The management approach of tennis elbow is known as Lateral Epicondyle Tendinopathy, is adapted from general principles of Tendinopathy rehabilitation. For the benefit of achieving long term goals and to meet individuals need, rehabilitation should be a multi-modal perspective. This includes education, exercise, tissue loading management, manual therapy, steroid injection and taping.
· Patient education: Educating patients on their condition, prognosis, management options and self-management may be effective with long term if used in combination with other measures for the management of Tennis elbow.
Smoking, high consumption of processed and fatty food and obesity can delay recovery.
· Exercises: Exercise for Tendinopathy rehabilitation is eccentric contraction. They are considered to be an effective measure for tendon overuse injuries.
Gradual progression of exercise is essential to increase tendon tolerance to loads. The following are the different ways to progress your exercise;
Elbow and forearm position: begin with flexed elbow and forearm in supination, then progress by increase elbow extension angle.
Fingers flexion vs extension: Beginning with fingers in flexion, then progressing to extension to load the long extensors.
. Adding weights: whether by an exercise band or dumbbells.
. Weight bearing exercises.
· Load management: Reduction of load on the tendon is an effective management strategy which has to go hand in hand with building tissue resilience to allow for gradual progression to target load by training the mechanical properties of the tendon. A good way of altering the load is to ask patients to work under the pain threshold and engage them in exercises that load the tendon below the level of exaggerated pain.
· Manual therapy: Mobilization with movement can be utilized with other measures to reduce pain and facilitate exercise. Mulligan’s mobilization with movement in TE has proved to be effective.
· Steroid injection: Corticosteroid injection has good outcome for short term use only (only 6 weeks). It’s long term use resulted in high recurrence. However, the short-term benefit of pain relief can be sought to encourage patient’s engagement with exercise program.
· Taping: Taping has a good placebo pain relief effect and pain-free grip strength in patients with chronic tennis elbow. Studies support that a combination of kinesio tape and exercise is very effective.