How Soon After a Tennis Elbow Tendon Injury Should One Seek Physical Therapy?

How Soon After a Tennis Elbow Tendon Injury Should One Seek Physical Therapy?

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Ice massage can decrease pain after tennis elbow injury.

Digital Vision./Photodisc/Getty Images

Physical therapy is often useful in alleviating painful conditions affecting the elbow. Tennis elbow -- irritation of a large tendon on the outside of the elbow -- is commonly treated with various forms of physical therapy. Treatment is more likely to be successful if the problem is caught early. Physical therapy can begin immediately after a tennis elbow tendon injury.

Pain Relief: Acute Onset

Pain that occurs after an initial tennis elbow injury -- acute onset -- is caused by inflammation. This pain develops quickly after activity, such as a sporting event or day of manual labor. Physical therapy treatments initially include ice, ultrasound and electrical stimulation to decrease pain and inflammation at the outside of the elbow. Stretches are performed with the elbow straight, in a palm-down position and wrist bent down toward the ground. The opposite hand gently pushes the wrist further into a bent position until a stretch is felt along the back of the forearm. These stretches are typically held for 15 to 20 seconds and repeated 3 times, several times each day.

Pain Relief: Chronic

Tennis elbow can be a chronic disorder, with pain developing slowly over a period of weeks. This is usually caused by repetitive use of the wrist muscles, particularly while making a fist. This type of pain is not limited to people who play racquet sports. Jobs, such as construction or carpentry, can also lead to chronic tennis elbow. Physical therapy treatment includes ultrasound, electrical stimulation and stretching -- the same treatments used for an acute injury. For this type of tennis elbow, heat is applied instead of ice. This type of pain is not caused by inflammation, it is due to tiny tears that develop in the tendon. Heat dilates blood vessels, increasing blood flow to the area to promote healing.


Strengthening exercises are performed in physical therapy to address weakness in muscles that move the wrist and support grip. These exercises are started during the chronic phase of tennis elbow or after acute pain has subsided. With the forearm resting on your thigh or a table, a small dumbbell is held in the hand as the wrist bends backward. This position is held for 3 seconds, then the wrist is slowly lowered. This movement is typically performed 10 times in a row, working up to 3 sets. The exercise is repeated with the forearm neutral -- thumb up toward the ceiling -- and in a palm-up position.

Activity Modification

One of the most important things taught in physical therapy is how to modify your activities to prevent tennis elbow from recurring. You should get this information as soon as possible after a tennis elbow injury. Whenever possible, aggravating activities should be avoided. If these activities are part of your occupation, this may not be an option. Physical therapists can teach you how to better position yourself as you work to decrease pressure on the elbow. In some cases, tools can be modified to better fit your hand, making your muscles more efficient. Sports technique can be analyzed and modified to prevent further issues.