Tennis Elbow present for 3 months – How is it Treated Successfully?
Chronic Stage tennis Elbow is defined as tender elbow Pain that lasts for more than 3 months in duration. Indeed recent research has found that up to 20% of Patient’s presenting with Tennis Elbow for greater than one year. So how is this injury successfully treated and rehabilitated back to normal painfree function?
Well the answer is to use Eccentric Exercise loading as the primary treatment driver with the goal of reduction in pain and progressive strengthening of the weakened Wrist Extensor tendons attaching to the lateral Epicondyle bone of the elbow. Overload of the tendon means that when we lift or carry an object, the stress of carrying or lifting that object is greater than what the weak elbow extensor tendons can cope with, hence what follows is micro tearing causing injury and pain response to the wrist extensor tendons attachment point of the elbow. So when we reduce the sore inflammation with ice and rest, we then need to focus on gradually increasing the strength of these wrist extensor tendons that attach to the outer elbow.
Eccentric Wrist Extension Exercise Isometric Wrist extension exercise
So what is the right Exercise?
Eccentric loading exercises involve progressively strengthening the weak tendon during gradual stretching movement of the tendon with an appropriate light weight initially. Recent studies have found that eccentric exercises help strengthen and heal tennis elbow quicker than other types of exercise. The Exercise involves, sitting down, with arm rested on edge of table, palm facing downwards with a light hand weight, as per the illustration. The exercise should only be performed under the guidance of your practitioner, who will decide the initial weight to be used and if this exercise is appropriate to the stage of your Tennis Elbow condition. With improvement, the weight resistance is gradually increased under the Guidance of your Practitioner. Prior to the commencement of this exercise, your Practitioner will prescribe an isometric exercise, see illustration. This exercise serves to reduce pain sensitivity and warm up the injured tendons prior to the eccentric loading exercises.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles.
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