How To Fix Tennis Elbow & Golfer’s Elbow

April 20, 2020Dr. Grant Radermacher

They’re a giant pain in the, well, elbow.

And you don’t even have to have ever stepped foot on a tennis court or golf course. Golfer’s and tennis elbow, or medial and lateral epicondylitis, are naggingly painful inflammatory conditions that are named for the repetitive movement patterns and loading of the forearm musculature required by each sport. But there are a ton of activities that can lead to these overuse injuries – anything from holding a baby to throwing a football or even repeated typing and texting with poor body mechanics.

What is epicondylitis?

You use your elbows constantly, but you probably don’t think much about how the joint works unless there’s pain.

Epicondyles are the bony protuberances on both the inside and outside of your elbow where 9 important sets of muscles that control the wrist attach. Doing the same movement with your elbow over and over can cause inflammation, or tendinopathies, at the point where the tendons attach to the bone.

So what’s the difference between tennis elbow and golfer’s elbow?

Medial epicondylitis (Golfer’s elbow)

The medial epicondyle is located on the inside aspect of your elbow and is an attachment point for the wrist flexors. Pain and inflammation at this location is called medial epicondylitis, and is often referred to as “golfer’s elbow.” It’s associated with golf because a ton of stress is placed on the muscle attachments at the inside of the elbow at the peak of a golfer’s backswing.

Couple that with some poor shoulder biomechanics, repeat this kind of motion thousands and thousands of times over the course of a golf season and it’s easy to see why microtears and inflammation surrounding those tendons is so common.

Patients with medial epicondylitis often complain of pain starting at the medial epicondyle and sometimes extending down the forearm, stiffness in the elbow, weakness in the hands and wrist, and sometimes numbness or tingling in the ring and pinky finger due to compression of the ulnar nerve.

Lateral epicondylitis (Tennis elbow)

The lateral epicondyle is located on the outside of the elbow. Pain and inflammation at this point is called lateral epicondylitis, usually referred to as “tennis elbow.” It’s called tennis elbow because the follow-through when swinging a tennis racket puts a ton of stress on those tendon attachment points on the outside of the elbow.

It’s also sometimes referred to as “computer elbow” or “mouse elbow” because it commonly strikes folks who spend hours at the computer as well.

Symptoms usually include pain on the outside of the elbow, pain gripping or squeezing with your hands, and/or weakness in your grip strength.

The fix?

Epicondylitis has always been a challenging condition for mainstream medicine to treat, which in practice has meant that patients are left with some not-so-helpful common advice for treatment. That usually includes the dreaded “Ice, ibuprofen, and rest” coupled with some old-school strengthening exercises (e.g. squeezing balls), corticosteroid injections and sometimes even surgery. The old-school approach generally has limited – if any – long-term success.

But there’s a better way to treat achy tendons in your elbow, and that’s with a two-pronged approach of remodeling the tendons with eccentric exercises and reinforcing them with kinesio taping.

Disclaimer: Please consult a doctor or healthcare professional to get a medical diagnosis and advice on a treatment plan for your particular condition before beginning any self-treatment described here.

Eccentric exercises

Eccentric exercises are exercises in which the muscle lengthens as it tenses. Think of a biceps curl. When you raise the dumbbell, your bicep shortens and tightens. That’s concentric contraction. When you lower the weight, the muscle lengthens, straining against the force of the weight. That’s eccentric.

You can load and remodel the tendons in the elbow much more effectively eccentrically than with concentric exercises. Clinical studies have shown that 80% of elbow pain sufferers report improvement with eccentric exercises even when traditional medical treatment failed them.

We’ll be using a rubber bar called the Theraband Flexbar. You can get it at Ascent Chiropractic or on our online store.

1. Tyler Twist for tennis elbow

For tennis elbow, the specific movement is called the Tyler Twist. To do it, you hold the bar upright at your side using the hand connected to the sore elbow, then grasps it near the top with the good hand. The top hand twists as the bar is brought around in front of the body and positioned perpendicular to the ground; the hand of the painful arm then takes over, slowly untwisting the bar by flexing the wrist.

For tennis elbow, you’ll be doing this daily for 3 sets of 15 repetitions for a minimum of six weeks – it should only take about five minutes per day.

2. Reverse Tyler Twist for golfer’s elbow

The reverse version of the Tyler Twist exercise works equally well for golfer’s elbow. It’s the same exercise as the Tyler Twist, only with different hand placements. The Flexbar is twisted in the opposite direction to help strengthen the muscles in the lower forearm.

Again, this is done daily for 3 sets of 15 repetitions for at least six weeks.

Kinesio Taping

Finally, you’re going to want to use kinesio tape or RockTape to give extra reinforcement to those tendons and minimize the stress being placed on them throughout your day – check with your chiropractor on exactly how it should be applied for your specific condition. You’ll want to use about 70% of the tape’s tension in the middle of a strip (directly over the painful joint) and 0% tension at the ends.

Correcting the entire chain

While the pain may be isolated to the elbow, there’s almost always dysfunction also going on in other joints as well – especially the shoulder and scapula. When bigger muscles aren’t doing their job effectively, it usually leads to overuse of the smaller muscles.

Every body’s different, so there’s not a true one-size-fits-all treatment plan. At Ascent Chiropractic, we’ll address your elbow pain directly but also look at your overall alignment and muscle patterns in order to identify and correct its root cause, so you can avoid it in the future.

The Ascent Chiropractic Difference

At Ascent Chiropractic we’re committed to not just relieving that nagging elbow pain but to correcting it’s cause and optimizing your body to function better than it ever has before. Our unique, low-force, evidence-based approach to treatment allows us to correct biomechanics, restore normal function, and get you out of pain and on the road back to optimal health.

Don’t want chronic pain and inflammation to be part of your future? Schedule an appointment by calling us at 262-345-4166 or use our online scheduling app.

About the Author

Dr. Grant Radermacher

Dr. Grant Radermacher is a Brookfield, WI chiropractor providing unmatched results through gentle, evidence-based chiropractic care. Our mission is simple: get you out of pain so you can get back to being you, only better.

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