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How To Use The Foam Roller For Tennis Elbow

Introduction

Have you ever suffered tennis elbow? There is a huge chance that you or someone you know has suffered from this condition, as there is an annual prevalence of 1% to 2% in the general public (Shiri et al., 2006). Unfortunately, this is even higher in particular groups of athletes, such as in the condition’s namesake tennis, in which nearly 40% to 50% of recreational tennis players will develpo this injury at some point in their lives. (Hume et al., 2006; Mackay et al., 2003). Wow, that is common!  Given the frequency with which this condition presents, there is a huge demand of quality information regarding its management. As such, this article will discuss tennis elbow, also known as lateral epicondylitis, epicondylosis and epicondylalgia, including background information on the condition, the relevant anatomy and of course the most appropriate rehabilitation exercises.

What Is Tennis Elbow?

Tennis elbow is a degenerative overuse condition of the tendons of the muscles on the outside of the forearm. Contrary to popular belief it is not an inflammatory condition, but rather a continuum of pathology that results from degeneration of the forearm tendons in response to overuse (known as repeated bouts of microtrauma) (Kraushaar and Nirschl, 1999).

So… what happens?

Essentially, what occurs is that repeated motions (particularly extending the wrist) causes the forearm muscles to contract. This can cause small tears in the common tendon which attaches on the outside of the elbow. As you continue the aggravating activity (tennis, gripping tasks, typing) further tears occur and eventually the elbow becomes painful. This is particularly when contracting the muscles on the outside of the elbow i.e. gripping and lifting tasks.

The most commonly affected tendons are:

  • Extensor Carpi Radialis Brevis
  • Extensor Digitorum Communis (up to 30% of cases) (Taylor & Hannafin, 2012)

The pathology and background information of tennis elbow is further explained in the video below.

Anatomy and Muscular Contributions to Tennis Elbow

Sports medicine professionals will agree that there are a number of forearm muscles that may contribute to the development of tennis elbow. This includes tightness/reduced flexibility and active trigger points in the:

  • Extensor Muscles i.e. muscles on the outside of the forearm (especially extensor carpi radailis brevis and extensor digitorum communis)
  • Flexor Muscles i.e. muscles on the inside of the forearm
  • Brachioradalis (see image below)
  • Pronator Teres (see image below)

So, what can be done about this condition?

Foam Roller Exercises for Tennis Elbow

The most appropriate exercises are those that target the myofascial structures of the:

  • Extensor Muscles i.e. muscles on the outside of the forearm (especially extensor carpi radailis brevis and extensor digitorum communis)
  • Flexor Muscles i.e. muscles on the inside of the forearm
  • Brachioradalis (see image below)
  • Pronator Teres

The videos below displays all of these components:

Exercises For Tennis Elbow

What Size Will Be Most Useful?

Given that you are going to cover a small to medium sized  area and i.e. the elbow and forearm area, the best foam rollers for this condition would be:

Should I Do Anything Else For Tennis Elbow?

Yes! Unfortunately, the foam roller is only one component of the successful rehabilitation of tennis elbow. To fully resolve this complex problem you should also undertake:

  • Regular Forearm Stretching (Extensors, Flexors and Pronators)
  • Forearm Strengthening (focus on eccentric extensor exercises, shown in the video below)
  • Appropriate load management i.e. get enough rest and do not do too much too quickly!
  • Be guided by your physiotherapist – who can take you through all of this including a full rehabilitation program

Eccentric Strength Exercises For Tennis Elbow

References

Hume PA, Reid D, Edwards T. Epicondylar injury in sport: epidemiology,  type, mechanisms, assessment, management and prevention. Sports Med.  2006;36(2):151-170.

Kraushaar BS, Nirschl RP. Tendinosis of the elbow (tennis elbow): clinical  features and findings of histological, immunohistochemical, and electron  microscopy studies. J Bone Joint Surg Am. 1999;81(2):259-278

Mackay D, Rangan A, Hide G, Hughes T, Latimer J. The objective diagnosis  of early tennis elbow by magnetic resonance imaging. Occup Med (Lond).  2003;53(5):309-312.

Shiri R, Viikari-Juntura E, Varonen H, Heliovaara M. Prevalence and  determinants of lateral and medial epicondylitis: a population study. Am J  Epidemiol. 2006;164(11):1065-1074.

Taylor SA, Hannafin JA. Evaluation and management of elbow tendinopathy. Sports Health: A Multidisciplinary Approach 2012;4: 384

Photo Credit: WikiCommons

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