Pain along the outer side of the elbow is colloquially called ‘tennis elbow’ but this condition can develop from many different types of activities other than athletics. This pain is commonly brought on through repetitive tasks especially involving gripping and twisting the forearm. Examples include painting, driving screws, cutting while cooking, operating a chainsaw, or carpentry work such as hammering and sawing. The two bones which make up the forearm are the radius and ulna, and muscles which connect to the outer elbow include wrist, finger, and gripping muscles. The most common muscle to be impacted is extensor carpi radialis brevis as well as extensor digitorum, extensor carpi radialis longus, extensor carpi ulnaris, and supinator. Treatments for this condition include hands on work by the physical therapist to reduce pain in these muscles and connecting tendons, taping to support this area and reduce ongoing strain, stretching to increase the available flexibility for these muscles to work, and strengthening exercises to improve the tolerance within these muscles to complete the work required of them.
Eccentric exercise has long been recommended as the main form of strength training for this condition. Recent research suggests that completing a variety of strength training types including concentric and isometric is more beneficial at reducing recovery time during physical therapy. It is also recommended to expand the strengthening area to encompass the whole arm or kinetic chain from the scapular muscles in the back to the rotator cuff muscles in the shoulder, down to the elbow, wrist, and hand. Proprioceptive training is also recommended to improve coordination with the painful arm which likely increases awareness of positioning to assist with body mechanics and reduce reinjury during repetitive tasks.