Tennis Elbow Rehab

• REST
  Avoid all activity that aggravates the injury. It is important to maintain your activity level. Absolute rest should be avoided as it may lead to additional muscle atrophy. It also deconditions the tissue. High activity levels contribute to an increased blood supply to the area, all of which helps the healthy process. Listen to your body. Pain will be the best guide as to what is an appropriate level of activity. If it hurts, don't do it.
  
• ICE
  Icing the affected area is recommended as long as the inflammation is present. Ice may come in the form of cold packs, Ice in a Ziploc bag, or even ice in frozen paper cups. The cold temperatures help to slow down local metabolism in the elbow. Depending on the type of injury, you may want to continue icing the area for as long as inflammation is present. This may mean icing the area during the entire rehabilitation process. It may be particularly beneficial to ice the area as you return to more strenuous activity.
  
• COMPRESS
• ELEVATE We want to keep the swelling as light as possible. Fortunately, we have 2 powerful tools, compression and elevation. Compression works by minimizing the volume. Elevation takes advantage of the natural forces of gravity to assist venous return of the fluid causing the swelling. This is fancy way of saying that the gravity makes the blood run down the arm versus pooling in the swollen area. This helps to keep the swelling to lower levels. Less swelling means less secondary trauma to the area.

• Stretching
  1. Focus on the gentle stretching exercises. You should work on increasing the range of motion during wrist flexion, wrist extension and wrist rotation.
  2. Make certain that the elbow is extended and the arm is straight. Keeping the arm straight increase the range of the stretch.
  3. Hold each stretch for 20 - 30 seconds
  4. Focus on feeling the muscles gradually relax into the stretch.
  5. Repeat at least twice a day.
  6. Stretch only to the point of comfortable motion.
  7. REMEMBER you want to help the area, NOT re-injure it.
  
  Stretch 1 - Forearm Flexors
  

  Stretch 2 - Forearm Extensors
  

• Strengthening
  • Perform the following exercises with the wrist supported and the elbow bent.
    1. Wrist Flexion
       

    2. Wrist Extension
       

    3. Forearm Pronation / Supination
       
    4. Finger Extension with Rubber band
       

    5. Ball Squeeze
       
       
  
  

It is very common for people to reinjure themselves at this stage by subjecting themselves far too much strain before the tendons have fully healed. During Phase 3, continue stretching and strengthening exercise from Phase 2.

Below, we have created an example of how a tennis player with lateral epicondylitis should progress back to high activity levels. Most commonly, a tennis player will develop tennis elbow in their dominant arm. This progression takes that into account.