Tennis Elbow: Why it Should Be Called “Activity Elbow” (and how to treat it)

First, a little explanation. Lateral epicondylitis, also known as tennis elbow, is inflammation at the lateral epicondyle of the elbow that causes pain in that distinct location as well as radiating into the forearm. Where is the lateral epicondyle, you may ask? Well turn your hand palm up, find your elbow, and look for the knobby spot on the outside of the arm. If you have sharp pain there, you may have lateral epicondylitis.

But why does tennis get all the credit for causing this pain? It’s true that tennis is a sport with repetitive movements that can cause this inflammation, but more often than not it’s other movement. Any kind of repetitive motion that can cause it! A lot of people with jobs that involve repetitive lifting (packaging, working on a line, etc) are succeptible to lateral epicondylitis. This is not only an athletic injury – thus my proposal of “activity elbow”. It’s more inclusive!

If you feel like you may have pain in the region that I described and are guilty of performing a lot of repetitive upper extremity movement, watch the above YouTube video to see demonstrations of some exercises that may help. Here are some more in-depth descriptions of the recommended exercises:

  • Weighted forearm flexion using a small weight or improvizing with a soup can. This exercise as well as the next couple are targeting the forearm which is where pain can radiate to with this diagnosis. Keep elbow bent to 90 degrees and tucked in close to your abdomen in order to isolate the proper musculature.
  • Weighted forearm extension (see positioning recommendations in above exercise). In the YouTube video I flipped my wrist over to work against gravity, making this exercise a bit more challenging. You can modify to make it a little easier by keeping the palm up do do this. You can also prop the forearm on a surface such as a table for this or the flexion exercise to make it slightly easier and to isolate the muscles more.
  • Weighted forearm pronation and supination (turning palm over) with elbow bent to 90 degrees and arm close to your body. Pinching a towel may help to keep your arm close to your body so you don’t forget.
  • While you have your towel out, towel twists are another good way to engage the forearm and improve mobility while decreasing pain.
  • Tricep stretch to target compensatory muscle tightness above and at the elbow. To do a triceps stretch, raise your arm over your head with your elbow bent, like you’re trying to scratch your back. Use your other arm for overpressure.
  • Radial nerve flossing. The radial nerve runs close to the area of the forearm that could be getting tight. This is good to do if you start to feel numbness or tingling down into the forearm or fingers. Nerves can’t be stretched, but they can be wiggled back and forth (kinda like flossing between teeth) to break up the sticky spots that they are getting trapped in under tight muscles. This exercise is difficult to explain, so definitely watch the YouTube video to see the visual demonstration.

One thing that is super important with lateral epicondylitis is to rest it. The inflammation was caused in the first place because of overuse, so this is your body’s warning shot to take it easy. If possible, take a break from the activity that caused it to flare up in the first place. If this isn’t an option, think of ways or talk to your physical therapist or medical professional about ways you can modify your activity to decrease the stress on that elbow. It’s amazing how a small change in the way you move can yield big results. PTs are pretty obsessed with body mechanics for exactly this reason.

We do all these exercises and more at my clinic in Troy, Michigan! Feel free to reach out with any questions, future blog suggestions, or to schedule an appointment to reduce your pain!