The most common cause of elbow pain is an inflammation of the tendons that attach here,
in this piece of bone called lateral epicondyle, and this is called “lateral epicondylitis”.
A common cause of lateral epicondylitis is repetitive movements of the wrist,
like when a person has a poor stroke technique to play tennis.
That is why lateral epicondylitis is known as tennis elbow.
Other causes of lateral epicondylitis are repetitive movements in certain occupations like
screw driving, computer mouse or cutting up meat. Today, I’ll show you some strategies that you
can try at home to improve your pain and avoid that this problem becomes chronic.
So, let’s talk about Tennis elbow today
The lateral epicondyle is this part of the humerus bone.
Here is where the muscles of the wrist attach, so they can move your wrist and fingers up like this.
The tendon is the part of the muscle that attaches to the bone.
When the tendon gets swollen and inflamed, there is pain, and this is called tendinitis.
So, tennis elbow is a type of tendinitis of the elbow.
When the pain starts, it is usually localized right above the bone. Even a tiny pressure
on the bone will cause excruciating pain. And with time this may spread to the muscles
all around the elbow, this one here, this one here, this is myofascial pain. Like the muscles
are trying to protect the tendons, and now they start having trigger points in the muscles too.
So, it is one problem on the top of the other. The sooner you start this treatment the better.
However, if this home-based exercises or treatment program is not improving your symptoms, or if
notice numbness, tingling, burning or weakness in your arm, forearm or hand, go see your doctor
because there might be something more serious like a nerve compression, bursitis, or arthritis.
Here are 10 steps for you to try at home. Remember that the symptoms may persist for
weeks or months before this condition gets better. Tendons take a long time to heal, and sometimes
they don’t heal completely until 6 months or more. Number 1. Find out if there is an activity you are
doing that is causing this tendinitis. If you find what it is, try to avoid or modify that activity.
Use proper tennis technique and racquet size.
At work, use ergonomic tools, and avoid excessive movements.
Number 2. You may use a forearm band or strap when doing repetitive movements at work or playing
sports. The most important thing to pay attention when you buy a forearm strap is to get one that
can be adjusted easily, and is soft. You need to apply it correctly on the muscle belly right
bellow the elbow. You may use it for many hours during the day, when you are doing activities,
but take it off when you do the exercises. Number 3. Apply heat to the muscles in the forearm
before you do any exercise. I prefer a hot water bag, but you can use a heating pad,
a hot towel, or a hot compress. And this is where I apply, because this is going to relax
the muscles before you start exercising them. And you can leave this here for
5 minutes or 10 before you do any stretching or range of motion exercise.
Number 4. Apply a topical cream containing anti-inflammatory after the application of
heat. The skin will be warm and the medication will be better absorbed by the skin. Apply a small
amount around the lateral epicondyle. And you may do this 3 times a day. I usually like one that is
extra-strength, that contains diclofenac, It has to contain some anti-inflammatory, and you can buy
over-the-counter. Number 5.
Massage the muscles, you may use your other hand or a stress ball. You can use friction. Try to
find trigger points in the muscles and get rid of them. You may move the wrist up and down while you
do the massage. You may do this here. You can also do these muscles, but mostly, will be in
these muscles here where you have the pain. And if you want to massage, just go with your other hand,
and massage using friction. The muscle fibers go in this direction here, so I recommend that
you go transversal to the muscle fibers. Number 6. now do some warm-up exercises
This can be just bend and stretch the elbows gently also move the shoulders up and down
in circles, front and back, move the elbows and also move your wrists up and down
a couple of times, and also supination, pronation. This is just to warm up the muscles
before we start stretching them, so the elbows, they do basically two movements:
flexion, extension. Bended and stretched. They also do supination and pronation,
supination, pronation Remember, when you do these exercises to relax your shoulders,
so you're not getting too tense Now, we'll do stretching exercises,
with the elbow straight it's important that the elbows are straight because the muscles,
they cross this joint and they also cross the wrist, so you need to keep it straight,
with the other hand, you're going to pull downwards here, in front of the hand, so you
pull down, down down, down, this is for the whole hand, and you can hold for eight seconds, so one,
two, three, four, five, six, seven, eight, and then you're going to do finger by finger. It's
really important that you do the thumb, so here it is pull the thumb down and
two, three, four, five, six, seven, eight, and do this for each finger, you're going to feel
that those muscles are stretching and go for each one separately, the four fingers here,
the tendons are together, so it's more important that you really do separately for the thumb,
and then the other groups of muscles like the other four fingers, you can do them together,
so two, three, four, five, six, seven, eight. You don't need to cause any pain,
just need to feel that it's stretching here, a little bit, and that's enough.
