What Causes “Tennis Elbow” (aka Lateral Epicondylitis) and How to Treat It (Plus Top 2 Exercises)

Yes it’s true, most of the people suffering from tennis elbow have never even picked up a racquet…

Which is a shame, because tennis is actually really fun!  My back-hand is horrible though…

So what is tennis elbow?  And what causes it?

I’m going to use my mother-in-law, the lovely Vikkie, as an example.

While Vikkie doesn’t play tennis, she does cook with a really heavy cast iron skillet.

And boy can she cook!  Since I live across the street from her, I’m at least partly to blame for her troubles (where to start, I’m sure!).

So back to Vikkie…she’s lifting these heavy skillets day after day, which requires quite a bit on strength in her wrists and forearms.

And of course she’s out working in the yard and the flower beds this time of year, so she’s gripping a bunch of tools.

And after a while she starts getting this nagging pain along the outside of her right forearm.

If you push on it, the worst spot is right near the outside of the elbow, near this little bony point the we call your “lateral epicondyle”.

(This is why tennis elbow is also called “lateral epicondylitis”, which is just a fancy way of saying that the muscles that attach to this bone are irritated and inflamed.  That’s the “-itis” part.)

What Vikkie is dealing with is essentially this: those forearm muscles have been overused so much that now they’re really irritated.

And as with most of these nagging pains, Vikkie thought it would just go away after a little while.

She even tried a little ice, and tried not to use her right arm for a while.

Unfortunately, the pain didn’t go away (and it still hasn’t because I haven’t dragged her into the clinic yet…)

So that’s the quick rundown of what is causing her tennis elbow pain.  Other folks we see in the clinic have done things like repetitively using tools.

And some have actually been tennis players, but it’s quite rare.

Now that you have that background, you next question is probably “What can I do about it?”

And to answer that question, I’m going to give you the 2 best exercises you can do at home.

If you want to see me demonstrate these exercises, I’m also posting a YouTube video at the bottom of this post.

Top 2 Exercises for Tennis Elbow:

1).  Stretch the wrist extensors.  The wrist extensors are the muscles that are irritated, and they all attach to the lateral epicondyle.  To stretch them, extend your elbow all the way straight and bend your wrist down towards your palm.  You should feel a comfortable stretch along the irritated forearm muscles.  As long as this feels comfortable, go ahead and hold the stretch for 30 seconds at a time.  You can repeat this stretch several times a day, again as long as it doesn’t cause you pain.

2).  Eccentric strengthening.  This is another technical term, but what it means is that you’re going to now strengthen the muscles that are irritated, in order to improve bloodflow.  The extra strength will also prevent future injury.  To perform eccentric exercises, start with forearm supported by something like an armrest.  Your palm should be facing down.  Using a light weight, like a 2-3# dumbbell or soup can, pull your wrist back into extension.  Now here’s the key: when you lower the weight back down towards your palm (into flexion), go really slow (about 4 seconds total).  This is the “eccentric” part of the exercise.  As long as this is well tolerated, perform 20-40 reps, until the forearm starts to burn with fatigue.  Then rest for a minute or two and perform 3 sets (again, as long as it isn’t too painful).  You can do this exercise once/day.

One last thing about tennis elbow: ice is also your friend, so make sure to ice at least a couple times/day.

And just one more thing: tennis elbow also responds very positively to friction massage.  This is where PT will typically come in.

So if you experience some pain relief with all these tips, but you can’t quite get rid of all the pain, we’ll be here to help you out.

Here’s that YouTube video.  Enjoy 🙂