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PT For Tennis Elbow – The 5 Best Exercises

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Both stretching and strengthening exercises are important and provide the foundation of a rehabilitation program. The exercises should be performed as soon as pain allows and then continued until and after full fitness has been achieved.

Wrist extension stretches and exercises are the most important with the aim of gradually increasing the load transmitted through the tendon and its attachment whilst also being within the limits of pain. Isometric (also known as static exercises) are done first and involve contracting the muscles without actually moving the wrist. They should only be started once the initial pain and inflammation has settled down.

Below is a walk through of the 5 best exercises to cure tennis elbow yourself. An aggregated summary of the five most effective exercises to help in the recovery of tennis elbow. After speaking with physical therapists, occupational therapists, and medical professionals and combining their feedback with readily available information online and gaining additional insight from patients who have effectively recovered from a tennis elbow injury using various exercises, I’ve compiled a list consisting of the exercises that were most frequently referenced and stated to be effective in treatment.

The Fist clench

Poor grip strength is a common symptom of tennis elbow. Improving grip strength by building the muscles of the forearm can help improve ability to perform daily activities.

Equipment needed: table and towel

Muscles worked: long flexor tendons of the fingers and thumb


  1. Sit at a table with your forearm resting on the table.
  2. Hold a rolled up towel or small ball in your hand.
  3. Squeeze the towel in your hand and hold for 10 seconds.
  4. Release and repeat 10 times. Switch and do the other arm.


Supination with a dumbbell

The supinator muscle is a large muscle of the forearm that attaches into the elbow. It’s responsible for turning the palm upward and is often involved in movements that can cause tennis elbow.

Equipment needed: table and 2-pound dumbbell

Muscles worked: supinator muscle


  1. Sit in a chair holding a 2-pound dumbbell vertically in your hand with your elbow resting on your knee.
  2. Let the weight of the dumbbell help rotate the arm outward, turning the palm up.
  3. Rotate the hand back the other direction until your palm is facing downward.
  4. Repeat 20 times on each side.
  5. Try to isolate the movement to your lower arm, keeping your upper arm and elbow still.

Wrist extension

The wrist extensors are a group of muscles that are responsible for bending the wrist, like during the hand signal for stop. These small muscles that connect into the elbow are often subject to overuse, especially during racquet sports.

Equipment needed: table and 2-pound dumbbell

Muscles worked: wrist extensors


  1. Sit in a chair holding a 2-pound dumbbell in your hand with your palm facing down, resting your elbow comfortably on your knee.
  2. Keeping your palm facing down, extend your wrist by curling it towards your body. If this is too challenging, do the movement with no weight.
  3. Return to starting position and repeat 10 times on each side.
  4. Try to isolate the movement to the wrist, keeping the rest of the arm still.

Wrist flexion

The wrist flexors are a group of muscles that work opposite the wrist extensors. These small muscles that connect into the elbow are also subject to overuse, leading to pain and inflammation.

Equipment needed: table and 2-pound dumbbell

Muscles worked: wrist flexors


  1. Sit in a chair holding a 2-pound dumbbell in your hand with your palm facing up and elbow resting comfortably on your knee.
  2. Keeping your palm facing up, flex your wrist by curling it towards your body.
  3. Return to starting position and repeat 10 times on each side.
  4. Try to isolate the movement to the wrist, keeping the rest of the arm still.

Towel twist

Equipment needed: hand towel

Muscles worked: wrist extensors, wrist flexors


  1. Sit in a chair holding a towel with both hands, shoulders relaxed.
  2. Twist the towel with both hands in opposite directions as if you are wringing out water.
  3. Repeat 10 times then repeat another 10 times in the other direction.
Best Doggy Toy

Best Doggy Toy

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What is the best doggy toy and dog training tool out there?

It may be obvious, it may be not. But when looking at all the different variable; cost, longevity, fun, ease, accessibility, effectiveness, there is a clear winner – the tennis ball!

A tennis ball is perfectly shaped to fit inside dog’s mouth, the round small ball is almost identical to the natural curvature of the inside of your dogs front teeth. A tennis ball bounces and rolls and can be easily spotted in long green grass.

A tennis ball has a furry outer cover layer of material that dogs love, similar to a plush style doggy toy, and it picks up the scents it comes in contact with, like your scent, after you’ve held the ball in your hand and thrown it around a few times.

A tennis ball floats in water.

A tennis ball can fit inside your pant pocket, making it easily transportable and allows you to bring it to the park or the yard for a game of fetch without having to carry anything in your arms.

