When an individual gets pain at the elbow, frequently the diagnosis is tennis elbow. This condition is considered to be the result of irritation of the tendons from the muscles that extend the wrist and fingers found on the top of the forearm. The pain  typically results from repetitive motion activities like tennis but can also occur with hammering, typing, or other functional activities.

When an individual seeks medical attention for this condition, it is common that a cortisone shot is given near the elbow or iontophoresis—a technique where electrical stimulation is used to pass a topical anti-inflammatory through the skin—is provided by a physical therapist. My concern with these very common practices is that they focus on the pain exhibited at the tendons of the muscles and do nothing to address the cause of the irritation of the tendons which are strained muscles.

What Causes Tennis Elbow?

To understand this concept, it is important to recognize that a tendon is an extension of a muscle that attaches the muscle to a bone. The forces that the tendon must endure are based on the pull of the attached muscle. If a muscle strains, then there is a tendency for the muscle to have an increased desire to shorten. This causes increased forces on the tendon which can create irritation of the tendon causing a pain signal to develop. The cause of the pain signal is the altered force on the tendon due to the strained muscle. Therefore, the way to correct the forces on the tendon is to resolve the strain of the muscle.

The muscle strains because it was asked to perform an activity where the muscle did not have enough strength. This causes the muscle to overwork and strain creating the forces that irritated the tendon.

Treating the Pain

Strengthening of the muscle will resolve the strain, allowing the muscle to maintain its proper length and force on the tendon that attaches it to the bone. In this case, strengthening of the wrist extensors by performing wrist extension exercises would resolve the tendon pain at the elbow.

Along with the wrist extensors, I would also recommend strengthening the shoulder rotator cuff. I have found in my experience that muscles of the forearm strain typically because the shoulder muscles are weak. The shoulder muscles are responsible for supporting the arm and objects grabbed while the forearm muscles help to grab and lift objects. If the shoulder muscles are weak, the forearm muscles must also work to support the object which makes these muscles susceptible to straining.

Give this a try and you will not only resolve your elbow pain but prevent it from reoccurring.