Tennis Elbow: How Manual Therapy Can Help Relieve Pain and Restore Function
As a manual therapist, who works in Bethesda Gwynedd ( near Bangor , North wales) I've seen how this overuse injury can affect people of all activity levels, from weekend warriors to professional athletes
Tennis elbow, or lateral epicondylitis, is a common overuse injury that causes pain and tenderness on the outer part of the elbow. Despite its name, this condition affects not only tennis players but also individuals engaged in repetitive arm motions such as painters, plumbers, and office workers. As a manual therapist, who works in Bethesda Gwynedd ( near Bangor , North wales) I've seen how this overuse injury can affect people of all activity levels, from weekend warriors to professional athletes
If you're struggling with persistent elbow pain, manual therapy offers an effective, non-invasive approach to reducing discomfort and improving mobility.
Understanding Tennis Elbow
Symptoms of Tennis Elbow
- Pain and tenderness on the outer elbow.
- Discomfort that may radiate into the forearm and wrist.
- Weak grip strength.
- Increased pain with gripping, lifting, or wrist movements.
Causes of Tennis Elbow
- Overuse of forearm muscles and tendons.
- Repetitive wrist and arm motions, such as playing racquet sports, typing, or using tools.
- Poor technique or excessive strain on the forearm.
How Manual Therapy Can Help Tennis Elbow
Manual therapy includes a variety of hands-on techniques aimed at relieving pain, breaking down adhesions, and improving function. Here are some of the most effective techniques for tennis elbow rehabilitation:
1. Massage Therapy
- Deep Tissue Massage: Helps break down scar tissue and adhesions in the affected tendons.
- Cross-Friction Massage: Stimulates blood flow to promote healing in damaged tissues.
2. Joint Mobilization
- Gentle techniques to improve movement in the elbow and wrist.
- Helps reduce stiffness and restore normal joint function.
3. Soft Tissue Mobilization
- Techniques such as myofascial release to relieve muscle tightness and improve flexibility.
- Reduces strain on the forearm muscles and tendons.
4. Stretching and Strengthening Exercises
- Eccentric Exercises: Controlled movements that help strengthen the tendons and prevent reinjury.
- Flexibility Training: Improves the range of motion in the wrist and elbow.
- Strengthening Exercises: Builds forearm muscle endurance to reduce strain on the tendons.
5. Trigger Point Therapy
- Applying pressure to tight areas in the forearm muscles to reduce pain and tension.
6. Mobilization with Movement (MWM)
- A technique that combines manual mobilization with active movement to improve pain-free function.
Benefits of Manual Therapy for Tennis Elbow
✅ Pain Relief – Reduces discomfort by improving circulation and relaxing tight muscles.
✅Improved Function – Restores strength and range of motion for better performance in daily activities.
✅Faster Healing – Encourages natural healing by increasing blood flow and reducing inflammation.
✅Prevention of Recurrence – Strengthening and mobility exercises help prevent future flare-ups.
Combining Manual Therapy with Other Treatments
For optimal recovery, manual therapy can be combined with:
- Physical Therapy – A comprehensive rehabilitation program with targeted exercises.
- Rest & Activity Modification – Avoiding repetitive motions that aggravate symptoms.
- Bracing or Splinting – Reducing strain on the affected tendons.
- Cold & Heat Therapy – Managing pain and inflammation naturally.
- Anti-Inflammatory Medications – For short-term pain relief, if needed.
Final Thoughts
Manual therapy is an effective, hands-on approach to managing tennis elbow, helping to reduce pain, restore function, and accelerate recovery. When combined with stretching, strengthening, and lifestyle modifications, it offers a long-term solution to this painful condition.
If you're experiencing persistent elbow pain, consult a manual therapist or physical therapy specialist to develop a treatment plan tailored to your needs.
Additional Resources
Some videos and Exercises
( These exercises seem simple and safe to me if done according to the instructions. However this is at the user`s own risk)
https://www.youtube.com/watch?v=eIdYNJRa2Hk
https://www.youtube.com/watch?v=s0BbfW0iY7Y
Reference list
Eapen, C., Rosita, R., Sohani, M.S. and Patel, V.D. (2023). A systematic review of the effectiveness of wrist manipulative therapy in patients with lateral epicondylitis. Journal of Hand Therapy, [online] 0(0). doi:https://doi.org/10.1016/j.jht.2022.10.002.
Girgis, B. and Duarte, J.A. (2019). Efficacy of physical therapy interventions for chronic lateral elbow tendinopathy: a systematic review. Physical Therapy Reviews, 25(1), pp.42–59. doi:https://doi.org/10.1080/10833196.2019.1695355.
Rachold, W., Reis, O., Berger, C. and Buchmann, J. (2022). Therapeutic Effects of Manual Therapy on Lateral Epicondylitis: A
Randomised Controlled Trial. Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin, 33(02). doi:https://doi.org/10.1055/a-1870-3073.
Uttamchandani, S.R. and Pratik Phansopkar (2024). Efficacy of PowerBall Versus Mulligan Mobilization With Movement on Pain and Function in Patients With Lateral Epicondylitis: A Randomized Clinical Trial. Cureus. doi:https://doi.org/10.7759/cureus.56444.