A tennis ball can be tossed and travel long distances, allowing your dog to run a significant distance to grab it and get some solid exercise. All of which can be accomplished with little effort from you, as a tennis ball is light and can easily be thrown far by anyone.

A tennis ball is robust and resilient and can withstand harsh weather and all types of environmental factors and still be a functional, usable toy for years to come. Even young, small puppies can pick them up, and carry them around.

Tennis balls are cheap, cheap, cheap. A tennis ball is cheaper than any other doggy toy on the market. You can find them at a variety of stores, and easily replace them at any time if needed.

A tennis ball makes a unique sound when it’s bounced and your dog will learn to identify and recognize that unique sound and will know it signifies play time.

Tennis balls are usually a green yellow neon color which makes them perfect for hiding in the grass and your dog will love looking for it. It is close enough to the color of grass to be a fun find for you dog, but unique enough in color that the prize is attainable.

You can hollow out the tennis ball, creating a space inside of it, and use that space for hidden treats and treasures for your pup to encourage training and learn new tricks or just to add some additional excitement to play time.

The tennis ball is unparalleled as training device as well as toy. Treasure it. There is virtually no reason to set off on a search for the most costly dog toy or the fanciest training tool or some new gimmick item promising to keep your dog entertained, when you most likely already own the best dog toy you will ever find. Your dog will love it, they all do, and they’ll thank you for it.

Some tips:

1) Try not to give canines a chance to play unattended with a tennis ball. Less is more. Leaving the toy, any toy by itself giving unlimited access, and the toy will loose it’s appeal rather quickly. If you limit the tennis ball to play only when you are available to play to, when you are actively involved in play time, and don’t over saturate your dogs access to the ball, it will remain as an exciting toy that your dog will jump and bark for every time you pull it out of your pocket it, or your pup here’s it’s signature bounce on the lawn.

2) Don’t let dogs chew or destroy the tennis ball. The tennis ball is to be treasured. It is an orb of pure mystery and should be treated as preciously as a Fabergé egg for that is how your dog shall view it if you keep their tennis ball interest in tact.

3) Introduce puppies to the joys of the tennis ball early in life. It will pay off later.

4) Never be without one. An emergency tennis ball is, in many cases, as useful as a distress flare on a sinking ship. The tennis ball. The best dog toy ever invented. Fact.


Tennis Regulations

Tennis Regulations

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Tennis Regulations:


There’s two different ways that you can play, there’s doubles or singles. A Doubles match would be when two partners play two partners and a singles match is one-on-one and the match consists of sets and games.


A set consists of the first person to win six games winning by two, with a tiebreaker being played at six-to-six. The winner of a match is the first person to win two out of three sets. The attire for tennis differs at every club and facility that you’re playing at one of the main recommendations for tennis is an all court purpose shoe or sneaker, which is basically a shoe with a non-marking outer sole. This is recommended so you don’t mark up the courts and scuff up the paint job, especially on hard courts.


The equipment needed for tennis is a tennis racket, and multiple tennis balls and access to a regulation court. The courts measurements for doubles is 36 feet by 78 feet and for singles is 27 feet by 78 feet and the net is three feet high in the middle.


On the court are a few different white lines that outline the playing territory for the game as well as the out of line boundaries that result in the loss of a point. The boundaries will vary depending on whether it’s a singles match or doubles match.


For doubles, you will pay attention to the doubles alleys (doubles lines), which are used exclusively in a doubles game. You will also want to be mindful of the service line, which marks off the service boxes and indicates where the initial serve has to land to be considered ‘in.’ You will also want to be aware of the base line, which is the farthest line marked on the back of the court.


Within the game of tennis there are penalties one of which is the ‘foot fault,’ which is when your foot has gone on or over the line before you’ve made contact with the serve. There’s also a ‘double fault’ penalty, which indicates that you have missed both of your opportunities to get your serve in. And the last penalty is called the ‘let,’ which carries two variable meanings. A let can mean that you hit a serve and the ball hit the net then went in, and as a result you get to repeat that serve and that serve only. A let penalty can also mean any hindrance in play. For example, if you’re playing a game and the people playing next to you hit a ball that rolls onto your court, you can call a let and replay that point and only that point


When playing in a doubles match, the first serve will always be served from the right hand side of the rectangular shaped court. The served ball must land within the service box diagonally across the net. One partner of the pair will serve the ball while the other partner waits, diligently watching, and awaiting to receive the ball as it returns.


