As a Physical Therapist, I have the delight of providing pain relief to every patient who walks through my clinic doors. Decreasing pain leads to improved function and quality of life. If you or someone you know had or is currently experiencing elbow pain, you’ll want to read along. As a disclaimer, none of this is personalized medical advice and you should consult with your Physical Therapist or Physician if you are in pain.
Lateral elbow pain, formally known as lateral epicondylitis is a common source of elbow pain. You may have heard this referred to as tennis elbow. This usually occurs because of overuse to a muscle called the extensor carpi radialis brevis (ECRB) and microscopic tears occur where it attaches to the elbow bone (lateral epicondyle). Contrary to popular belief it’s not just tennis players who experience this type of elbow pain.
Who is at Risk?
This condition is caused by overuse of the wrist extensors. Wrist extension is when the wrist is cocked backwards. In the photo below, the hand holding the phone is in wrist extension. Think of wrist extension as a backwards motion of the wrist. Conversely, the woman’s left hand with the watch on, is in flexion, or a bent position. Anyone who overuses their wrist extensors is at risk for developing tennis elbow.
- Administrative office workers – due to excessive typing or poor desk posture
- Cooks – who are constantly using their wrists to cut and/or hold pans
- Painters – require a strong grip while holding the paint brush and also complete repetitive motions
- Mechanics – are often using their hands or lifting and laboring while at work
- Gym goers – especially common with those who complete weight bearing exercises through their hands such as push ups
These are just some examples of people at risk for elbow pain. Realistically anyone who uses their wrists excessively and with repetition could experience lateral elbow pain.
6 Steps to Reduce Elbow Pain
If you have been diagnosed with lateral epicondylitis, you likely have pain with resisted wrist extension, point tenderness or burning pain on the elbow bone, and potentially a weak grip strength. Refer to these 6 points below which are my favorite scientifically backed methods to treating elbow pain.
1. Massage the elbow
Refer to the YouTube video above to learn how to massage out the pain. Feel for the elbow bone. Most people will have pain at this location. Complaints of pain may also be right above the elbow bone, right below it, or in the muscle belly.
I would highly suggest purchasing an anti-inflammatory pain relieving cream such as the one I’ve link here. The Feel Good Lab produces an all natural lotion which is highly regarded in the ability to relieve pain and speed up recovery. I use it on myself and in my clinic daily and have found excellent results. Use code HEALTHYPROFIT10 for 10% off your order at The Feel Good Lab.
2. Stretch your wrist extensors
After you’ve complete a massage in the spot of pain you’ll want to stretch. Refer to the YouTube video above to learn how to stretch in what is referred to as the Mill’s position. Supporting your arm on a table, bend your wrist (flex) and pull your fingers over towards the pinky side to optimize your stretch.
Complete this stretch for 30 seconds, 3 times.
3. Strengthen eccentrically
After stretching, we need to strengthen the wrist extensors in a controlled fashion which is called eccentric. To complete these eccentric exercises properly, refer to the YouTube video above. You’ll want to begin with a light 1lb. weight. If you don’t have a light weight at home, you can purchase one from Amazon here. Another idea is to hold a can of tomato paste which is about 1lb.
To complete the eccentric exercises properly you’ll need to use your unaffected hand to help your painful wrist up (into extension) then slowly lower into a bent (flexed position). Complete this exercise for 3 sets of 10 repetitions. As it gets easier try for 3×12 or a 2lb. weight.
4. Exercise surrounding muscles
My philosophy as a Physical Therapist is to treat everyone will a holistic, full body approach. Often times, the wrist pain is due to compensation from weak back muscles or weak grip. Just because a client comes to me with wrist pain does not mean I only examine their wrists. It’s important to find the source of the pain to truly heal. Refer to the YouTube video for some ideas of additional muscles to strengthen.
I produced a blog with my 8 favorite upper body workout routine which you can check out here. All of these exercises are indicated and appropriate for people suffering from elbow pain with the exception to exercise #6 which is diamond pushups. With strengthening for uninvolved upper extremity muscles, you’ll want to complete 3 sets of 10 reps
- Wrist curls with a light 2lb. weight
- Supination/pronation while holding imbalance adjustable dumbbell or hammer
- Gripping exercises using silly puddy or stress ball
- Rows using a resistance band
- Shoulder (military) press with dumbbells and the shoulder in the scapular plane
- Bicep & tricep work
- Bench press with dumbbell
5. Avoid extremes
During the time of pain it is critical that you avoid painful movements. You should and still can lift and workout but with modification. Be aware of how your wrists are moving and ensure a neutral wrist. A neutral wrist means the wrist is not bending or extending.
Even with wrist pain and lateral epicondylitis in particular, you can certainly still exercise and work but with some modifications. If you frequent the gym, perhaps try to be more cautious about your wrist position with upper body lifting and avoid weight bearing.
Throughout the day be aware of how often your wrist are cocked backwards.
6. Check your posture
If you work at a desk for your career, refer to my YouTube video above for proper posture while sitting at your desk. I also wrote a blog about proper posture to avoid neck and back pain which may be helpful, too. That blog can be found here.
Additionally, being aware of posture with lifting is just as important as your sitting posture. Always remember to engage the mid back by relaxing the shoulder down the back and engage those muscles more by squeezing the shoulder blades together. Strengthening the scapular muscles
If you have a preference towards heat/ice feel free to use what feels best. In the clinic we usually begin with heat as it is a method of warming up the tissue prior to completing stretches and exercises. Ice is great for more acute injuries but can be used before bed to numb the pain. I often like to massage the tender spot with an ice stick like this one found on Amazon. In my video, I also address other common questions like using a brace or tape.
If you found this blog and video helpful please do subscribe to my YouTube channel, blog, and follow me on other social media platforms for more helpful content!
If you have any questions please write them in the comments below or contact me directly!