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Tennis elbow
The dreaded tennis elbow – funny thing is that most people who get “tennis elbow” don’t even play tennis. Seriously. It’s also known as lateral epicondylitis and now more commonly referred to as lateral epicondylalgia. Why the change in a name? The suffix itis at the end of epicondyl conveys that the condition is inflammatory in nature. Recent research disputes this claim, so it has been dropped and algia has been added. The algia part refers to non-inflammatory changes in the extensor carpi radials brevis tendon, weird name for the tendon that attaches to the outside of your elbow.
The collagen of the tendon essentially starts to break down and is no longer healthy. Then it hurts, and you want it not to hurt. Even though the majority of people with lateral elbow pain have what is correctly termed lateral epicondylalgia, it’s still possible for a person to have lateral epicondylitis.
The itis type is more acute and easier to treat. It’s due to inflammation, so a simple over the counter anti-inflammatory reduces symptoms considerably. Lateral epicondylalgia is a different story since the changes in the collagen of the tendon are not due to inflammation. This variety of lateral elbow pain often proves difficult to treat and is well-known for hanging around for months. If you have tennis elbow, there’s a good chance it’s the algia, not the itis variety, particularly if it’s been around for over a month or two. What to do?
In order to “fix” the problem the collagen fibers of the tendon need to be “remodeled.” Sounds weird, huh? “Remodeling” collagen?
The collagen that comprises the tendon gets all jumbled up and is just not right when this condition is present. The collagen should be oriented in a parallel fashion without cross linking and overlapping. Remodeling simply means taking the collagen from a jumbled up mess to an orderly, parallel configuration. How to do that? Your good friend exercise of course! Exercise is the only treatment that actually changes live tissues positively and naturally. Everything else is a cover-up of symptoms or an attempt to change tissues without exercise. Sometimes these things work, sometimes they make things worse, and sometimes they do nothing.
There are two issues people have with exercise: you actually have to do something, and results are not immediate. For these reasons the simple, but not easy, fix of exercise for many health issues is ignored altogether. If you really want to beat tennis elbow, a specific type of exercise is the best way. It’s called eccentric loading. This means a muscle contracts as it lengthens. For tennis elbow, you want the muscle that connects to the tendon that’s affected, to contract while it’s lengthening.
The tough part is this type of exercise causes soreness and can be uncomfortable while you’re doing it. This is because the tissues that have become dysfunctional are being whipped back into shape. In order to address the underlying problem opposed to just the symptoms, this pain must be endured.
To load the exercise, you can use a light dumbbell (1-5 pounds), elastic tubing, a weird rubber bar (thera-bar), or a can of food. I recommend using a can of food because you won’t have to buy anything. One can of food is 1 pound. This may be too light. If you need more weight, get a plastic bag and put two to five cans in it to get two to five pounds of resistance.
1. Straighten arm; pull wrist back.
2. Place weight, can of food, loaded bag, etc. in hand that is pulled back.
3. Slowly lower hand so it is pointing down.
4. Before you pull wrist back up, remove weight from hand.
5. Now pull wrist back up WITHOUT weight in hand.
6. Place weight back in hand with wrist pulled back and repeat steps 3 and 4.
The lowering of the wrist with the weight is what eccentrically loads the tendon. This increases blood flow to the tendon and helps align the collagen fibers correctly.
Exercise should be done every day.
Week 1: 3 sets x 5 reps
Week 2: 3 sets x 10 reps
Week 3: 3 sets x 15 reps
Week 4: 3 sets x 15 reps
Week 5: 4 sets x 15 reps
Week 6: 4 sets x 20 reps
Week 7: 4 sets x 20 reps
Week 8: 4 sets x 20 reps
Commit to this exercise program for eight weeks and your tennis elbow pain will be greatly reduced or will go away completely. Eight weeks is nothing considering tennis elbow can linger for up to 48 months! The condition is self-limiting, meaning it will eventually quit hurting, in 12 to 48 months though. This exercise will reduce pain and actually promote healing of the damaged tendon in a MUCH shorter amount of time compared to letting the condition heal on its own.