The tennis match begins as the server serves the first ball. You have to get the ball from your side of the net to the opponents’ side of the net, and if the ball doesn’t make it, it’s referred to as a fault. In the case of a fault during your serve, you will get a second chance to try to serve again successfully. If you fault a second time, it is called a ‘double fault.’ In the case of a double fault, your opponent will be awarded a point.


A tennis match is made up of multiple sets, which are comprised of games, each game consists of points. So each match consists of points, games, and sets. A set consists of a number of games (six games minimum), and each game is comprised of points. The set is won by the side that is first to win 6 games, with at least 2 games margin over the other side; 6-to-3 or 7-to-5. When both sides are tied at the end of the set, or at the end of six games, then a tie-breaker will take place.


Most tennis matches are played in a best-of-three sets format, so if you’re the winner of two consecutive sets, than you’ve won the match. Since you are playing within a ‘best out of three’ format, once you’ve won two consecutive sets (two of the three possible sets), you’ve already achieved the best of the three, and there would be no need to play the third set. The match ends as soon as this winning condition is met. While most tennis matches employ the best-of-three formula, some matches are played using a best-of-five sets formula instead. The best-of-five sets formula is practiced during the men’s singles or doubles matches at the Majors as well as the Davis Cup matches.


The current score is typically called out loud by the person serving the ball at the start of the game. The server calls out their score first, followed by their opponents score second. The score calling system is unusual in the game of tennis, as a unique language has been established to refer to the number of points achieved by either side. The terms and numbers that are used to signify one point or two points earned, do not correlate to the actual and literal number of points earned, and do not reflect their true numeric value. It is easiest to understand when viewing the chart below. The scoring system could be very hard to follow without knowledge of what each term means. For instance, one point would not be one point, instead one point is called ‘15.’

To give you an example of this, if the server has won three points so far in the game, and the non-server has only won one point, the score to be announced would be “40-15”.


If both sides have won the same number of points, the score will be expressed by the referenced term followed by the word ‘all.’ For example, if both sides have scored once, then the current score vocalized by the server would be “15-all.” If both sides have scored twice it would similarly be expressed as “30-all,” and so on. However if each side has accumulated three total points, then the server will vocalize “deuce,” when serving, instead of “40-all.” From that point on in the continued game, as long as the score remains tied between both sides, the score is expressed as ‘deuce,’ regardless of how many more points have been played.


The system or order of scoring points will increase in this order; love > 15 > 30 > 40 > game. But if you and your opponent, let’s call him Mike both reach 40 points, within the same game, which is called a deuce then you will need to score two consecutive points in a row, and two points more than Mike in order to win the game.


In a standard game, scoring beyond the “deuce,” which signifies that both players have scored a total of three points each, requires that one of the players must achieve a two point lead ahead of their opponent in order to win the game. Once you’ve reached this point in the game, the scoring is called “advantage scoring” or “ads.” Whichever side wins the next point after the “deuce,” is the side that is said to have the advantage. If the side with the advantage point looses the following point, the score is again a “deuce,” since the score becomes a tie yet again. If the side with the advantage point wins the next consecutive point, than they are now 2 points ahead of their opponent following the tie, and will win the game.


When the server is the player with the advantage, the score may be referred to as the ‘advantage in.’ On the contrary, when the server’s opponent is the side who has the advantage, the score may be expressed as the ‘advantage out.’ These terms can similarly be shortened and expressed as the ‘ad in’ or ‘van in’ or ‘my ad in’ and ‘ad out’ or ‘your ad.’ During professional tournaments the umpire will be the person announcing the scores and will instead use the players’ names; ‘advantage Williams’ or ‘advantage Nadal.’


The role of receiver and server will rotate back and forth, server becoming receiver and receiver becoming server, rotating with each new game. On the initial serve, the ball is served from the right hand side of the court, and must land within the service box, on the other side of the net, on the server’s left side (diagonally across). You can take a look at the image below to get a better visualization of this.


In a singles match, since there is only one player on each side of the net, the receiver will return the ball from the service box diagonally across from the server. Whereas in a doubles match, since there are two players on either side, the player of the pair standing diagonally across from the server, would be the player responsible for returning the initial serve.


Once the ball is successfully served, it can be returned anywhere within the guiding lines of the court, and is no longer limited to the service boxes and service lines. The guiding lines in a doubles game are slightly wider than that of a singles tennis match. As there are more players involved in a doubles match, the boundaries of the court are extended through the doubles alley’s, providing a larger total playing area.

Within an advantage set, the set will continue until one team or player wins six games and achieves a two game lead over their opponent or opponents. So, the set continues on until one team wins the set by two games.


