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Why Your Tennis Elbow Won't Heal

Have you been dealing with pain at your elbow joint that doesn’t seem to go away? It may feel like a burning, aching or sharp sensation on the outside of your elbow. Typically it hurts at rest, with gripping activities or activities where your arm may be extended like hammering, typing, repetitive movements or with sport activities.

manual therapy, physical therapy for tennis elbow

As a physical therapist, tennis elbow is a very common condition we treat and see often in the clinic. Oftentimes, people wait to see us until the pain has gotten unbearable, or if they have tried a variety of treatments on their own and their elbow has not improved much.

The muscle group involved in lateral elbow pain are the muscles that actively extend your wrist. This includes: extensor carpi radialis longus and brevis, extensor digitorum, and extensor carpi ulnaris, with extensor carpi radialis brevis being the most likely culprit. The site of pain is usually most intense where the tendon inserts into the bony lateral epicondyle.

tennis elbow treatment, tennis elbow rehabilitation

Tennis elbow is also known as Lateral epicondylitis if the condition has been occurring for 0-3 months. After that time frame, tennis elbow has shifted from a tendonitis to a tendinopathy. This is the main reason why tennis elbow does not heal quickly-- because it progresses to the tendinopathy stage.

At the tendinopathy stage, there are degenerative changes happening at the tendon level including collagen fiber disruptions, tenocyte proliferation and neovascularization. Basically when you go to use your arm, the tendon is not transferring force like it should.

What you may be experiencing is frequently increasing pain levels that are usually related to how much you’ve used your elbow. It may not go away when you rest your elbow because the tendon is “angry” and reactive.

If you find that you're in this stage, seek an evaluation from a trusted physical therapist! We would assess your mobility, neural tissue, soft tissue, strength, posture, cervical spine and upper quarter bio-mechanics to better understand what is causing your specific condition.

If you feel like you want to learn more about the root cause of YOUR pain, reach out to me directly at or 615.978.4062!

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