Despite its name, Tennis Elbow (lateral epicondylitis) affects far more than just athletes. In fact, the majority of people who experience this persistent outer elbow pain have never picked up a racket. It is primarily a repetitive strain injury caused by overloading the tendons that attach your forearm muscles to the bone.
Whether you’re an avid tennis player, a carpenter using a screwdriver, or an office professional spending long hours typing, the repetitive nature of these tasks can lead to microscopic irritation and strain in the tendon. At Surrey 152 St Fleetwood Physiotherapy and Sports Injury Clinic in Surrey, BC, we help identify the mechanical causes of your pain and provide a structured path to recovery.
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Signs and Symptoms of Tennis Elbow
Tennis elbow typically begins as a dull ache on the bony bump on the outside of your elbow. Over time, this can progress to:
- Pain that radiates down the forearm toward the wrist.
- Weakness in your grip strength, making it difficult to hold a coffee mug or turn a doorknob.
- Sharp pain when extending the wrist or fingers against resistance.
- Increased soreness the morning after repetitive activity.
If left untreated, this condition can move from an acute inflammatory state to a chronic degenerative state, where the tendon tissue begins to break down. Early intervention is key to a faster recovery.
RELATED READING: 10 Exercises to Relieve Tennis Elbow
How Physiotherapy Treats Tennis Elbow
At our Fleetwood clinic, we move beyond simply masking the pain. We focus on healing the tendon and correcting the movement patterns that caused the injury in the first place.
1. Load Management and Education
The first step is often learning how to modify your daily activities to stop “poking the fire.” We help you identify which movements are aggravating the tendon and how to perform those tasks differently while you heal.
2. Isotonic Loading: The Modern Approach
While older research focused heavily on eccentric training (lengthening the muscle under load), modern clinical evidence suggests that the tendon thrives on Isotonic Loading. This includes both concentric (shortening) and eccentric (lengthening) phases.
The tendon tissue itself cannot distinguish between the direction of the muscle contraction. What it does respond to is Total Time Under Tension and the magnitude of the load. By using both phases of the movement, we maximize the mechanical stimulus to the tendon, encouraging the collagen fibers to realign and strengthen. This comprehensive approach ensures that your forearm is prepared for the real world demands of both lifting (concentric) and controlled lowering (eccentric) of objects.
3. Manual Therapy and IMS
Our therapists use hands-on techniques to improve mobility in the elbow and wrist joints. We may also utilize Intramuscular Stimulation (IMS) or dry needling to release chronic tension in the forearm muscles, which takes the mechanical pull off the injured tendon.
4. Assessing the Shoulder and Neck
Interestingly, elbow pain is often a symptom of weakness elsewhere. If your shoulder is weak or your neck is stiff, your elbow often has to work twice as hard to compensate. We assess your entire “upper kinetic chain” to ensure the elbow isn’t being overloaded by a lack of support from above.
Prognosis: What the Research Says About Recovery
If you are frustrated that your elbow isn’t better after two weeks, you are not alone. High level meta-analyses and systematic reviews on the prognosis of tennis elbow indicate that it is a notoriously stubborn condition.
The One Year Reality
Large scale studies often describe tennis elbow as a self limiting condition, but the timeframe is longer than most expect. Systematic reviews show that for many patients, symptoms can persist for 6 to 12 months. Research indicates that while 80% to 90% of patients recover within a year with conservative management (like physiotherapy), the road is often non-linear, with periods of improvement followed by minor flare ups.
Why Does It Take So Long?
Tendons have a much lower blood supply than muscles, meaning the cellular turnover and repair process is significantly slower. Physiotherapy is designed to optimize this environment, ensuring you fall into that 90% recovery bracket and helping you manage the load so you can stay functional during the healing months.
Ergonomics and Technique Modification
For many residents in Surrey, work is a primary driver of elbow strain. As part of your treatment, we look at your environment. This might include:
- Office Ergonomics: Adjusting keyboard and mouse height to reduce constant wrist extension.
- Tool Modification: Using different grip sizes or specialized tools to reduce the force required by the forearm.
- Sporting Technique: Analyzing your backhand or grip tension to ensure your equipment and form are working with your body, not against it.
Reclaiming Your Strength
Tennis elbow can be a stubborn injury, but it is highly treatable with a patient, evidence based approach. The goal is not just to get you pain free, but to make your tendons stronger than they were before the injury occurred.
If you are struggling with persistent elbow pain that is limiting your work or your hobbies, the team at Surrey 152 St Fleetwood Physiotherapy and Sports Injury Clinic is here to help. We provide the expertise and tools needed to resolve your symptoms and get you back to your favorite activities with a firm, pain free grip.