Treatments And Technologies We Use To Treat Tennis Elbow Pain
There are a wide range of therapeutic options for golfers elbow and tennis elbow. Broadly speaking there are the classical medical approaches ie. drugs and surgery. There are the classical hand therapist approaches like braces and hand exercises. And there are the more physical tissue healing interventions favored by European style physical therapists.
At Severn we tend to lean towards the European ‘tissue healing’ style of treatment at first, then later encourage our patients to work on gentle forearm strengthening. We only opt for drug and surgical options as a last resort, unless of course anti-inflammatories are needed in the short term, prior to our treatments taking effect.
ESWT utilizes shock waves to directly target and stimulate the healing process within the affected tendon, providing a non-invasive and effective alternative for treating both tennis elbow and golfer’s elbow.
Numerous studies suggest that ESWT should be considered as an initial treatment for epicondylitis, especially for chronic patients with calcified lesions, as it has shown effectiveness for newly diagnosed cases. Let’s delve into how ESWT works to improve and alleviate symptoms of both lateral and medial epicondylitis.
During the procedure, high-energy shock waves are precisely directed to the affected tendons, triggering a series of biological responses that promote healing and tissue regeneration. These shock waves penetrate deep into the tendons, prompting the release of growth factors and encouraging the formation of new blood vessels, a process known as neovascularization. This surge in blood flow enhances the delivery of oxygen and nutrients to the damaged tissues, expediting the healing process.
Furthermore, ESWT disrupts abnormal tissue within the tendons, breaking down scar tissue and stimulating the production of collagen, which strengthens and repairs the tendons. Additionally, ESWT offers an analgesic effect, easing the pain and inflammation associated with both lateral and medial epicondylitis. By directly targeting the root cause of both tennis elbow and golfer’s elbow, ESWT provides a non-invasive and effective treatment option for individuals struggling with these conditions.
We offer focused shockwave therapy (FSWT) as an alternative to radial shockwave for lateral or medial epicondylitis for those who do not experience improvement from radial shockwave therapy. FSWT is specifically designed to target deeper structures within the affected elbow joint, delivering high-intensity shockwaves directly to the source of pain and inflammation. This focused approach allows for greater penetration and precision in treating stubborn cases of tennis elbow or golfer’s elbow. Our compassionate and experienced team understands the physical and emotional toll that chronic elbow pain can take on individuals. That’s why we prioritize patient comfort and support throughout the entire treatment process.
We specialize in offering cutting-edge Low-Level Laser Therapy (LLLT) as a highly effective treatment for lateral or medial epicondylitis. Utilizing specific light wavelengths, LLLT penetrates deep into tissues, initiating cellular repair processes and mitigating inflammation. This non-invasive therapy is renowned for its ability to expedite tissue healing and provide substantial pain relief, akin to receiving a steroid shot but without any side effects. LLLT works by stimulating the release of ATP (adenosine triphosphate) in the soft tissue, thereby increasing tissue metabolism and promoting cellular repair. Through LLLT, individuals receive targeted and impactful treatment, facilitating accelerated recovery and allowing them to swiftly return to their daily activities with improved comfort and mobility.
Our therapists specialize in manual release techniques, including cross-friction massage and ischemic compression techniques. These alleviate muscle tension and fascial adhesions commonly associated with tennis and golfer’s elbow. By targeting areas of repetitive stress and unresolved injuries in the adjacent soft tissue surrounding the elbow joint, these techniques aim to break down scar tissue and promote tissue healing. Cross-friction massage and Ischemic compression help stimulate blood flow and oxygen delivery to the affected tissues, reducing inflammation and pain.
Additionally, manual therapy techniques help improve joint mobility and restore proper biomechanics, relieving strain on the elbow tendons. Through personalized care and skilled hands-on therapy, we empower patients to overcome tennis and golfers elbow pain and regain optimal arm function.
Instrument-Assisted Soft Tissue Mobilization (IASTM) is an integral part of our treatment approach for lateral or medial epicondylitis. This technique effectively breaks down scar tissue and stimulates tissue healing, promoting faster recovery and improved outcomes for our patients. With IASTM, we target the underlying issues contributing to epicondylitis, promoting tissue regeneration and restoring function. Our skilled therapists utilize advanced tools and techniques to deliver targeted care and support optimal recovery for our patients.
