Physiotherapy Treatment of Tennis Elbow

Tennis elbow (lateral epicondylitis)

Definition: Inflammation in the common origin of elbow extensors.

Physiotherapy treatment

Conservative treatment

1. Cryotherapy (cold therapy)

2. Supportive measures (Tennis elbow straps)

3. Electrical stimulation

4. Iontophoresis

5. TENS

6. Gentle effleurage and kneading during the first two weeks (inter friction treatment)

7. Active movements and mild resistive exercise

Postoperative physiotherapy treatments

Note: Surgery is rarely indicated in resistant cases not responding to conservative treatment

1. Measures to reduce pain and inflammation

2. Limb elevation and speedy as well as sustained active movements to the joints free of immobilization.

When mobilization is allowed (1 week)

3. Begin with slow relaxed full ROM passive movement to the elbow, forearm and wrist.

4. Shoulder and shoulder girdle should be mobilized to full ROM to avoid adhesive capsulitis.

5. Begins with gradual active assisted exercise and progress to self-resistive techniques. Ultrasound and TENS can be used to reduce pain.

6. Functional movements, carefully avoiding repetitive supination, wrist extension and strong grip.  

7. Progress gradually to PRE. By 5-6 weeks, functionally painless elbow, forearm and wrist movements should be regained.