You can do this when you are sitting in your computer, or when you are taking breaks at work,
or when you wake up in the morning, so if you do many times during the day, that's better,
and that's the stretching exercises for the extensors of this muscles here.
So, then the second type of exercises is strengthening exercises.
These muscles need to be strengthened, so eccentric exercises are better. I'll explain the
difference. Now you can do with the elbow banded. This muscle here, if you are strengthening,
the exercise if you're doing a strengthening when you're going down, this is eccentric,
if you're doing exercise when going up this is concentric, so eccentric is better. I'll show
you how you can do this. The first strengthening exercise is what I call the praying position,
you can do this when you're lying in bed, when you're sitting in a chair, or even standing up,
just relax your shoulders, and so this hand is going to put some resistance,
so the left, let's say that this this left side is the one that has lateral epicondylitis,
so this hand will put resistance, and then i'll go i'll start putting you see? One hand is fighting
against the other, one so here i am putting resistance, and then go to the other side,
so go this side and this side, so you can start doing this exercises on your breaks,
and when you do this for this side here it's basically this hand is doing eccentric
strengthening there, so start doing this The second strengthening exercise,
you need some sort of weights, and i recommend for example a bottle of water, or a can of soup, or if
you have weights at home you can hold something, so this would be the other exercise, just remember
relax your shoulder, always relax your shoulder, and you're going to go down and up and down.
so two repeat this eight times.
Three, so when you're going down, don't just drop the bottle, when you're going down this
is the eccentric part of the exercise, and you're going to do this slowly, because this
is important your muscle is getting stronger when you do this, okay, down all the way down,
and then all the way up, okay, the more weight you put in the hands the better, so you can progress,
you can start with half a pound, then one pound, and then two, and three as you can tolerate.
Repeat this eight times, and always do for the other side,, because we don't want
one side of your body to be stronger than the other one so whatever you do with one hamd, even
if you don't have pain on the other side, always do with the other one, so they will be balanced.
So after you do these exercises i really like to apply some ice to reduce the pain. Always remember
to cover your skin with some fabric so then you avoid some burn in your skin
and just leave the ice here, so you need to put some fabric here, can be a pillow case, or a
small towel, and just put in the area that hurts more, so remember the lateral epicondyle, is it's
just right above the elbow crease here, that's the bone where you will have the most painful
tendonitis, and you're going to leave the ice there for about 10 or 20 minutes. If you can,
and this is going to reduce any inflammation, any pain. I like to do this after the exercise.
So before the exercise apply heat, and after the exercise apply ice, or any time that the pain is
excruciating, you're having a lot of inflammation there, it's really sensitive, you can apply ice
and that will reduce the inflammation, but you need to leave it for at least 20 minutes,
and don't forget to protect the skin. If these home base strategies don't work,
talk to your doctor or physiotherapist they may suggest other therapies to treat the elbow pain.
This may include kinesiotaping, deep-heat with ultrasound, electrotherapy,
microwave therapy, shockwave therapy, injections with corticosteroids, or platelet-rich plasma,
and even surgery for the most resistant cases of lateral epicondylitis.
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you may find a summary of these positions and exercises that you
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