must be addressed with treatment in order to assure a good response. Although many people obtain symptomatic relief, the condition often recurs unless all factors are addressed: inflammation, decreased flexibility, weakness and scar formation.

Inflammation can be treated by aspirin or aspirin-like medications: non-steroidal anti-inflammatory drugs (NSAID’s). Often one or several steroid injections are necessary and helpful. Phonophoresis or iontophoresis are means by which deep heat or electricity, respectively, can deliver medication into involved tissues without use of a needle.

Scar tissue can be made more elastic through ultrasound and deep massage techniques. Mobilization is sometimes used to help with adhesions (bound down scarring).

Stretching exercises should be started by a therapist and continued by the patient as soon as tolerated. It is essential to determine the specific muscles involved to best direct stretching. Strengthening should be limited until there is adequate healing and then progressed gradually as tolerated.

The muscles most crucial for strengthening are those involved with wrist and finger motion: e.g. grip, wrist extension and flexion, supination, and radial deviation. Increased control of these motions reduces stress on the common extensor tendon where tennis elbow symptoms occur. (Exercises for these muscles are shown).

STRETCH: With arm extended and palm facing down, grasp the back of the hand and push wrist down as far as possible. Hold for count of 5. Repeat 10 times.

WRIST EXTENSION: Forearm should be supported on a table with hand off edge. Palm should face downward. Using a weight, lower the hand as far as possible, then bring wrist up. Repeat 10 times.

WRIST FLEXION: Same as extension exercise, except palm should face upward.

SUPINATION - PRONATION: With the forearm supported on a table, hold wrist in neutral position. Using a weight held in a normal hammering position, roll the wrist to one side as far as possible. Hold for a count of 2. Bring wrist back to starting position. Roll wrist to the other side. Hold for a count of 2. Repeat 10 times.

RADIAL DEVIATION: With the forearm supported on table, hold wrist in neutral position. Hang hand off table. Using a weight held in normal hammering position, lower wrist down as far as possible. Hold for count of 2. Then bring wrist back up as far as possible. Hold for count of 2. Repeat 10 times.

What Else Can Be Done To Reduce Symptoms?

Tennis elbow splints serve to absorb some of the muscle forces, in this way reducing the chance of recurrent tearing. It is, therefore advisable to resume activities initially with the protection of such a device.

In addition, one should attempt to eliminate predisposing factors such as poor body mechanics or an improper backhand in tennis.

What Is The Prognosis For Recovery?

Occasionally patients have to alter their lifestyle or recreational activities. However, the vast majority of patients do well with a concise comprehensive treatment program as described above. A small percentage of people require surgical intervention if they have failed simple conservative management.