The United States Tennis Association rules no longer include advantage sets, meaning advantage sets are no longer used within United States Tennis Association followed games. However advantage sets are still played in the men’s and women’s draws in singles matches of the Australian Open, French Open, Wimbledon, and Fed Cup. Wimbledon plays a best-of-three match, the first two are played as tie-break sets, and the final is played as an advantage set. All other mixed doubles at the Gran Slams are played as best-of-three and the final set played is a ‘super tie-break’ set, which can also be referred to as a best-of-two set.


A tie-break set is played in accordance with the same rules as an advantage set except with one distinguishing difference. Unlike an advantage set, within a tie-break set when the score is tied at 6-to-6, a tie-break game or tiebreaker is played.


A tie-break game is typically played until one player wins seven points by a lead of two or more points. However, the tie-break point requirements can vary, sometimes instead of 7 points the rule may be 8 or 10 points instead. When the set score is tied at 6-6, a 7-point tie-breaker game will often be played to determine who wins the set. A score of the number of games won within a given set is counted in the ordinary numerical fashion, except when a player or team has a score of zero having not won any games, in that scenario their score is expressed as ‘love.’ The score is written out using numeral digits, separated by a dash and will be announced by either the judge or the server at the start of each new game.


A popular alternative to the advantage scoring format, is the ‘no-advantage’ or ‘no-ad’ scoring model, created by James Van Alen. The ‘no-advantage’ system was created in an effort to minimize the duration of playing time within the match. Within the no-advantage scoring system, the first player to win four points, wins that game. No-ads scoring eliminates the two point lead requirement, thus establishing a game winner, sooner. In the case of a tied game, a deuce within this scoring system, the next player to win a point, wins that game (match point). This no-advantage scoring system is practiced in most World TeamTennis matches. When the no-advantage system is implemented, at deuce, the receiver has the option to choose which side of the court he or she would like to return the serve from. However, in no-ad mixed doubles play gender always serves to the same gender at game point and during the final point of tiebreaks.


Because of the way the game of tennis is scored, set by set and game by game, a player may win the match despite having lost majority of the games. Similarly, a player can loose the match despite having won majority of the games and/or points. An example of this was when Rodger Federer won the 2009 Wimbledon final against Andy Roddick, despite Roddick having won 39 of the games played and Federer winning 38 of the games. See table below for a detailed summary of their 2009 Wimbledon final match:


Rodger Federer Andy Roddick Game Winner
Game 1 5 7 Roddick
Game 2 7 6 Federer
Game 3 7 6 Federer
Game 4 3 6 Roddick
Game 5 16 14 Federer
Total Points 38 39


Now that we’ve all got a bit of an education, it’s time to get on the tennis court…. and hit some balls!


How to Play Tennis – Basic Rules of The Game



The game of tennis originated in England back in the 19th century. Tennis has expanded and is now played all over the world. There are four major tennis tournaments that are referred to as the ‘majors’ which include Wimbledon, US Open, French Open and Australian tournament.


Basic Rules of The Game

So you’ve purchased your new tennis outfit, and you’re looking the part from head to toe. You have sun visor, your shirt and your shorts, and some great looking, comfortable athletic sneakers on foot. You’ve selected a racquet, but now what?

I’m here to help explain the basic rules of the game, to ensure your questions are answered, and the rules are clearly laid out ahead of time. This way you can focus on enjoying the game and harnessing your skills without the distraction.


Players & Equipment

Tennis can be played individually or with a partner on your team, referred to as either a singles match or a doubles match. Within the rectangle court is a base line, service areas, and two tram lines down either side. Which lines are used will vary depending on whether you are playing singles, or doubles. In a singles match game you would use the inner side tram lines. However, in a doubles match you would instead be using the outer tram lines.

  • baseline – at the back
  • service areas – two spaces just over the net in which successful serves must land
  • two tram lines – down either side

take a look at the accompanied images to help visualize the sections and dimensions of the tennis court layout


Object of The Game

Tennis is played on a rectangular court, with a mesh tennis running down middle, cutting the rectangle into two equal halves. Each player is aiming to hit the ball over the net so that it lands within the margins of the opposite side of the court, while also aiming to make their opponent unable to successfully return the ball. Each time your opponent is unable to return the ball, assuming you did not hit the ball outside, you are awarded 1 point.


Who Serves First

Believe it or not…. usually a simple coin toss or spin of the racquet determines who will serve first in a tennis game. The winner of the coin toss has the option of serving first or receiving first. And their opponent gets to pick which side of the court they will claim to begin the game.

