Lateral elbow pain, tennis elbow, is a limiting condition causing pain with repetitive movements including gripping. This condition was previously though to occur secondary to inflammation within the wrist and fingers tendons insertion into the arm, but current researchers have not found inflammatory cells in patients with this condition. Instead, cells of the injured tendons display degeneration and disorganization consistent with the healing process. Gradual loading of these injured tendons with exercise has been shown to accelerate the recovery process and tendon remodeling.
Loading of the injured tendon through exercise is critical to its’ healing. Both over loading and under loading are equally detrimental to the recovery of the tendon. New research demonstrates utilizing shoulder strengthening reduces pain and improves arm function in patients with lateral elbow pain. Lee and colleagues randomized patients to either elbow or shoulder strengthening groups (J PT Sci. 2018). Authors reported both groups improved grip strength, pain, and tenderness after the completion of the strengthening program. No differences were noted between groups indicating loading of the injured tendons can be done specifically at the elbow or globally through the shoulder. The key is loading based on the tissue tolerance of the injured tendon.