Tennis elbow

Not only tennis players can suffer from tennis elbow. 40% of people will experience tennis elbow at some point in their lives. Most are between 35 and 54 years old, with women being slightly more affected.

This irritation usually occurs due to overuse or increased pulling and shear forces at the muscle attachments. Overuse includes repetitive movements of the elbow and wrist, such as manual work like screwing, hammering, painting, work on the computer or mobile phone, on construction sites, etc.

Overuse is not a necessity, as tennis elbow can also occur without a specific trigger. An unhealthy lifestyle, diabetes mellitus, oral corticosteroids (anti-inflammatory tablets), and adverse psychosocial influences can also negatively affect the development of tennis elbow.

Tennis elbow itself is not a serious condition – but it causes pain.

It is important to know that tennis elbow is essentially a “benign condition” and not dangerous in itself. However, it can be quite painful, annoying, and limiting for those affected.

Tennis elbow is diagnosed based on the typical symptom profile and through manual examination of the elbow with pressure provocation on the outer side, as well as strength testing of the affected muscles.

In cases resistant to therapy or extremely pronounced cases of tennis elbow, imaging such as X-rays, ultrasound, or MRI may be performed to rule out other conditions. However, some studies show that there is no correlation between the findings from imaging procedures and the symptoms.

Since tennis elbow involves a tendon issue, most cases require a somewhat longer recovery time. This is primarily because tendons are not as well supplied with blood as, for example, muscle tissue.

Healing requires load!

Current science tells us that tendon regeneration needs progressive loading. Strengthening exercises in physical therapy for the wrist extensor muscles have proven effective and, according to studies, show the best results in combination with a mobilizing therapy.

However, patience is required, as exercises often need to be performed over 12 weeks to achieve the desired effect.

Ultrasound, electrotherapy, shockwave therapy, laser therapy, and cryotherapy have shown in studies to be not much more effective than a placebo effect and are not recommended as standalone measures.

Science is also divided on orthoses/braces. Therefore, it must be assessed individually whether it is sensible in a specific case.

Scientific studies agree on corticosteroid injections: these are clearly discouraged! They do not provide long-term success.

Below are some examples of exercises you can use for tennis elbow:

Hand lift with elbow flexion

Hand lift with elbow extension

Hand rotation

It is recommended to start with 3 sets of 15 repetitions. However, this should also be adapted to the pain. This means:

Mild pain (up to 3 on a pain scale of 0 to 10) can be tolerated during the activity. For stronger pain, caution is advised. Pain must return to baseline levels the next day. If not, a break should be taken or the exercise adjusted. You can also start the exercises statically, meaning you hold the position without movement.

Hand lift without movement

Over the next few weeks, you should be able to slowly but steadily increase the intensity (more repetitions, weight).

Overall, therapy is very individual and requires adjustments to the current situation. While continuous improvement is desirable, it is not always realistic. Smaller setbacks in the healing process should always be anticipated. At ostejo, we are happy to handle the mobilization part of the therapy. If you have further questions, please contact us.