Once it is determined who will serve first to being the game, that person will continue to serve the ball until the set is finished. Once the set is over, the two players will rotate, and the prior receiver will become the server. This rotation process will continue throughout the game, and the players will rotate at the end of each set.


Fault and Double Fault

Do note that the server is given two opportunities to serve the ball within the service court as marked in the diagram below. When the server fails to get his first serve into the diagonally opposite service court, it is called a fault serve. A double fault is committed if the server fails to get his second serve into the diagonally opposite service court and the receiver will then earn a point.

If the ball hits the net and falls within the service court, this is called a “let serve”, the server will be entitled to re-serve the ball into the service court. For example, if a “net serve” is made on the server’s first serve, the server will be entitled to re-serve his first serve. There are no limits to the number of “net serves” a player can commit.

The server should stand before the right side of the baseline and serve the ball diagonally across to the receiver’s right service court and then proceed to serve from his left side of the baseline diagonally across to the receiver’s left service court.


Counting score in tennis match is some tricky business. The server’s score is always announced first before the receiver’s throughout the game.
The point system of a tennis match is as follows:

• No points are scored = Love
• 1 point scored = 15 points
• 2 points scored = 30 points
• 3 points scored = 40 points
• 4 points earned = set point (set over)

For a tennis player to win a game, he/she must win with at least a two point lead.

If the score is tied at 40 to 40 (what is called as a “Deuce”), a player must earn two consecutive points (an “Advantage” point and “Point”) to win the game. If the player who has an “Advantage” point loses the next point, the score will be “Deuce” once again.

A set is won when a player has won a minimum of six games with a two game advantage over his opponent, for example, the potential score for a six game set maybe 6 – 0 or 6 – 4 but not 6 – 5. In a scenario where the score is tied at 5 – 5, a player must win 2 consecutive games before he wins a set. For example, a player may win a set with the score of 7 – 5 or 8 – 6.

In or Out

Is the shot in or out? The time old question and the focal point of many mid-game arguments during professional tournaments. You can almost count on an argument breaking out at some point during professional tournament tennis match between the tennis pro and the match officials, regarding whether or not the tennis ball is in or out as it lands.

Singles – in a singles game the ball must hit within the service courts, the back court and the alley line as marked in the diagram above in order to be considered ‘in’ and for a point to be scored. Balls that hit between the side line and alley line are considered ‘out’ or off the court and therefore the opponent earns the point.

Doubles – in a doubles game the ball must hit within both the service courts the back court and the area between the alley line and side line for a point to be scored and to be considered ‘in.’

Winning the Game

To win the game you must win a certain amount of sets (best of three for women’s matches and best of 5 sets for men’s matches). Winning a set is simply the first player to reach 6 games but have to be clear by at least 2 games. If your opponent wins 5 games you must win the set 7-5. If the set goes to 6-6 then a tie break is played and it’s simply the first player to 7 points.

Rules of Tennis

  • The game starts with a coin toss to determine which player must serve first and which side they want to serve from.
  • The server must then serve each point from alternative sides on the base line. At no point must the server’s feet move in front of the baseline on the court prior to hitting their serve.
  • If the server fails to get their first serve in they may take advantage of a second serve. If they again fail to get their second serve in then a double fault will be called and the point lost.
  • If the server clips the net but the ball goes in the service area still then let is called and they get to take that serve again without penalty. If the ball hits the net and fails to go in the service area then out is called and they lose that serve.
  • The receiver may stand where they wish upon receipt of the serve. If the ball is struck without the serve bouncing then the server will receive the point.
  • Once a serve has been made the amount of shots between the players can be unlimited. The point is won by hitting the ball so the opponent fails to return it in the scoring areas.
  • Points are awarded in scores of 15, 30 and 40. 15 represent 1 point, 30 = 2 and 40 = 3. You need 4 points to win a game. If a game lands on 40-40 it’s known as deuce. From deuce a player needs to win 2 consecutive points to win the game. After winning one point from the deuce that player is on advantage. If the player wins the next point they win the game, if they loose it goes back to deuce.
  • To win the set a player must win 6 games by 2 or more. The opening sets will go to a tie break if its ends up 6-6 where players play first to 7 points. The final set will not have a tie break and requires players to win by two games with no limits.
  • If a player touches the net, distracts his opponent or impedes in anyway then they automatically lose the point.
  • The ball can hit any part of the line for the point to be called in, outside the line and the ball is out.
  • The balls in a tennis match are changed for new balls every 6 games
  • A player loses a point if they fail to return the ball in either the correct areas on the court, hits the net and doesn’t go into opponent’s area or fails to return the ball before it bounces twice in their half.





