Time to have the talk. The talk about Tennis Elbow.
This great unruly beast of pain and uncertainty is one of the most common, and most feared experiences known to athlete-kind.
Whether you’ve been dealing with outer elbow pain for years, or experienced your first bout after a day at the courts, I am here to tell you that you can get through it. You can be ok. You don’t have to be stuck with this problem forever, you don’t have to get surgery, and you don’t have to lose function in your hands.
The reasons tennis elbow is so disconcerting are many, but not least of which is the difficulty in treating this very preventable problem.
In most cases, treating painful tissue is largely a matter of unloading the tissues. That gets difficult with the elbow because we use our hands all the time.
In addition, we often think of treating tennis elbow as a musculature issue, when in reality it’s an insertion issue. Tennis elbow, and it’s kissing cousin golf elbow, are problems of inflammation where the tendons of our forearm connect to the bone in our elbow.
Here at The Ready State, we believe this problem is both preventable and treatable. Using our awareness of tennis elbow as an insertion issue, we can use the appropriate tools for the job and finally conquer this unruly beast. This is the essence of our Tennis Elbow Protocol, a tailored program designed specifically for solving elbow pain in the long run. In this article, I’m going to provide you with some basic tools for addressing tennis elbow, with the hope that you’ll be able to see both immediate and long-term changes. If the techniques stick, I suggest using our pain protocol to access a full toolbox for this issue.
Desensitize, Restore, and Prevent
The basis of all our pain protocols is simple. First, we learn about the cause of our pain, as we did in the introduction of this article.
Then we use a three-pronged approach to make change.
The first thing we want is to lower our pain immediately. We do these using techniques to desensitize the tissues for immediate relief and increases in function. This is the Desensitize component.
Next, we want to focus on long-term change by restoring tissues. The techniques used for restoration involve taking the tissues into their full range of motion, and building resilience in the tissues without increasing pain.
Finally, we use prevention techniques to address and remove the common causes of pain. We use prevention to maintain resilience in the tissue moving into a pain-free future.
Tennis elbow is primarily an issue of swelling inside a space with very little room. Creating immediate relief hinges on decongesting the pain area and restoring sliding surface mechanics.
One of the oldest methods for desensitizing and improving blood flow to and around an injury site is a very old technique commonly called “Gua Sha.”
People have been using tools like soup spoons, bones, and horns as tissue scraping tools for as long as there have been people.
To perform this exercise, simply take the back of a butter knife or similar instrument and use it to mobilize the afflicted tissues with scraping motions. Remember, the goal is to desenstize, not to irritate, and the pressure you use should reflect this.
Prescription: Perform Gua Sha 1x per day while symptoms persist, for 2 to 3 minutes max.
The next phase of our protocol is to restore and improve the soft tissue of your elbow. Unlike many internet protocols that don’t work, you won’t see a lof of traditional elbow and forearm “stretches” in our Tennis Elbow Protocol.
Instead, we use what we call “position transfer exercises” or “mobilizations”. These interventions are designed to restore your body’s ability to do what it is supposed to do.
The first technique in this article is to address tricep stiffness using two lacrosse balls, or a “peanut” device.
Tape two lacrosse balls together and place them on a coffee table. From a kneeling position, rest the bottom of your tricep in the middle of the peanut, just above the elbow joint. Use pressure from your other hand against your bicep, then floss the tissue by rotating and extending your arm at the elbow. If you find points of great sensitivity, pause, inhale for 4 seconds, contract the tricep for 4 seconds by flexing, and then relax for 8 seconds. Repeat contract-and-relax until you feel you can completely relax your tricep in that position.
Other tissues that affect tennis elbow include the forearm, rotator cuff, and scapula, so we include these in the tennis elbow protocol.
Prescription: Aim to spend 10 minutes and no more than 20 minutes using tissue mashing techniques to restore function in the elbow. If you purchase the tennis elbow protocol, I suggest performing the exercises provided in order.
The next technique you can use is to restore tissues with load. If you have access to a pullup bar, one powerful technique is simply hanging.
Place your hands together on a pullup bar and hang for 5 to 10 breaths.
Prescription: perform 3 to 5 sets hanging for 5 to 10 full breaths either as a solo restoration exercise or after your workouts. I suggest spending 10 to 15 minutes per day on rotation restoration exercises like this in addition to the previous tissue mashing exercises.
Moving forward, we want to prevent tennis elbow from becoming worse or happening again in the future.
Before workouts, perform our shoulder spin-up routine to properly prepare the tissues and create blood flow.
The Full Tennis Elbow Protocol
The techniques in this article represent 4 of a total of 19 strategies for solving tennis elbow. If you are dealing with more than mild pain, I strongly recommend our full protocol in order to completely solve the problem.
In the meantime, the general structure provided here works for desensitizing some pain in the short run, restoring the tissues, and then preventing further injury.
Pain does not have to be permanent, and we have dedicated our lives to this belief here at The Ready State.