A tennis elbow is a very common and painful elbow injury. It can be caused by doing heavy work for a long time or by doing something you normally don’t do.
Unfortunately very often it’s unclear why happens.
The good news is that cause of the pain is known and that we know how you can treat it the right way.
And in this detailed post I’m going to tell you exactly how you can cure your tennis elbow at home with a few exercises.
I know this for a fact because it’s the exact method I use to treat my own patients.
The most important thing is that you start right away. That is because the longer you wait, the longer your recovery will take.
But even when you have it for a long time already I can still help you.
So keep reading and follow the instructions carefully to totally cure your tennis elbow with the right exercises.
In fact: This is what you will learn today:
- The anatomy of your elbow
- What is a tennis elbow?
- What are the symptoms of a tennis elbow?
- What causes a tennis elbow?
- Tennis elbow treatment
- What does tennis elbow surgery looks like?
The anatomy of your elbow
Before we start with your tennis elbow treatment, it’s important to know the anatomy of your elbow. When you understand this, you will understand the cause of your tennis elbow and why it doesn’t recovery by itself.
After that you will also understand why our treatment works so well.
So let’s start:
Your elbow is formed by 3 bones:
The humerus is also known as the upper arm. The ulna is also known as the cubit bone.
The main connection of your elbow is formed between your humerus and ulna. When you bend and extend your elbow, these are the bones that move.
Your radius only connects to your ulna, both in your elbow joint and in your wrist. When you rotate your forearm, only these bones move when performing this movement.
Here lies one of the reasons why your tennis elbow doesn’t easily recover by itself. But more about that later.
Your radius is located at the side of your thumb where your cubit bone is located at the side of your pinkie. When you rotate your forearm, your radius actually moves over your cubit to the other side and your cubit stays in the same position. You can feel this movement in your wrist area.
Your arm is in the neutral position when the palm of your hand faces up. In this position your cubit and radius lay next to each other.
When you rotate your arm, you can even feel the head of your radius rotate on the lateral side of your elbow. The head of your radius stays at the same position but is able to rotate in that position.
The rotation of your forearm is called pronation and supination. Unsurprisingly the muscles for these movements are called the pronator and supinator.
There is one muscle connected to the elbow that we have to discuss here as described by teachmeanathomy.
Extensor Carpi Radialis Longus and Brevis
The extensor carpi radialis muscles are situated on the outer side of your elbow. They run all the way to your index finger. Therefore there function is to lift your hand and to bend it to the outer side in your wrist joint.
- Attachments: The Extensor carpi radialis longus originates from the supracondylar ridge, while the extensor carpi radialis brevis originates from the lateral epicondyle. Their tendons attach to metacarpal bones II and III.
- Actions: Extends and abducts the wrist.
This is the muscle that causes the pain in a tennis elbow.
Now you know a little bit more about the anatomy of your elbow, it’s time to discuss the cause of your tennis elbow.
What is a tennis elbow?
Now you know a little bit more about the anatomy of the elbow, we can explain you what a tennis elbow actually is.
A tennis elbow is caused by an inflammation of the tendon of the extensor capri radialis longus.
The scientific name of a tennis elbow is epicondylitis lateralis.
And here is why:
- The epicondyle is the location of the inflammation of the elbow
- Itis is the latin name for an inflammation
- Lateralis tells us that it’s located on the outside or lateral side of the elbow.
The inflammation of the tendon is a result of damaged tissue. A tennis elbow is a result of the long period overuse of your forearm causing the damage of the tendon. The purpose of the inflammation is to repair the tendon.
The problem with a tennis elbow is that the balance in your arm is disturbed. A tennis elbow is an injury in a vicious circle. This is why a tennis elbow doesn’t recover well by itself.
Later I’ll explain how this works and how you can solve this problem but first I’ll tell you the symptoms of which you can recognize a tennis elbow by.
What are the symptoms of a tennis elbow?
The following symptoms may indicate that you have a tennis elbow:
- Pain in your elbow at the lateral side
- Pain in the morning or after a long time of inactivity of your elbow
- Stiffness in your elbow
- Radiating pain in your forearm and sometimes in your hand.
- Loss of power in your hand.
The most prominent symptom is the pain on the lateral side of your elbow. This is the location of the damaged tendon. The pain is one of the signs of the inflammation that is taking place.
The second sign of the inflammation is the stiffness and sometimes a little swelling. The stiffness can be both in your elbow and in your wrist.
Also the radiating pain in your forearm and fingers is a very common problem for tennis elbow patients. The radiation pain is usually felt in your thumb and index finger.
The loss of power in your hand is caused by the damaged tendon. Because of the pain and the damaged tendon the muscles in your forearm loose there functionality. It’s like when you’ve trained to heavy and you’re sore the next day. You don’t have as much power as you usually have. In a tennis elbow this is the case every day.