Dry needling is a technique used to address stubborn pain associated with tennis or golfer’s elbow by targeting trigger points, adhesions, and scar tissue in the affected muscles. During the procedure, thin needles are inserted into specific areas of the muscles to stimulate a healing response. This process helps release tight knots of muscle fibers and break down adhesions, allowing for improved blood flow and tissue healing. By targeting these trigger points and adhesions directly, dry needling can effectively relieve pain, reduce inflammation, and restore mobility in the elbow joint. This non-invasive approach offers a valuable option for individuals seeking relief from persistent elbow pain and dysfunction.
Part of any comprehensive strategy to treat tennis elbow and golfer’s elbow should be aimed at restoring function and optimal strength at the elbow ,forearm and wrist to prevent relapse. Personalized stretching, strengthening, and functional training protocols target the root causes of tennis elbow and golfer’s elbow.
Stretching exercises improve flexibility in the forearm, wrist, and elbow, reducing muscle tension and promoting tissue healing. Strengthening protocols address muscular imbalances and weaknesses, providing stability and support to the affected tendons. Additionally, functional training focuses on modifying movement patterns to reduce stress on the medial tendons, facilitating a safe return to daily activities. By combining these strategies, we provide individuals with the tools they need to overcome tennis and golfer’s elbow, restoring function and improving quality of life.
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage pain and inflammation associated with lateral or medial epicondylitis. These medications help reduce pain and swelling, allowing individuals to perform daily activities with greater comfort. However, NSAIDs should be used with caution and under medical supervision due to potential side effects. While effective in providing short-term relief, they are often part of a comprehensive treatment plan that includes other modalities such as physical therapy and rest. And due to the inherent risks of long term medication use they should be considered a non-preferred option for long term management of tennis elbow and golfer’s elbow.
Braces or bandages worn around the elbow or forearm can help alleviate strain on the muscles and tendons, providing support and stability during daily activities. These supportive devices reduce excessive movement of the elbow joint, allowing injured tissues to heal properly and minimizing discomfort associated with lateral or medial epicondylitis. Short term tennis elbow / golfers elbow symptom relief can be achieved in this manner.
There is a very definite risk with the prolonged use of braces for issues like tennis elbow / golfers elbow. Prolonged use of artificial support can easily cause muscle wasting and further tightening of tissues. Best practice guidelines indicate that sparing use of braces and supports should be heavily supported by rehab work like that outlined in some of the other tennis elbow treatment options on this list.
Regularly applying ice packs or cold therapy to the affected elbow can help reduce pain and inflammation associated with lateral or medial epicondylitis. Cold therapy constricts blood vessels, numbs the area, and reduces swelling, providing temporary relief from symptoms and promoting healing in the affected tissues.
Cold therapy is an excellent, safe and non-toxic way to reduce your pain during the rehabilitation process. It can also be good for settling down treatment reactions. Longer term most people find that interventions like cold therapy offer good symptom relief from tennis elbow and golfer’s elbow but ultimately do not ‘fix’ the issue.
Steroid injections are often administered to individuals with severe or persistent symptoms of lateral or medial epicondylitis. These injections deliver anti-inflammatory medication directly into the affected area, providing immediate relief from pain and swelling. However, steroid injections are typically reserved for short-term symptom management and may not address the underlying cause of the condition. In addition to steroid injections, other substances such as Botox, hyaluronic acid, or autologous blood (the body’s own blood) may be injected into the elbow joint to alleviate pain and inflammation in individuals with lateral or medial epicondylitis. These injections aim to provide symptomatic relief and improve joint function.
Steroid injections are extremely bad for the body’s soft tissues which is why your surgeon will only give you 2 per body part in your entire lifetime. Theory should absolutely be considered a last resort to managing tennis elbow and golfer’s elbow.
In severe cases of tennis elbow and golfer’s elbow that do not respond to conservative treatments, surgical intervention may be recommended. Surgical approaches may involve detaching parts of the forearm muscles or separating and destroying nerves that carry pain signals from the affected area. Surgery aims to alleviate pain, improve function, and promote long-term healing in individuals with chronic or debilitating lateral or medial epicondylitis.
Happily surgery is seldom required in tennis elbow and golfer’s elbow treatment, and it should always be a last resort due the inherent risks.