Why won’t my tennis elbow go away?

Tennis elbow can be a debilitating problem. The pain can so severe it is tough to hold a cup of coffee, and suffers are frequently worried they might drop their children if they pick them up.  So what is tennis elbow, and how can you fix it? The current technical term for tennis elbow is lateral epicondylosis, which literally means, “condition of the outside bump on the arm”. This doesn’t really tell you much, so let’s look at what’s actually going on.

The problem is an imbalance of movement, where the body tries to substitute with one movement for another which is dysfunctional.  Poor ergonomics can cause the problem, but classically, the patient can’t do a backhand swing in tennis, and has started to substitute wrist extension and supination (turning the palm up).  With repetition, the wrist extensor tendons become irritated, and if it continues, the body’s normal repair process degenerates.  The big culprits here are a wrist extensor muscle, extensor carpi radialis longus (Aka ECRL, seen here in purple), which pulls the back of the hand toward the forearm; and an elbow flexor, the brachiradialis (seen outlined in purple).

So what is the treatment? Active Release Technique (ART) is a powerful hands-on treatment system which breaks up scar tissue which has built up in the muscles and encourages the body to repair the tendons correctly. Traditional chiropractic manipulation has been shown to reduce tennis elbow pain immediately, in many cases.  Finally, the faulty body mechanics or ergonomics which caused the problem must be addressed, which is a process very individual to the patient. This combination of treatments corrects the movement imbalances which caused the problem in the first place. In our office, a small number of stretching and strengthening exercises are also used after ART to maintain the improvement in the muscular imbalance and prevent the problem from recurring.