Pickleball/Tennis Elbow | Recovery and Management

Tennis elbow, also known as pickleball elbow, or more formally lateral epicondylitis, is caused by overuse of the wrist extensor muscles in the forearm, which connect to the elbow through the common extensor tendon. It is often seen with racquet sports, throwing sports, carpenters, plumbers, and butchers. Repetitive gripping or repetitive motions of the wrist cause irritation or inflammation of the tendon. This leads to pain at the side of the elbow, which often gets worse with more repetitive wrist motion and gripping such as holding a mug or turning a door knob; As a result, this often limits one’s ability to complete even everyday tasks, let alone the sport or activity that caused it. The good news is that most cases of lateral epicondylitis recover without need for surgery^2,3. Physical therapy is very helpful in resolving the condition¹. In addition, there are a few steps and exercises you can do at home to manage the pain and facilitate recovery. With that being said, let’s get to it so that you can get back to work, your hobbies, or even on the court (or wherever you like to play pickleball!).

RICE

Rest, ice, compression, and elevation (RICE) are beneficial for reducing the pain associated with tennis elbow¹. However, rest does not mean to utterly avoid using your arm; instead, it’s about finding ways to modify activities so as to limit excessive movement in your wrist and provide comfort. Icing is especially helpful; 5-10 minutes should bring reprieve. Compression can also be used – either by wearing a supportive brace or bandage – to offer additional support and reduction of discomfort. Finally, while swelling isn’t usually a problem with this type of injury, if the elbow area is swollen then elevating it (above heart level) can help reduce the amount of fluid retention in that spot. While RICE is great for pain management, it is not a treatment for tennis elbow. In order for the tendon to heal, you must engage it with an appropriate amount of exercise.

Exercise

Strengthening, stretching, and endurance exercises are all essential components of a rehabilitation plan for lateral epicondylitis.

Note that while I do give you the repetitions, these are general guidelines. If the pain becomes unbearable, then stop the activity. What is too much pain? Using a scale of 0 to 10, with 0 being no pain and 10 being the worst pain you have ever felt — I suggest staying below a 5 rating. While physical therapy is associated with some discomfort and soreness, it should never lead to sharp, severe pain. On a similar note, if these strengthening exercises seem like a walk in the park, then it’s likely time to increase the weight, or add on extra repetitions. Remember, exercise and physical therapy lead to reduced pain overtime.

Wrist Extension and Flexion Stretch

Hold each position for 30 seconds and repeat 3 times. Keep your arm straight but don’t lock out your elbows. You can start with this stretch before doing the exercises below.