Do you need an elbow brace or strap to help you get through your regular pickleball games? What if I told you there’s a BETTER way to manage your elbow pain AND prevent it from coming back? If you’re willing to devote ten minutes per day to a few exercises and some self-massage techniques, there’s a good chance you can ditch that elbow strap and get back to the court WITHOUT pain and with improved motion in your arm to have you playing at the top of your game?
If you’re having pain on the outside of your elbow, there’s a good chance you could have lateral epicondylitis, or more commonly known as “tennis elbow.” This condition can also occupational, such as with people who turn a wrench for a living or perform any task involving repetitive twisting of the forearm. I even have seen a pastor with this condition, which he attributed to doing some renovations around his church (talk about hands on!) He was actually a pretty decent golfer too (though not playing frequently at the time) which may have irritated the area previously.
Here are four simple do-it-yourself interventions plus one simple treatment that work quite reliably when done consistently. If these approaches don’t resolve your pain AND help you return to the pickleball court, the next step would be to seek help from a rehab professional who has other techniques available and can also look for potential causes such as in shoulder function.
Mobilization with movement – Whether performed on yourself or delivered by a professional, this is the “go-to” technique for persistent tennis elbow. Both options are shown below. Note that you can vary the angle of arm bend to provide different stimuli to the area, as patients can vary in which angle works best for them. Typically the treatment is performed by applying lateral pressure and then having the patient grip and release, though you’ll find different variations on the same theme commonly practiced. The key point here is that PAIN SHOULD REDUCE with this treatment. If pain is getting worse, this likely isn’t the right treatment for you. Which is fine, because there are other options….
Self massage – Not as ideal as having it performed by a professional, and I generally don’t expect this to resolve the condition permanently as a “stand alone” intervention, but it does work well to complement other interventions. I typically tell patients you’re very unlikely to do any additional damage to the area, so depth and intensity is a matter of your own tolerance (though harder isn’t necessarily better!). Personally I prefer hands/fingers for self massage, but if your hands aren’t used to the stress of performing massage, then using a tool of some type may work better. But use caution, and understand that HARDER isn’t necessarily better!
Pin and stretch – Apply pressure at some point along the outside of your forearm near the area that feels tight. While maintaining pressure, try to pull your fist toward the inside of your forearm. You can repeat the process while changing the location of the pressure.
Flexbar – The Flexbar is another tool with a high success rate for those with tennis elbow. Below is one protocol that was studied with good results. (Page 2010)
Cervical mobilizations –This may seem out of place as it is not a true do-it-yourself intervention, but it is worth including due to its effectiveness. You might also wonder why targeting the NECK could possibly help the elbow? One possible explanation is that because the nerves that supply the elbow region all originate from the cervical spine (neck), treatment to that area may calm those nerves down and at the very least allow you to do more with your exercises to recondition the brain to accept movement again.
If tennis elbow is giving you trouble, fear not! There are far better options than the ol’ elbow strap to manage pain. Even if you’ve been dealing with the condition for a long time, that there are several proven techniques to help restore your normal abilities should give you hope. If you have any questions, please feel free to reach out and set up a free consultation!
Dr. Allan Phillips
Ventana Physiotherapy, Oro Valley, Arizona
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Allan Phillips, PT, DPT is owner of Ventana Physiotherapy