That pain on the outside of your elbow – you know that pain on the bony bit when you grip or twist or funnily enough, play tennis?

This could be Tennis Elbow. It can be be irritating at best and absolutely debilitating at worst. It’s actually being caused by an over use or repetitive strain action on the tendon that attaches the forearm muscles to the elbow joint on the outside.

It may even be painful to touch and and the pain rockets if you bump your elbow against a door frame – which you always seem to do more of when suffering with Tennis Elbow!

There are many strategies that have been developed to help you manage your elbow pain. Annoyingly, there is not one treatment that solves every sore elbow but read on to see the one that has helped the most of my patients over the years – it’s a cracker!

TIP #1

Try and find the cause of your pain and modify that.

Remember, it may not be tennis! But it could be something that you’re doing repetitively during the course of your day. I see a lot of people with Tennis Elbow that has developed from having a poor work station or even using a laptop on their lap for long periods of time but it could also be caused by overload activities in the gym or work related movements such as an electrician using a screwdriver for example.

Try and modify that activity first. Set up your laptop better – use a table so that your elbows can be bent comfortably at 90 degrees. Consider using a separate plug in keyboard. Break up your work into shorter periods of time.

If the gym is your main issue, you’ll need to identify those activities that aggravate your pain and ease back on those.

Temporarily.

Strengthening the tendon involved is going to be one of our main strategies for getting this better after all.

TIP # 2

Ice it!

Now this piece of advice believe it or not will cause some Physio’s to lose their heads! They’ll tell you it isn’t an inflammatory condition blah blah blah and they are right, but we are searching for pain relief here and that’s why you’re going to use it.

Procedure:

Wet the ice cube. Yes that’s right, run it under a cold tap till it’s nice and cold and messy. Now take that ice cube and rub it over the sore point of your elbow. Good old fashioned ice massage. Run it over the elbow for a few minutes or until the ice cube melts or you’ve made so much mess that you look like you’ve wet yourself. Which ever comes first.

You can do this as first aid whenever the elbow is sore but I like to use this after activity even if you aren’t (sore). A gym session is a prime example. You’re pre-emptively striking any pain and any minor inflammatory response that happens.

TIP #3

DO THIS AMAZING QUICK MIKE TUCK DEVELOPED TENNIS ELBOW ROUTINE!

1. Cross Friction Massage
2. Nerve Glides
3. Isometric Strengthening

As I mentioned earlier not every regime works for every elbow but this has a great strike rate and I use it as a go to piece of self management advice for my patients and you can try it for yourself.

Cross Friction Massage

The technique is simple and please watch my very amateur videography skills for full technique.

The tendon and muscle runs down the forearm from elbow to wrist/hand.

Find the tender spot on the bony part of the elbow and now take your thumb and with  a short deep thumb movement, rub your thumb across the tendon.

This is going to be a little sore! You need to use moderate pressure here.

Do it for approximately 2 minutes or until the elbow stops being sore or even becomes a little numb.

Nerve Glides

Whilst sitting or standing with your arm straight out in front of you. Palm facing down.

Bend your elbow and flex the wrist at the same time.

If you’re doing this right the back of your hand will be near your face and facing up towards the ceiling.

Next step: Straighten your arm and flatten your wrist so that you are back to your original start point with your palm facing down.

Do this 10-20 times in a nice flow-y type movement.

Isometric Strengthening

Sitting with your elbow bent and your palm facing down. Allow your wrist to flex.

Take your other hand and place it on the back of your wrist.

Now extend your bent wrist up into your hand. Use your “good” hand to resist the movement. Your wrist shouldn’t move but you’ll still be creating tension in the muscle and tendon.

Hold the tension for 3-5 seconds and then relax for 5 seconds and repeat.

Do 10-15 reps to begin with. As this becomes a little less sore add a few more reps each day.

Do this routine 2-3 x per day. EVERY DAY.

This little holy trinity of self management movements and techniques can make an immediate difference to your symptoms but most people notice a difference after completing the regime over a couple weeks.

One last piece of commentary on Tennis Elbow Clasps….

Personally, I’m not a big fan. I’m not sure that they “offload” the tendon sufficiently but it works for you? Go for it.

Finally, the doctor will prescribe some pain relief and anti inflammatories and these can help – lots of people have their own ideas around use of these and it’s an entirely personal thing. As a rule of thumb I advise the use of these medications if your pain is sufficient to stop you completing your activities of daily living comfortably. In rehab terms if you cannot complete my exercise regime, you should first reduce the time or number of reps of the exercises and if that fails, take some pain relief in order to complete the rehab programme.

Remember if your pain is persistent or you are experiencing pins and needles, numbness or weakness in the arm, you should seek the advice of a local physiotherapist or seek the advice of your doctor.

So good luck! You are now sufficiently armed and ready to sort out your elbow pain!