In short,
- Early intervention with rest and activity modification produces better outcomes.
- Physical therapy restores strength, function, and prevents recurrence.
- Most cases respond well to conservative treatment without requiring surgery.
Understanding Elbow Tendinitis
Tendinitis of the elbow treatment begins with understanding this common condition that affects tendons connecting forearm muscles to the elbow joint. Also known as epicondylitis, elbow tendinitis develops when repetitive movements create small tears in the tendons, leading to inflammation, pain, and reduced function.
Two primary forms of elbow tendinitis exist: lateral epicondylitis, commonly called tennis elbow, and medial epicondylitis, known as golfer’s elbow. Despite their names, these conditions affect many people who have never played these sports. The distinction lies in which tendons are affected and where pain is experienced.
What Causes Elbow Tendinitis?
Elbow tendinitis results from repetitive strain and overuse that exceeds the tendon’s capacity to heal between activities. The tendons connecting forearm muscles to the bony prominences on either side of the elbow experience microscopic tears with repeated stress. When these tears accumulate faster than the body can repair them, inflammation and pain develop.
Activities involving repetitive wrist and arm movements are common culprits. Tennis, golf, painting, carpentry, plumbing, typing, and assembly line work all place significant stress on elbow tendons. Poor technique during these activities compounds the problem by creating inefficient movement patterns that increase tendon strain.
Certain factors increase your risk of developing elbow tendinitis. Age plays a role, with the condition most commonly affecting adults between 30 and 50 years old. Occupations requiring repetitive arm movements elevate risk, as do racquet sports, golf, and throwing activities. Using equipment that doesn’t fit properly or working in awkward positions also contributes to tendon stress.
Recognizing Elbow Tendinitis Symptoms
Tennis elbow primarily affects the outer side of the elbow where the forearm extensor muscles attach. Pain radiates from the lateral epicondyle down the forearm and worsens with activities requiring wrist extension or gripping. Weakness in the wrist and hand makes grasping objects difficult. Simple tasks like shaking hands, turning doorknobs, or lifting a coffee cup can trigger significant discomfort.
Golfer’s elbow affects the inner side of the elbow where the forearm flexor muscles attach. Pain centers on the medial epicondyle and intensifies with wrist flexion and forearm pronation. Activities like gripping, lifting, or twisting motions aggravate symptoms. Some patients experience numbness or tingling radiating into the ring and little fingers due to ulnar nerve irritation.
Both conditions typically develop gradually rather than from a single injury. Pain may start mild and progressively worsen over weeks or months as tendon damage accumulates.
How Elbow Tendinitis Is Diagnosed
Diagnosis begins with a comprehensive evaluation by an orthopedic doctor. Your physician will discuss symptom onset, activity patterns, and factors that worsen or relieve pain. A detailed medical history helps identify contributing activities and risk factors.
Physical examination includes palpation to identify specific areas of tenderness along the epicondyles. Range of motion testing assesses elbow flexibility and identifies movements that reproduce pain. Resisted wrist extension or flexion tests help distinguish between tennis elbow and golfer’s elbow.
Imaging studies aren’t always necessary, but may be ordered to rule out other conditions or assess severe tendon damage. X-rays can exclude arthritis, bone spurs, or fractures. MRI provides detailed images of soft tissue and reveals tendon tears or degeneration.
Ultrasound offers dynamic visualization of tendons during movement and can identify areas of inflammation or structural damage.
Conservative Treatment Approaches
Most cases of elbow tendinitis respond well to conservative treatment. The first step involves modifying or temporarily stopping activities that trigger pain. This rest period allows tendons to begin healing without continued stress. Complete immobilization isn’t recommended, as some movement promotes healthy tendon remodeling.
Ice application reduces inflammation and provides pain relief. Apply ice packs for 15 to 20 minutes several times daily, particularly after activities. Over-the-counter nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen help manage pain and reduce inflammation when used as directed.
Counterforce braces or straps worn just below the elbow can reduce stress on affected tendons during activities. These devices redistribute forces away from the damaged tendon insertion, allowing continued function while healing occurs.
Physical Therapy for Tennis Elbow and Golfer’s Elbow
Physical therapy for tennis elbow represents one of the most effective treatments for elbow tendinitis. A skilled physical therapist designs a personalized program addressing your specific condition, functional limitations, and goals.
