Tennis Elbow Self-Care Using Physical Therapy Principles

Tennis Elbow is a repetitive stress injury of a tendon in your forearm, called Extensor Carpi Radialis Brevis (ECRB). Tennis Elbow occurs when the load that goes through the ECRB tendon exceeds its capacity to handle it. What does that mean?

The ECRB tendon has two functions:

• It extends the hand at the wrist, meaning it moves the fingers away from the palm.

• It also abducts the hand, meaning it rotates the hand toward the thumb.

When you grip, hold, or rotate something - like a doorknob, a mug, or a racket, the weight of the objects and the force of the movements go through the tendon as a stressor. That’s what we call “load.” When that load is more than what the tendon can handle, tiny tears form in the tendon, leading to pain, weakness, and inflammation.

Over time, with more repetitive stress on the tendon, these tiny tears become scar tissue, further weakening the tissue and reducing your grip strength. This is what Tennis Elbow is, in essence.

Unfortunately, many primary care doctors dismiss Tennis Elbow as a minor inconvenience that should get better with simple rest and don’t make physical therapy referrals. Or, even with a referral, there may be a long wait before you can see a good PT. So, many Tennis Elbow patients end up spending months in pain or unable to do what they love to do.

The good news is that it’s relatively straightforward to treat Tennis Elbow yourself, using the methodology that’s been used effectively in physical therapy. Let’s dive into what an effective self-treatment plan looks like.

Physical therapy is considered the most effective, non-invasive treatment for Tennis Elbow that resolves the root cause. If you’re lucky enough to work with a good physical therapist, here are the three treatments you’re likely to get:

With the reduced load, the tendon now has time and space to start healing, while you can stay active without severe pain holding you back. This means you’re able to maintain your capacity and overall fitness, which wouldn’t be the case if you simply took a break from all activities that cause you elbow pain.

Working directly on the problematic tissue is one of the cornerstones of PT treatment. In the case of Tennis Elbow, your physical therapist will massage the ECRB tendon to reduce pain, break down adhesions, and encourage the growth of healthier, stronger tissue that can withstand the load.

Some PTs use their hands to massage, but many use stainless steel instruments. This method is called Instrument-Assisted Soft Tissue Mobilization (IASTM).

Most people don’t think of massage when they’re faced with Tennis Elbow, but it’s a very effective way to not just reduce pain now, but also resolve the root cause of the pain. Massaging the surrounding tissue can also be effective in releasing tightness and reducing discomfort.

The third pillar of PT treatment is strengthening exercises. Starting with easy, simple movements that target a single tissue in isolation, your physical therapist will help you gradually build up strength in the hand, wrist, arm, and shoulder.

These Tennis Elbow exercises build capacity in the entire kinetic chain, so that the ECRB tendon is well supported. This is how physical therapy builds defenses against flare-ups and resolves the root cause of Tennis Elbow: the imbalance between the load and your capacity to handle it.

Because high-quality physical therapy is out of reach for many, we developed both the methodology and the tools for everyone to take care of Tennis Elbow at home. The Alleviate Method is an at-home application of the gold standard of physical therapy care we just outlined. Our Tennis Elbow System makes it simple to follow the Alleviate Method, with everything you need for Tennis Elbow self-care.

Here’s how we adapted in-person PT to at-home recovery:

You can use the same principle when you’re treating yourself. In the Guided Recovery Program, we use a Tennis Elbow test called Maudsley’s Test after every session to track your progress.

If you’re only using the Tennis Elbow Brace (though we strongly recommend upgrading to the full System for full resolution, especially if you’ve had your symptoms for more than a week or two), you can use the same test before and after you put on the brace to quantify its benefit. Our beta testers were very excited to see their pain levels go down by 40% (on average) as soon as they put on the brace - and you’ll be, too.

Alleviate was founded by a patient-clinician duo to bring the effective chronic pain treatment from physical therapy offices to everyone's home. With the all-in-one Tennis Elbow System, you can use the Alleviate Method to treat your elbow pain, without the hassle of traditional physical therapy.

For most people with symptoms lasting more than 2 weeks, we recommend the System, but if you are unsure, take the elbow pain quiz to see which Alleviate tool fits your needs the best.