Tennis elbow is treatable
The good news is that it is perfectly possible to do your own tennis elbow treatment at home. The not-so-good news is that a cure for tennis elbow can be challenging. Patience is essential in this process. There are no new treatments for tennis elbow that are proven but there are tried and tested treatment options which do work.
As described earlier, the changes in tennis elbow have developed over a long period of time and will therefore take typically months to heal. However, patient expectation tends to be the opposite as many people think that tennis elbow should get better more quickly such as over a couple of weeks. They often ask how to heal or cure tennis elbow fast which is really not possible.
1. Relative rest
Since tennis elbow is an overuse disorder then you will need to either stop the activity that caused it for a period of time or modify it so that you get relative rest.
One of the main factors that can make tennis elbow last longer is if patients continue to do the same activity which caused the tennis elbow to develop in the first place. In the case of hobbies, it might be easy to stop for a period of time to allow healing to take place. However, if that activity is related to your work, then it may be completely impractical to ask you to stop altogether. It is especially difficult if you have your own business and work by yourself.
Examples of modifications include taking regular breaks during work, using the other hand, using a lighter grip or getting help with certain tasks. Do you have a holiday coming up? That would be great because you would get complete rest from work. If you use a keyboard, then consider using speech recognition software to give your hands some rest or use the wrist supports mentioned below. All of these things will take some, but not all the strain from your muscles and tendons.
Modify the way you lift objects
A: This is the correct way to lift an object with your palms facing upwards. This allows you to use your big biceps muscles to do the lifting and avoid strain around the elbow.
B: In this diagram, the hands are held so that the palms are facing each other. You are still using the biceps a little but are now straining the smaller muscles around your elbows.
C: Now the palms are facing downwards and all the strain is being taken by the smaller muscles around the elbow. This is the worst possible position for tennis elbow and should be avoided.
Modify the way you use a keyboard and mouse
Incorrect position: The wrist is angled upwards or to the side. This puts the muscles around the elbow under tension for long periods of time. This can cause tennis elbow or wrist pain. Sometimes it is called RSI or a Repetitive Strain Injury.
Correct position: The wrist is not angled either upwards, downwards or sideways. This prevents strain of the muscles and tendons around the elbow. You can achieve this position more easily by getting a rest for your wrists when using a keyboard and mouse.
Use a rest in order to keep your wrist level when using a keyboard or mouse. This is a really simple solution for tennis elbow if you spend long hours in front of a computer. It will keep stop you from falling into bad habits and straining your muscles and tendons. Most people also find it a more comfortable position and you will wonder why you did not use one before.
2. Take simple painkillers
Simple pain-relieving medicines can give you symptomatic relief. Examples include paracetamol and ibuprofen. These can commonly be bought over the counter.
Of course, the medicines give you temporary relief only and do not treat the underlying cause of the problem. However, they can make the pain more bearable whilst you are doing other forms of treatment. No painkiller is better than another. You should find what suits you best.
3. Do regular stretching exercises
You can stretch the correct muscles and tendons affected by tennis elbow by holding your elbow straight and then flexing the wrist using your other hand. In the second diagram above, notice how the hand is also rotated inwards at the same time to get a better stretch.
Then you will need to stretch in the opposite direction and hold the wrist in extension using the other hand.
All stretches should be held for about 30 seconds and repeated 10 times. They should also be passive. This means that it is the other hand that is holding the tennis elbow arm in stretch. Applying ice for 10-15 minutes to make the area feel numb before stretching also adds to pain relief.
4. Eccentric exercise
Eccentric exercises are one of the few proven therapies for tendon pain as there is in tennis elbow.
See the video below for an eccentric exercise for tennis elbow:
This exercise involves holding a 1-3kg weight in the affected hand whilst the forearm is supported. The weight is then lowered slowly over 4-5 seconds using a wrist movement. At the bottom of the movement, you then use the other hand to lift the weight to its starting position. This is to avoid straining the affected muscles and tendons. You then lower the weight again slowly over 4-5 seconds.
This movement effectively stretches the muscles and tendons under strain from the weight held in the hand.
5. Tennis elbow massage
Using massage balls is an effective method to treat tennis elbow. Simply use a small rubber ball for this purpose. The goal is to target and massage the muscles on the side and back of the forearm associated with tennis elbow, applying extra pressure on tender areas. It is beneficial to perform this massage prior to the stretching exercises mentioned above. You can use a single massage ball or some people find that the peanut-shaped ball is more stable and easier to use. Take a look at the video below to see the technique for using massage balls.
6. Use a tennis elbow brace
A tennis elbow brace is worn around the broadest part of the forearm and not over the elbow itself. It gives temporary relief of pain whilst it is worn. It can therefore be used during the day and can be useful whilst at work. It works most likely by putting pressure on ‘trigger points’ in the affected muscles similar to acupressure. It is sometimes called a tennis elbow strap or support. Studies show that it is effective.
7. Wear a wrist splint
A wrist splint consists of a material which overlaps your wrist joint and contains a metal insert which stops the wrist from moving. Unlike a tennis elbow brace, a wrist splint is difficult to wear at work. The best time to wear it is after work and at bedtime. It works by allowing the muscles and tendons around your elbow to rest and allow healing to take place.
8. What about a steroid injection for tennis elbow?
Steroid injections are the treatment most used by doctors to treat tennis elbow. Studies show that they do give short-term relief for up to a few months.
However, evidence suggests that the problem ends up lasting much longer in people who have had injections after the initial period of relief.
Steroid injections do not treat the underlying cause. They were initially used because we thought that the problem was due to inflammation. However, we now know that this is not the case.
Summary
Tennis elbow is an overuse problem. The most important first treatment is relative rest or modification of the movements causing it.
Active treatment works best in the form of massage and stretching, plus eccentric exercises.
Passive treatment in the form of a tennis elbow brace or wrist splint works less well. These should only be used as an addition to the exercises and not relied on to work by themselves.
Steroid injections may be useful for some people for short-term relief.
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