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What is Tennis Elbow? Symptoms, Causes & Treatments

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  • tennis elbow is caused by overuse
  • it will usually get better on its own without treatment
  • the best cure for tennis elbow is rest
  • recovery time can take 6 months to 1 year
  • there are non-surgical treatments for tennis elbow, both medical and holistic

In this article we’re going to take a deep dive into tennis elbow and discuss an overview of all the basics regarding the cause of a tennis elbow injury, the symptoms to be aware of to properly identify the injury, various treatment options, and provide a link to various braces that can assist in the recovery process

Tennis elbow is an injury caused by overuse. It typically comes as a result of repetitive motions and strenuous activities that cause a strain in the forearm. Tennis elbow can also develop following trauma, after knocking or banging the elbow into something hard that causes injury to the tendon.

Tennis elbow is a self-limiting condition which means it will eventually get better on it’s own without the need for treatment intervention. The healing process for tennis elbow can take anywhere from 6 months up to a year. The healing process can vary based on the severity of the injury. Because tendons heal very slowly, depending on the extent of injury to the tendons, the recovery time can take many months.

The injury site of tennis elbow is typically the lateral epicondyle, which is a bony bump on the outside of the elbow where the muscles attach to the bone. When symptoms of tennis elbow last for 6 weeks or less, they are categorized as sub-acute. However, when symptoms of tennis elbow persist for more than three months, it is considered to be chronic tennis elbow.


What is tennis elbow?

Tennis elbow is the term most commonly used for the medical syndrome, Lateral Epicondylitis. Tennis elbow is a painful condition and the most common overuse syndrome of the elbow, often related to excessive wrist extension.

More specifically, it is an inflammation of the tendons on the outside of the elbow, an injury involving the extensor muscles of the forearm. These tendons join the forearm muscles, and as these tendons and muscles are repeating the same repetitive movements, the overuse of these motions cause damage to the muscles and the tendons. The result is pain and discomfort on the outside of the elbow.

It is not surprising that a syndrome associated with overuse of the elbow, would often be associated with the sport of tennis and racquet sports and other sports activities involving frequent extension, flexing and general movement of the arm. However it is actually less commonly found in tennis players than non-tennis players.

Research shows that only 5% of people suffering from tennis elbow relate the injury to playing tennis. And of that 5% who do link tennis activity to their tennis elbow, those athletes are typically playing tennis a minimum of 3 days per week for at least 30 minutes per day.

Anyone who is regularly and consistently engaged in activity involving repetitive motions of the arm, is susceptible to a tennis elbow injury. However, most people who have experienced tennis elbow are between the ages of 30 and 50 years old. When it comes to sports like tennis or any racquet sport, the use of improper equipment or improper technique can instigate a tennis elbow injury. For instance, a frequently replicated improper tennis stroke, can cause injury to the lateral epicondylitis.



What is Lateral Epicondylitis?

Lateral Epicondylitis , more commonly called tennis elbow is when the extensor muscles of the forearm have experienced an injury. The extensor muscles originate on the lateral epicondylar region of the distal humerus. In a lot of cases, the insertion of the extensor carpi radialis brevis is involved.

The primary cause of epicondylitis is chronic stress of the tendon that attaches on the humerus. Chronic stress of the tendon happens as a result of contractile overuse. When the upper arm extremity is involved in repetitive activities and sport, overuse can occur. Activities that have been known to cause overuse include heavy use of the computer, heavy weight lifting, pronation and supination of the forearm with force, and reoccurring vibration. Despite the word tennis being used to describe this ailment, tennis elbow is commonly seen in sports like squash, badminton, baseball, swimming and sports involving field throwing. The repetition of winding back and forcefully releasing your arm, focused on one side of the body, is a movement also practiced regularly within specialized fields like electrical work, carpentry, gardening, and therefore tennis elbow can also be seen within these fields of practice.


Anatomy – Getting more familiar with the anatomy of our forearms

Our elbow joints are made up of 3 bones:

  1. Humerus (upper arm bone) – long bone that extends from the elbow to the shoulder. The humerus bone consists of 3 sections; a rounded head, narrow neck, and two short processes. It functions to connect the scapula to the two bones of the lower arm.
  2. Radius or radial bone – one of the two large bones in the forearm, stretches from lateral side (farther away from your body) of the elbow to the thumb side of the wrist and runs parallel to the ulna. It’s main purpose is to anchor the muscles of the upper arm and forearm.
  3. Ulna – one of the two large bones in the forearm, extends from the medial side (closer to your body) of the elbow to the smallest finger. It runs parallel to the radius and is the longer and larger of the two forearm bones.

