There aren’t many conditions with as misleading a name as “tennis elbow.” Also (and more accurately) known as lateral epicondylitis, it’s caused by the overuse of muscles and tendons in the elbow, leading to pain and inflammation.
We’re not saying the name doesn’t make sense — tennis does involve a whole lot of using the elbow, and it’s especially easy to get tennis elbow when you use poor form, a bad racquet, and a weak forearm. But anyone who uses their elbow a lot can get the condition, and it’s a well-known phenomenon among strength athletes.
So Why Does My Elbow Hurt?
Epicondylitis actually comes in several forms, usually lateral epicondylitis (tennis elbow), or medial epicondylitis (golfer’s elbow).
“It’s almost the exact same thing,” says Eugene Babenko, DPT, a doctor of physical therapy and coach at Dubai’s CrossFit Gold Box. “The reason for the names is the mechanisms used. Golfer’s elbow causes pain on the inside of the elbow because that’s what’s used in the end range of the swing. Tennis elbow is felt on the outside, because it stems from the muscles used for the followthrough and concentric control.”
It stems from overuse, and strength athletes (particularly those involved with functional fitness) often perform high reps that load the elbow in a multitude of ways. Epicondylitis can occur when instead of gradually increasing the load and volume, an athlete does too much, too soon, too fast. Too many dips, rope climbs, pull-ups, and barbell cycling WODs can easily result in inflammation.
“The problem is the grand majority of folks are gonna have a little bit of pain and then ignore it, or kinda do what they have to do to get through their next training session,” says Dr. Babenko. “They’ll almost never take time off because of a little pain, and a lot of the time the pain will go away during a workout. It’ll hurt when you first pick up a barbell, but then the body adjusts to the work it has to do.”
That’s bad. While the body can do an admirable job of dulling the pain so it can do the work you’re putting it through, it makes it very easy to go from tendonitis (which is what the inflammation is called for the first three months you have it) to tendonosis, which is what tennis elbow is. Tendonosis is more than inflammation — it means damage is occurring at the cellular level and it’s much harder to recover from.
How to Reduce Your Risk of Tennis Elbow
Tennis elbow and golfer’s elbow happen when the tissues are put under more loading, more volume, and worse form than they’re equipped to handle. The solution? Besides always ensuring you stop doing an exercise before your form starts to degrade, you need to do the kind of unpopular exercises that will target the smaller muscles in the hands, forearm, and upper arm.
Here’s what that looks like. The following exercises can all be performed for one to three sets of ten to fifteen reps.
Wrist Flexion and Extension
Use light weight for these — remember that the muscles in your wrist and forearms are small, and you don’t want to pull any tendons or ligaments.
Wrist Supination and Pronation
Some folks like to use a hammer or a can for these, but your average dumbbell can work fine. It’s a good idea for the weight to be mostly pulling down on the same side as your thumb, so either hold the dumbbell handle on the far end (as opposed to holding it in the middle) or just grip the weight itself.
Wrist Hammer Curl
In addition to the exercise shown above, you also want to reverse the move. That can mean standing with your torso bent and your arms straight out behind you so that they’re almost parallel to the ground and you’re curling upward against gravity. Both these exercises can also be performed with resistance bands.
Internal and External Rotator Cuff Extensions
“Another aspect to consider is whether all the shoulder muscles working properly to take the pressure off your elbow,” says Dr. Babenko. “If you’re lifting anything, you’re lifting it with the shoulder too. So in terms exercises, let’s highlight the rotator cuff type exercises and shoulder and upper back.”
These are usually performed with resistance bands or cables, but you can also do them lying on your side with a dumbbell in your hand.
Tricep strength is a big one for avoiding issues with the elbow. There are a ton of compound exercises that strengthen the tricep, but it’s a good idea to isolate the muscle too with tricep extensions or skull crushers.
We’ve listed some super effective exercises above, but it’s also important to remember that tissue needs blood flow, so it’s also a good idea to increase your blood flow before a workout with rowing, biking, or moving your arms through a full range of motion.
And while the advice in this article can go a long way to preventing epicondylitis, it’s no substitution for a doctor — remember to get a regular assessment from a qualified practitioner, particularly if you’re experiencing any pain whatsoever.
Featured image via @steficohen on Instagram.