Tennis elbow or lateral epicondylitis occurs when there is damage to the muscles, tendons and ligaments around the outside of the elbow joint and forearm. Small tears, called micro tears, form in the tendons and muscles which control the movement of the forearm. They cause a restriction of movement, inflammation and pain. These micro tears eventually lead to the formation of scar tissue and calcium deposits. If untreated, this scar tissue and calcium deposits can put so much pressure on the muscles and nerves that they can cut off the blood flow and pinch the nerves responsible for controlling the muscles in the forearm.
- Gentle stretching exercises including wrist
flexion, extension and rotation.
- The elbow should be extended and not flexed to
increase the amount of stretch as required.
- These stretches should be held for
20-30 seconds and repeated 5-10 times, at least twice a day.
- Vigorous stretching should be avoided - do not stretch to the point of pain that reproduces your symptoms.
With the elbow bent and the wrist supported perform the following exercises:
- Wrist Extension. Place 500gm weight in hand with palm facing downward (pronated); support forearm at the edge of a table or on your knee so that only your hand can move. Raise wrist/hand up slowly (concentric contraction), and lower slowly (eccentric contraction).
- Wrist Flexion. Place 500gm weight in hand with palm facing upward (supinated); support forearm at the edge of a table or on your knee so that only your hand can move. Bend wrist up slowly (concentric), and then lower slowly (eccentric).
- Combined Flexion/Extension. Attach one end of a string to a cut broom stick or similar device; attach the other end to a weight. In standing, extend your arms and elbows straight out in front of you. Roll the weight up from the ground by turning the wrists. Flexors are worked with the palms facing upward. Extensors are worked with the palms facing downward.
- Forearm Pronation/Supination. Grasp hammer (wrench, or some similar device) in hand with forearm supported. Rotate hand to palm down position, return to start position (hammer perpendicular to floor), rotate to palm up position, repeat. To increase or decrease resistance, by move hand farther away or closer towards the head of the hammer.
- Finger Extension. Place a rubber band around all five finger tips. Spread fingers 25 times, repeat 3 times. If resistance is not enough, add a second rubber band or use a rubber band of greater thickness which will provide more resistance.
- Ball Squeeze. Place rubber ball or tennis ball in palm of hand, squeeze 25 times, repeat 3 times. If pain is reproduced squeeze a folded sponge or piece of foam.
For all of the exercises (except combined flexion\extension) perform 10 repetitions 3-5 times a day.