The musculoskeletal system of the forearm is made up of both the bones as shown above, as well as the musculature or the system of muscles within the forearm. This system of muscles within the forearm all work together to perform a variety of movements. These movements, or motions produced by the forearm muscles are abduction, adduction, extension, and flexion. The forearm muscles are also responsible for two special movements, the supination (anterior rotation) and pronation (posterior rotation) of the forearm and hands.

Now that we’ve covered the basic musculoskeletal anatomy of the forearm, let’s talk about what parts of the muscular system and skeletal system of the forearm that play a role in a tennis elbow injury.

A joint within the body is a place where two bones connect to allow for parts of the body to move. The elbow joint, as the title would indicate, is the joint located at the midsection of the arm, that we refer to as our elbow. The elbow joint as seen in the photo above, is the meeting place for all 3 bones of the arm; the upper arm bone called the humerus, as well as the two forearm bones, referred to as the ulna and the radius. The elbow joint, is where all 3 of these bones come together to allow for all the motions of the arm. The joint is made up of cartilage and fibrous tissue.

At the bottom of the humerus, there are bony bumps called epicondyles. The bony bump located on the lateral side, or the outside of the elbow is called the lateral epicondyle.

There are also nerves that run through the arm. When a nerve is pinched, which is called nerve entrapment, you may feel tingling,pain, numbness, or weakness of the arm. The nerve in or near the elbow that most commonly gets pinched is called the ulnar nerve.

The ulnar nerve is also the nerve responsible for what people often refer to as ‘hitting your funny bone.’ The funny feeling that results from bumping your humerus. This action doesn’t do any damage to your elbow, arm or nerve, but can cause a funny (temporary) sensation which is the result of the ulnar nerve bumping against the humerus bone.


Diagnosis :

What does tennis elbow feel like? What are the symptoms of tennis elbow?

The first sign of a tennis elbow injury is pain or tenderness of the lateral epicondyle (elbow). The pain may move from the elbow and eventually spread throughout the forearm. In some cases the pain may extend as far as the back of the middle and ring finger. In addition to the pain and tenderness, the muscles within the forearm may feel tight and sore.

If you feel a confirmed diagnosis is needed and decide to schedule a doctors appointment to examine you for tennis elbow, your doctor will want you to flex your arm, write and elbow and identify which movements of your arm are causing pain. Identifying the types of motions, rotations that are most painful will help the doctor to identify which muscles, tendons are involved. In some cases your doctor may want to request imagining tests like and X-ray or MRI (magnetic resonance imaging)to confirm the diagnosis of tennis elbow but to also simultaneously rule out other more serious injuries.

***The feeling of numbness or tingling is usually indicative of a pinched nerve on or near the elbow. The nerve (most often the ulnar nerve) is typically entrapped and can cause pain, tingling, numbness, weakness of the hand, wrist and arm. Tennis elbow injury by itself would not cause tingling or numbness unless a nerve is also pinched in addition to the tennis elbow injury.


Treatment  : How to treat tennis elbow

Tennis elbow is a self-limiting condition which means it will eventually get better on it’s own without the need for treatment intervention. The healing process for tennis elbow can take anywhere from 6 months up to a year. The healing process can vary based on the severity of the injury. Because tendons heal very slowly, depending on the extent of injury to the tendons, the recovery time can take many months.

The injury site of tennis elbow is typically the lateral epicondyle, which is a bony bump on the outside of the elbow where the muscles attach to the bone. When symptoms of tennis elbow last for 6 weeks or less, they are categorized as sub-acute. However, when symptoms of tennis elbow persist for more than three months, it is considered to be chronic tennis elbow.

Medical management for the remedy of tennis elbow consists of NSAID, ice, elevation and the use of an elbow counter-force brace. If and only if the symptoms are resistant to these treatments, surgical treatment may be suggested. There are various forms of physical management and therapies that are used in the treatment of tennis elbow. The most commonly suggested methods of treatment are Cyriax therapy, stretching and exercises with the Flexbar.

How long does it take to recover from tennis elbow?

A number of simple treatments can help alleviate tennis elbow related pain.  It is also possible for tennis elbow to improve on its own in time with sufficient rest to allow for the injured tendons to recover. However, due to the slow rate at which tendons heal, tennis elbow recovery can take 6 months to 12 months to fully recuperate from.

How to Heal Tennis Elbow Quickly

If you are looking to speed up the recovery process, there are a variety of recommend ways to best cure tennis elbow at home, holistically as well as options for medical intervention.

