Lateral epicondylitis—also known as tennis elbow—is a tendinopathy of the extensor forearm muscles, which are located on the back of the hand side of the forearm. It’s estimated the condition affects up to 3% of middle-aged adults. As with many musculoskeletal conditions, treatment guidelines emphasize exhausting non-surgical options before consulting with a surgeon.
In a 2022 systematic review that included 19 studies, researchers concluded that manual therapies and eccentric strength training offered the most favorable cost-to-benefit ratio for the lateral epicondylitis patient. The term eccentric means muscle elongation (the muscle lengthens/elongates during the exercise), which is the opposite of concentric, which means muscle contraction (the muscle shortens/contracts during the exercise). In the context of a bicep curl, the eccentric phase of the exercise occurs when you slowly lower the weight.
Let’s take a look at one eccentric strength training exercise your doctor may recommend in addition to manual therapies applied in a clinical setting.
Begin by resting your forearm on a narrow table or your thigh, grasping a small weight and have your palm facing downward. Use the opposite hand to lift the weight-bearing hand upward. Then, slowly lower the weight to its staring position, resisting gravity as much as possible. Start with a light weight, no more than 2-3 lbs. (.9-1.36 kg) gradually increasing repetitions, sets, and weight over time. Stay within reasonable pain boundaries and stop if you feel a sharp pain.
It’s also recommended to stretch the extensor forearm muscles several times a day by holding your arm straight in front of you, palm down, with your fingers and wrist limp. Use the other hand to bend the wrist downward until you feel a good stretch in the extensor forearm muscles. Hold for 30-45 seconds for three sets, resting 15-30 seconds between sets. This stretch can also be accomplished by pushing the back of the hand against a wall.
Your doctor of chiropractic can demonstrate these and other exercises that you can perform at home between visits to not only relieve your present tennis elbow symptoms but also reduce the risk of a future episode.