Tennis Elbow Recovery: Timelines, Treatment Options, and Rehabilitation Strategies

Tennis elbow, or lateral epicondylitis, is a common condition characterized by pain and inflammation around the outer part of the elbow. It typically results from overuse of the extensor muscles in the forearm, leading to microtears in the tendons that attach to the lateral epicondyle of the elbow. While it’s often associated with tennis players, it can affect anyone who performs repetitive arm movements, such as manual laborers, musicians, or office workers.

In this blog post, we’ll explore the recovery timelines for tennis elbow, the most effective tennis elbow exercises and evidence-based treatment options, and rehabilitation strategies, including shockwave therapy, which has gained attention as a viable treatment.

 

Recovery Timelines for Tennis Elbow

The timeline for recovery depends on the severity of the condition, the treatment approach, and how consistently rehabilitation strategies are applied. On average, here are the typical recovery periods:

• Mild to Moderate Tennis Elbow: Conservative treatments can often result in recovery within 6 to 12 weeks. Symptoms may start improving after 2-3 weeks of appropriate rest and therapy, but full resolution of symptoms may take longer.
• Chronic or Severe Tennis Elbow: Recovery can extend to 6 months or longer, especially if there are extensive tendon damage and degenerative changes. In such cases, more aggressive interventions, such as physical therapy or advanced treatments, are needed.

Returning to high-level sports or repetitive activities too early can delay recovery or worsen the condition, so patience is crucial.

 

Evidence-Based Treatment Options for Tennis Elbow

1. Rest and Activity Modification

Resting the affected arm and avoiding activities that exacerbate symptoms are often the first steps in recovery. In the early stages of tennis elbow, taking a break from repetitive activities can help reduce tendon irritation and inflammation. However, complete immobilization is not recommended, as some movement is important for tendon healing.

2. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs, such as ibuprofen or naproxen, can help manage pain and reduce inflammation in the short term. While they offer symptom relief, they do not address the root cause of the injury and should not be relied on as a long-term solution.

3. Physical Therapy

Physical therapy is a cornerstone of tennis elbow treatment. It aims to strengthen the forearm muscles, improve flexibility, and promote tendon healing. Research supports the use of eccentric exercises, which involve lengthening the muscles under tension, as one of the most effective ways to rehabilitate the affected tendons.

Common Physical Therapy Interventions:

• Eccentric Wrist Extensor Exercises: Strengthening the muscles that extend the wrist can help reduce strain on the tendons.
• Soft Tissue Mobilization: Massage techniques and manual therapy to relieve tension and promote blood flow to the injured area.
• Stretching: Forearm and wrist stretches improve flexibility and reduce stress on the elbow.

4. Corticosteroid Injections

Corticosteroid injections are sometimes used to reduce inflammation and provide short-term pain relief, particularly for patients who have not responded to other treatments. However, recent studies indicate that while corticosteroids may provide temporary relief, they can delay long-term healing. In some cases, patients may experience a recurrence of symptoms after a few months.

5. Platelet-Rich Plasma (PRP) Therapy

PRP therapy involves injecting a concentration of the patient’s platelets into the affected area to promote healing. Several studies have shown that PRP can improve pain and function in people with tennis elbow, particularly in chronic cases. PRP is thought to enhance tissue repair by delivering growth factors that aid in tendon healing.

 

Shockwave Therapy: A Viable Option for Tennis Elbow

Shockwave therapy, also known as extracorporeal shockwave therapy (ESWT), has gained popularity as an effective treatment for tendinopathies, including tennis elbow. The therapy involves delivering high-energy sound waves to the affected area, which stimulates blood flow, reduces pain, and promotes tissue regeneration.

How Shockwave Therapy Works:

• Stimulates Tendon Healing: By increasing circulation and promoting the growth of new blood vessels, shockwave therapy helps accelerate tissue repair.
• Reduces Pain: It works by altering nerve transmission in the area and reducing chronic inflammation.
• Breaks Down Calcifications: In some cases, shockwave therapy can help dissolve calcium deposits in tendons, which may contribute to pain and dysfunction.

Clinical Evidence:

Several studies have supported the use of shockwave therapy for tennis elbow. Research shows that it can be effective in reducing pain and improving function, especially in cases that have not responded to conservative treatments like rest or physical therapy. However, results can vary, and multiple sessions are often required for optimal outcomes.

 

Rehabilitation Strategies for Tennis Elbow

1. Gradual Strengthening and Loading Programs

Gradual reloading of the extensor muscles with strengthening exercises is crucial in long-term recovery. As pain subsides, a structured strengthening program is necessary to restore muscle balance and prevent re-injury. Eccentric loading programs have been particularly effective in promoting tendon health.

2. Bracing and Ergonomic Adjustments

• Counterforce Braces: These braces are worn around the forearm and help to reduce tension on the tendons during activity.
• Ergonomic Adjustments: For people whose work involves repetitive movements, modifying ergonomics can prevent further musculoskeletal strain. Simple adjustments, such as changing wrist positions or using a different grip size on tools or sports equipment, can significantly reduce stress on the tendons during daily activities.

 

Return-to-Activity Guidance

Rehabilitation isn’t just about reducing pain; it’s about preparing the body for a safe return to activity. Gradually reintroducing activity, with guidance from a physical therapist, ensures the tendons are strong enough to withstand stress without re-injury.

Conclusion

Tennis elbow tendinopathy is a challenging condition, but with a proper treatment and rehabilitation program, most individuals can fully recover and return to their normal activities. The recovery process ranges from a few weeks to several months, depending on the severity and the interventions chosen. Evidence-based treatments, such as physical therapy, eccentric exercises, and shockwave therapy, provide long-term solutions for resolving elbow pain, restoring range of motion and overall managing the condition.

If you’re dealing with tennis elbow, consult with a healthcare professional like those at South Island Physiotherapy to create a tailored treatment plan that includes the latest evidence-based strategies.

By combining rest, physical therapy, and advanced treatments like shockwave therapy, the outlook for tennis elbow recovery is positive.