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Tennis elbow (Lateral Epicondylitis) is an overuse injury of the wrist extensor muscles, especially the extensor carpi radialis brevis (ECRB). It causes pain on the outer side of the elbow, aggravated by gripping or wrist extension.
✅ 1. Acute Phase (Pain Relief & Protection)
🔹 Rest & Activity Modification
- Avoid repetitive gripping, lifting, twisting.
- Modify work/sports technique.
🔹 Ice Therapy
- 10–15 minutes, 2–3 times/day.
🔹 Elbow Strap (Counterforce Brace)
- Reduces load on wrist extensors.
🔹 Electrotherapy (if available)
- TENS
- Therapeutic ultrasound
- IFT
🔹 NSAIDs (if prescribed by physician)
💪 2. Subacute Phase (Mobility & Early Strengthening)
Stretching Exercises
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🔹 Wrist Extensor Stretch
- Elbow straight
- Flex wrist with opposite hand
- Hold 20–30 sec × 3–5 reps
🔹 Wrist Flexor Stretch
- Extend wrist backward gently
- Hold 20–30 sec
🏋️ 3. Strengthening Phase (Most Important)
Eccentric Strengthening (Gold Standard)
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🔹 Eccentric Wrist Extension
- Hold light dumbbell (0.5–1 kg)
- Use other hand to lift wrist up
- Slowly lower wrist down (3–5 seconds)
- 10–15 reps × 3 sets
🔹 Isometric Wrist Extension
- Hold 10 seconds × 10 reps
🔹 Grip Strengthening
- Soft ball squeeze
👐 4. Manual Therapy
- Deep transverse friction massage
- Mobilization with movement (MWM)
- Myofascial release
🎯 5. Advanced / Return to Sport
- Functional training
- Sport-specific drills
- Ergonomic correction
- Gradual load progression
💉 6. If Conservative Treatment Fails (After 3–6 Months)
- Corticosteroid injection (short-term relief)
- PRP injection
- Shockwave therapy
- Surgery (rare cases)
⚠️ Red Flags (Refer to Doctor)
- Severe swelling
- Persistent pain >6 months
- Numbness/tingling (possible nerve involvement)