Tennis Elbow Management
NOT JUST A TENNIS PROBLEM
“Tennis Elbow” aka Lateral Epicondylalgia (LE) is a common diagnoses seen in the physical and occupational therapy setting which usually consists of ultrasound, massage, stretching, and strengthening to the wrist and elbow region. That’s it. The patient then returns 6 months later with the same symptoms occurring, and receives the same treatment, and this cycle continues. (1)
LE results from repetitive recreational or occupational use, such as playing tennis, lifting bags/groceries/files, or twisting with the hand and wrist (think tightening a screw or using a screw driver). Symptoms include pain and tension to the outside of your elbow, you may find when you lift your middle finger up with some tension on top of it, this will elicit pain to the outside of the elbow.
What is missing? Treating the core and scapular stabilizers! Think about it; our core, which consists of the area basically from our collar bone to our pelvic region and all the muscles and ligaments in between, is our main power house. Our arms and legs are just appendages off of it. So if our core isn’t functioning in unison, then our shoulders, ELBOWS, wrists/hands, hips, knees, and feet are going to try and make up for it. This leads to overuse injuries, such as “Tennis Elbow”.
There are so many things to address with strengthening and stabilizing our core, but for today I’m just going to focus on the scapular stabilizers, specifically the Serratus Anterior (SA) and Lower Trapezius (LT).These are the muscles that attach to and around the scapula (shoulder blade), to our spine. The SA protracts our scapula (think pushing a door open with your elbow extended), and the LT assists in upward rotation of the scapula (lift your arm up and out to the side, feel the bottom part of your scapula rotating up). When these muscles are not strengthened properly, you will over use your upper trapezius, bicep, and wrist extensors to perform lifting, pushing, and reaching overhead with or without weight.
Try these beginner lower trapezius, serratus anterior, and overall scapular stabilizing exercises to help improve posture and reduce elbow pain. BE SURE to perform pain free, and do with controlled movements.
1. Lower trapezius and middle trapezius strengthening. 12-15 reps, 2-3 sets, 3xweek.
2. Serratus anterior strengthening, 12-15 reps, 2-3 sets, 3xweek.
Beginner Serratus Anterior Strengthening
3. Beginner Serratus Anterior strengthening with band, perform as many reps as possible each set, 2-3 sets, 3xweek.
Beginner Serratus Anterior Strengthening
4. Beginner Lower Trapezius combined with Serratus Anterior strengthening; as many reps as possible, 2-3 sets, 3xweek.
So there ya go, a few key exercises to get you started on postural control and reducing elbow pain. Please e-mail me with any questions or concerns and I'd be more than happy to help you out!
References:
1. Scapular Muscle Performance in Individuals With Lateral Epicondylalgia. https://www.jospt.org/doi/pdf/10.2519/jospt.2015.5290