What causes a tennis elbow?
A tennis elbow is a complex injury and becomes more complex the longer you have it. The problem with it is that it gets into a vicious circle very quickly.
In order to understand the tennis elbow treatment we’ll explain later, you’ll first have to understand this circle. We will explain now which factors contribute to this vicious circle.
Everything starts with the damaged tendon. The damage is usually caused by overuse of your arm.
This doesn’t necessarily have to come from playing tennis.
The damage is caused by rotation of your forearm for a long period of time or with a lot of force.
Typical examples are ironing, painting or mason.
When you play tennis you make these movements as well to give a little spin to the ball. This is where the name tennis elbow comes from.
Also a lot of heavy lifting can cause a tennis elbow.
Stiffening of the muscle
The damaged tendon is now causing pain in your elbow. The muscle attached to this tendon stiffens because of this pain. You can feel this stiffness very good in your forearm.
You can probably feel a little knot in your muscle, a trigger point.
This trigger point is activated by the pain in your damaged tendon. The trigger point also causes the radiation into your hand and fingers. The trigger point also disturbs the function of the muscle, causing the lack of strength in your hand that you can experience. Because of the trigger point your arm feels stiff, especially when you haven’t moved it for a long time. When you move you elbow for a while you’ll feel that the stiffness lessens.
Stiffness of the joint
The third aspect of the vicious circle is stiffness of the joint. The stiffness of your muscles reduce the mobility of your forearm, especially rotation.
When you bend your elbow to 90 degrees you’ll see that you can rotate your healthy arm more than your injured arm.
Your joint now adjusts to this new range of motion. It doesn’t need as much range of motion as it did before, so your body decreases the range of motion. We call this phenomenon “use it or lose it”. If you don’t use your muscles anymore, you’ll lose them. The same goes with range of motion.
These 3 factors contribute to the vicious circle of a tennis elbow injury. The vicious circle is the reason your tennis elbow doesn’t recover by itself.
This is how it works:
- Damaged tendon due to overuse of the elbow
- Stiff muscle due to the pain caused by the damaged tendon.
- Stiff joint due to the stiff muscle and limited range of motion.
- Damaged tendon due to overuse caused by the limited range of motion and muscle dysfunction.
As you can see the circle is completed. This is why your tendon doesn’t have time to recover. It keeps re-injuring.
In order to successfully treat your tennis elbow, you’ll have to break the circle. In order to be able to break the circle, you’ll have to treat all 3 aspects of that circle.
So now I’ll describe the 3 tennis elbow stretching exercises you’ll have to perform to for full recovery. I’ll also tell you the secret on how to completely recover.
After that I’ll discuss the tennis elbow surgery procedure. Tennis elbow surgery is going to be your last resort.
Luckily it’s rarely necessary. In 9 out of 10 cases a tennis elbow is very well treatable, if you know what to do.
Tennis elbow treatment
So in order to successfully treat you tennis elbow we have to make sure that we break the vicious circle. To do so we’ll describe 3 tennis elbow exercises to do so.
The first thing you have to do however, is to give your elbow rest.
Many people with a tennis elbow still continue to do their work just like they did before. This way your tennis elbow doesn’t get the rest it needs.
And like you learned before, this will continue the stress on the damaged tendon, keeping your tennis elbow in place.
So first let it rest as much as possible.
Together with rest, you’ll have to address all 3 factors that contribute to the vicious circle of your tennis elbow.
We do this with 2 exercises:
One will stretch the extensor carpi radialis muscle, which is the main cause of the pain.
The second exercise will restore the mobility of your elbow. This will reduce the tension on the tendon so it can recover.
The natural way of tendon repair takes about 6 weeks. This means that after about 6 weeks the damage of the tendon is restored, solving the pain.
After these 6 weeks however it takes about 3-6 months for the tendon to regain full strength.
That means that the risk of reinjure stays for a few more months. That’s why the third exercise will be a strengthening exercise so the injury doesn’t come back.
Tennis elbow exercise 1: Stretching the extensor carpi radialis longus
The first tennis elbow stretching exercise is also the most important one. It will stretch the extensor carpi radialis muscle to reduce the tension on the muscle. It goes like this:
- Grab the hand of the painful elbow with the hand of your healthy one.
- Extend your elbow
- Now bend your wrist of your painful elbow with your other hand.
- Now rotate your hand until you feel the tension in your elbow at the painful spot.
You can also find the stretching exercise on the youtube video below. Perform it a few times a day.
It is possible that when you perform this tennis elbow stretching exercise you don’t feel the pain or tension in your elbow but rather in your wrist or your forearm. This means that the extensor carpi radialis muscle doesn’t move well. This will maintain the pressure on the tendon and prevent you from recovering.
This is the main cause why some people don’t recover. This factor is often overlooked and will result in a chronic elbow injury.
