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Tennis and Golfers Elbow
Strategies to fight the pain.

Tennis and Golfers Elbow
Want to take care of elbow pain?

Tennis elbow (lateral epicondylitis) is a painful condition that typically happens when tendons in your elbow are overworked. It's often caused by actions that are repetitive like typing, painting, knitting or carpentry.  Sports that involve swinging a racket like tennis, racquetball and squash are also known culprits. Even fencing and weight lifting can be a problem when the same motion is frequently repeated.

The pain often starts, where the tendons of your forearm muscles attach to a bony bump on the OUTSIDE of your elbow. Over time the pain can move into your forearm and even the wrist.

Tennis Elbow

Pain that radiates out from the bony bump on the INSIDE of your elbow is commonly called golfers elbow (medial epicondylitis). Just like tennis elbow, golfers elbow is caused by repetitive motions that lead to overworking tendons in the elbow.

Treatment for either of these conditions was often nothing more than rest. It works, for awhile, but often comes back when people return to their regular activities. In more extreme cases doctors may prescribe forearm straps, braces or even surgery.

If you're suffering from tennis or golfers elbow, the first thing you should look at is the activity that may be causing it. Have a physical therapist evaluate your movement patterns to see if you need to change what you're doing. It may be poor form or underdeveloped muscles that should be strengthened. Something as simple as a grip change can mean the difference between painful and pain-free.

The next step is therapeutic exercises. In 2010 researchers published a study using a small rubber bar called a FlexBar to treat tennis elbow. Subjects were instructed to perform either standard physical therapy or a series of movements called the "Tyler Twist" with the FlexBar.

The results were stunning. 76% of the subjects performing the Tyler Twist saw marked improvement compared to only 13% of the people performing routine physical therapy. Results for pain were even more stunning, with 81% of the people using the FlexBar reporting improvement compared to only 22% of people using standard therapy. The results were so dramatic, researchers stopped the study early and opened it up to all the test subjects.

In 2014, another study was conducted to see if a modified version of the Tyler Twist could be used to help people with golfers elbow. The success rates were nearly as good as they had been for the treatment of tennis elbow.

The actual exercise is simple and takes less than nine minutes, three times a day.

Here are the instructions for TENNIS ELBOW.

(The following step-by-step instructions provided by thera-bandacademy.com.)

1. Hold FlexBar in involved (right) hand in maximum wrist extension.

Hold FlexBar
2. Grab the other end of FlexBar with uninvolved (left) hand.

Grab other end of FlexBar
3. Twist FlexBar with noninvolved wrist while holding the involved wrist in extension.

Twist FlexBar
4. Bring arms in front of the body with elbows in extension while maintaining twist in Flexbar by holding with the noninvolved wrist in full flexion and the involved wrist in full extension.

Bring arms in front of body while maintaining flex.
5. Slowly allow FlexBar to "untwist" by allowing the involved wrist to move into flexion.

Slowly allow FlexBar to "Untwist".

Here are the instructions for GOLFERS ELBOW,

(These instructions are from the International Journal of Sports Physical Therapy, May 2014 Edition.)

1. Rubber bar held in involved (right) hand in maximum wrist flexion.

Hold FlexBar
2. The other end of rubber bar grasped by noninvolved (left) hand.

Grasp end of FlexBar.
3. Rubber bar twisted by flexing the noninvolved wrist while holding the involved wrist in flexion.

Rubber FlexBar Twisted.
4. Arms brought in front of body with the elbows in extension while maintaining twist in rubber bar by holding with the noninvolved wrist in full flexion and the involved wrist in full flexion.

Rubber FlesBar Twisted
5. Rubber bar slowly untwisted by allowing the involved wrist to move into extension, slowly, approximately a five-second release.

Untwist FlexBar

Both versions of the exercise are to be performed three times a day. Each time you should do 15 reps, with a 30-second rest in-between each repetition. Keep doing the exercise for 7-8 weeks to see the best results.

Abstracts of the studies referred to in this article can be downloaded from the links below.

STUDY: Addition of isolated wrist extensor eccentric exercise to standard treatment for chronic lateral epicondylosis: A prospective randomized trial

STUDY: Clinical Outcomes of the Addition of Eccentrics for Rehabilitation of Previously Failed Treatments of Golfers Elbow

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