How to treat tennis elbow at home

The best cure for tennis elbow without medical intervention is rest and relaxation, allowing the tendons enough time to recuperate naturally. You can accomplish this by modifying and/or eliminating activities that involve repetitive movement of the arm. Applying heat, ice and creams has also proven to be a helpful remedy for tennis elbow and allow for the natural recovery from the injury at home. Many people have found that wearing an elbow brace to support the elbow and the unavoidable motions of daily activity, to be a great tool in alleviating symptoms and assisting in the healing process.

In order to cure tennis elbow yourself, at home you first want to ensure you’ve reduced inflammation of the area and given the tendons and muscles a chance to sufficiently rest. Ice and compression can be utilized to assist in the reduction of the inflammation. Once inflammation subsides, you can begin gentle tennis elbow exercises to strengthen the affected muscles and avoid a recurrence of the same injury.

Below is a link to more detailed information on suggested lateral epicondylitis exercises (tennis elbow exercises). It is always best to consult a doctor following an injury to ensure you are ready for exercise. You can also visit a physical therapist to be assisted in pt exercise for tennis elbow. A single visit to learn and gain familiarity in pt for tennis elbow is often helpful in the learning process. After being shown the proper exercises, you can repeat them on your own and continue to recover from your tennis elbow injury at home. It is also possible to learn these options of exercise online if you do not wish to to see a physical therapist.

Click here to view detailed information on lateral epicondylitis exercises

A counter-force tennis elbow strap is often thought to be the best remedy for tennis elbow. The tennis elbow brace assists in reducing tension of the muscles as they interact with the lateral epicondyle to create motions of the arm.

Here are some recommended elbow braces to look into:

Best medicine for tennis elbow

  • Taking an anti-inflammatory medication can be useful on the onset of tennis elbow injury. Nonsteroidal anti-inflammatory (NSAIDs), such as ibuprofen, naproxen, or aspirin.
  • PT or physical therapy can also be effective to cure tennis elbow. PT that involves strengthening exercises as well as ultrasound therapy is often recommended as the best cure for tennis elbow
  • Direct injections of steroids or cortisol shots into the affected area have also proven to be a great way to heal tennis elbow
  • Steroid or cortisol injections straight into the effected area
  • There is also research in support of platelet-rich plasma (PRP) or autoglous blood injections (ABI), which is a process of collecting blood from a healthy area within the body and then injecting that healthy blood into the injured area of the lateral epicondyle
  • When all else fails, there is also the option of surgery available if the less invasive, formerly mentioned options do not prove to be helpful.

Tennis Elbow Surgery (Lateral Epicondylitis Debridement)

Prior to surgery, doctors will likely recommend an arthroscopy procedure. Arthroscopy is a procedure in which a surgeon can inspect, diagnose and repair problems inside a joint. The literal meaning of the word arthroscopy is defined as, ‘to look within the joint.’ During the arthroscopy the surgeon will insert a small camera into the elbow joint called an arthroscope.

Tennis elbow surgery, or lateral epicondylitis debridement is only recommended when the pain related to the injury is incapacitating and all other forms of treatment have been exhausted. Since standard recovery time for tennis elbow is 6 months up until 1 year, a doctor will not consider surgery as a reasonable treatment protocol for tennis elbow unless the pain and discomfort has persisted beyond a year, and shown no sign of improvement despite multiple attempts of non-surgical intervention. Only after all other tennis elbow remedies have failed, will a doctor consider the surgical treatment for tennis elbow. The surgery that is available, when necessary removes the damaged or diseased tendon tissue and then reattaches the healthy tissue to the bone. This surgery can be performed in an outpatient setting. Recovery time for tennis elbow surgery is estimated to be roughly 3 months to 6 months and may require continued strength exercises to properly heal.

Surgery may leave your arm temporarily immobile for a period of time and a splint will be provided. The splint is typically removed after about a week. Once the splint is removed exercise to stretch and restore flexibility begins, followed by light and gradually increasing exercises to rebuild strength. Strength building is usually started roughly 2 months after surgery. Patients are usually advised to return to athletic activity about 4 to 6 months after surgery.  Patients report successful outcomes after surgery 80% to 90% percent of the time, however some report a loss of strength after surgery. Total elbow surgery recovery time can take six months or more.

Only when the pain you’re experiencing is incapacitating and hasn’t responded to conservative treatments over the last six to 12 months, is surgery considered. It involves removal of the degenerated, diseased tendon tissues in an outpatient center. Because of the inconsistent results of surgery for lateral epicondylitis, every effort is made to find successful conservative treatment before surgery is considered.