That is why you also should massage the muscle at the places where you feel the pain or tension during the stretching exercise. You will notice that after you’ve massaged it for 10 minutes and you perform the stretching exercise again, it will feel different. This time you will feel the stretch and the pain only in your elbow. This means that the muscle is free and can recover. Continue to the second exercise.
Tennis elbow exercise 2: Improving mobility of your elbow
The purpose of this second tennis elbow exercise is to increase the mobility of your lower arm. Since the tension in your lower arm muscles is reduced it’s easier to restore the rotation of your lower arm.
Increasing the mobility of your lower arm reduces the overuse and tension of your lower arm muscles even further.
The stretching exercise goes as follow:
- Place your painful elbow in bending position in front of you with the palm of your hand faced up on a table.
- Now locate the head of your radius with the thumb of your other hand. It feels like a little knot.
- Now apply pressure on the radius head with your thumb towards the table.
- Finally place the elbow of your health arm against the thumb of your painful arm and also push it down towards the table.
- Hold the for 20 seconds. Now you should feel the tension and the pain in your elbow.
You can find the stretching exercise also in the YouTube video below. Perform this exercise several times a day.
Additionally, you should also increase the mobility of your wrist. You can do this by bending your elbow and then bend your wrist in every possible direction. Usually flexion will be the movement that is limited the most and often painful.
Tennis elbow exercise 3: Training the muscles of your lower arm
The purpose of the this tennis elbow exercise is to increase the strength of your lower arm muscles. Due to the damage of your tendon and long period of inactivity of your elbow, the strength of your muscles is reduced. This increases the risk of reinjure during your recovery process.
Also training your lower arm muscles supports the healing of the tendon, reducing recovery time. This is the final stage of your recovery process
Perform this exercise as follow:
- Place your forearm on a table with your hand just over the edge.
- The palm of your hand should face the ground.
- Now lift up you hand 10 times without moving your forearm.
- Now turn your hand with the palm facing up.
- Again lift up your hand 10 times.
Repeat this exercise 3 times and 2 times a day. When it feels easy try to add some weight as you can see in the YouTube video below.
Together with these 3 exercises, Dry Needling can be a great addition to your tennis elbow recovery. It will help you to reduce your pain within 2 weeks to 50% of what it was before.
After that your elbow feels a lot looser and will recover faster.
Here is how this works:
A skilled physical therapist will insert an acupuncture needle inside the trigger point that is active in your extensor carpi radialis muscle. The trigger point is activated by the pain of the damaged tendon.
This trigger point is the reason for the stiffness of the muscle.
When you insert the needle it will give a great amount of pressure to the trigger point. This pressure will force the trigger point to relax. This usually happens with a little shock that goes through the muscle.
It feels like a little cramp attack.
You don’t feel the needle inserting at all and there will be nothing injected. The reaction after can be a stiff feeling in your lower arm for a few days, but then the pain of your tennis elbow is reduced significantly.
This also results in les tension on the damaged tendon, speeding up the recovery. Therefore it’s a great addition to your tennis elbow exercises program.
Tennis elbow taping
Also taping your tennis elbow can reduce your pain.
Taping will help your extensor carpi radialis muscle in its function. This results in less tension on the damaged tendon.
And less tension gives it the time to recover.
It works a little like rest for the damaged tendon.
Tennis elbow taping can also be done by a skilled physical therapist, but with a little research and training you can also do it yourself.
All these tennis elbow treatment options will help you to fully recover within 8 weeks.
However, sometimes it just don’t want to heal because the tendon is too much damaged. This only happens to very few people.
In those rare cases surgery is the only available option. That’s why I’ll explain how this surgery is performed.
What does tennis elbow surgery looks like?
When all non-surgical treatments are tried to recover your tennis elbow, your final option is surgery.
Tennis elbow surgery can be perform by means of arthroscopy, traditional open surgery, or a combination of the two techniques, depending on the type of problem and the method the doctor prefers to use. The surgery can be performed under general or regional anesthetic.
The doctor then has three options:
- Cutting the tendon
- Repairing the tendon
- Removing the inflamed tissue from the tendon
The most used option is cutting the tendon and then reattaching it again. This way the tension is released, giving it better changes to recover. Usually during this procedure the doctor will also remove some inflamed tissue and clean your elbow.
The last option is to repair the tendon. With this procedure the damaged tendon is stitched together. This improves the changes for recovery.
The tennis elbow surgery usually is a one day procedure. You will visit the hospital in the morning and leave in the afternoon.
The recovery period takes about 3 to 6 months. Unfortunately not everyone recovers completely resulting in a permanent slight lack of function of the elbow.
A tennis elbow is very well treatable with a series of tennis elbow stretching exercises. However some patients will need surgery for their tennis elbow pain. So when you have a tennis elbow, first try the exercises as described above for a few weeks.
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