Therapeutic Exercises
Therapeutic exercises form the foundation of rehabilitation. Eccentric strengthening exercises, which involve controlled lengthening of muscles under load, have proven particularly effective for tendon healing. These exercises stimulate collagen production and tendon remodeling, addressing the underlying structural damage rather than just symptoms.
Stretching exercises improve flexibility in forearm muscles, reducing tension on tendons. Range of motion exercises maintain elbow mobility and prevent stiffness. Progressive strengthening builds muscle endurance and prepares tendons for returning to regular activities.
Manual Therapy Techniques
Manual therapy techniques, including soft tissue mobilization and joint mobilization, reduce pain, improve blood flow, and restore normal movement patterns. Your therapist may also employ modalities like ultrasound or electrical stimulation to decrease inflammation and promote healing.
Education
Education on proper technique and ergonomics helps prevent recurrence. Learning how to perform activities with reduced tendon stress protects healing tissues and minimizes future injury risk.
Advanced Treatment Options
When conservative measures don’t provide adequate relief after several months, additional interventions may be considered.
Corticosteroid Injections
Corticosteroid injections deliver anti-inflammatory medication directly to the affected area, providing temporary pain relief. These injections can help break the pain cycle and allow participation in physical therapy. However, relief is typically temporary, and repeated injections may weaken tendons over time.
Platelet-Rich Plasma Therapy
Platelet-rich plasma therapy involves concentrating platelets from your own blood and injecting them into the damaged tendon. Platelets contain growth factors that may stimulate healing and tissue regeneration. Research continues to evaluate the long-term effectiveness of this treatment.
Dry Needling
Dry needling targets trigger points in muscles surrounding the elbow. Inserting thin needles into tight muscle bands can release tension, improve blood flow, and reduce pain referred to the tendon.
Surgical Intervention
Surgery is rarely needed but may be considered when symptoms persist despite 6 to 12 months of conservative treatment. Surgical procedures remove damaged tendon tissue and reattach healthy tendon to bone. Recovery from surgery requires several months of rehabilitation.
Preventing Elbow Tendinitis
Prevention strategies reduce your risk of developing elbow tendinitis or experiencing recurrence after treatment.
- Use proper technique during work and recreational activities. Seek instruction from qualified coaches or trainers to ensure efficient movement patterns that minimize tendon stress. Ensure equipment fits properly and is appropriate for your skill level.
- Improve workplace ergonomics by adjusting chair height, desk position, and computer placement to maintain neutral wrist and elbow positions. Take regular breaks during repetitive activities to allow tendons brief recovery periods.
- Maintain forearm muscle strength and flexibility through regular exercise. Strong, flexible muscles better absorb forces that would otherwise stress tendons. Incorporate both strengthening and stretching exercises into your routine.
- Gradually increase activity intensity rather than making sudden changes. Tendons adapt slowly to increased demands, and progressive loading allows adequate time for tissue strengthening.
Exercises for Elbow Tendinitis Management
Specific exercises support healing and prevent recurrence. Always consult your orthopedic doctor or physical therapist before starting new exercises to ensure they’re appropriate for your condition stage.
- Wrist extension stretches target tennis elbow. Extend your affected arm straight with palm facing down. Use your opposite hand to gently pull the hand downward until you feel a stretch along the top of your forearm. Hold for 15 to 30 seconds and repeat several times.
- Wrist flexion stretches address golfer’s elbow. Extend your affected arm with palm facing up. Use your opposite hand to gently pull the fingers downward, stretching the underside of your forearm. Hold for 15 to 30 seconds.
- Eccentric wrist extensions strengthen tennis elbow. Support your forearm on a table with your hand hanging over the edge, palm down. Hold a lightweight and slowly lower your hand, then use your opposite hand to help raise it back up. Repeat 10 to 15 times.
Comprehensive Tendinitis of the Elbow Treatment in Northeast Tennessee and Southwest Virginia
If you’re experiencing elbow pain that limits your activities and quality of life, Watauga Orthopaedics provides expert diagnosis and personalized treatment for elbow tendinitis. Our orthopedic doctors offer comprehensive care, from conservative management to advanced interventions, helping patients throughout Northeast Tennessee and Southwest Virginia return to pain-free function.
Call Watauga Orthopaedics today at (423) 282-9011 or schedule your appointment online and begin your path to recovery.
