Elbow Hand Hand Therapy Lateral Epicondylitis Tennis Elbow

Advice from a Certified Hand Therapist on Tennis Elbow

a man holds his painful, aching elbow ** Note: Shallow depth of field

I have pain on the outside of my elbow when reaching for objects with my elbow extended. The pain increases if the object weighs more than a few pounds, such as a gallon of milk, a coffee pot or the laundry detergent. How did I get this pain?

The condition you are describing may be lateral epicondylitis, more commonly known as “tennis elbow.” The irony is that this overuse condition often occurs in non-tennis players from improper lifting and carrying of objects, or from performing activities that are highly repetitive in nature. The activities translate force to the outside of the elbow, causing inflammation and micro-tears in the tendon (see diagram below).

TennisElbow_Fig1
There are times when my elbow is really painful. Is there a treatment for healing the micro-tears?

Yes, of course, if you’re willing to ask your physician for a referral to see a certified hand therapist. The hand therapist will most likely recommend that you wear a counterforce brace (see below), perform stretching exercises and ice the elbow.

That’s interesting, but how does the counterforce orthosis work?
Glad you asked, because the concept is a bit tricky. When a muscle contracts, it shortens and pulls on the tendon or “loads” the tendon. The orthosis simply supports the muscle so there is less load on the tendon.

Tennis Elbow counterforce brace example
How can I find a certified hand therapist in my area?
There is a handy search directory on the ASHT website. Simply visit https://www.asht.org/find-a-therapist. Please be certain to start your treatment as soon as possible. If you let the condition get to the chronic stage, it is much harder to treat!


Heidi Hermann Wright, DHS, MBA, OTR, CHT is a certified hand therapist and a member of the American Society of Hand Therapists (ASHT).

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2 Comments
  • Michelle Mazur
    September 24, 2015 at 7:53 PM
    Reply

    I prefer wrist cockup rather than counterforce which is rarely donned appropriately and can cause radial tunnel compression issues.

    • Hilary Bethell
      October 10, 2015 at 4:38 PM
      Reply

      I will use both a forearm strap and wrist neutral splint if the condition is severe and I always caution about development of edema &/or nerve issues with the strap. Ice, stretching then strengthening as usual.

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