I want to get back to pickleball without this elbow pain.
What exactly is tennis elbow, or the (outdated) technical term lateral epicondylitis? The suffix -itis means inflammation, so the term lateral epicondylitis means inflammation of your lateral epicondyle (part of your arm bone). This is a painful condition around the elbow, which is made worse with gripping, resisted wrist extension and passive wrist flexion. Although it is associated with racquet sports, most cases are related to manual labor, work or no identifiable cause at all. The term lateral epicondylitis has been around since 1936, but as early as the 1970s, researchers refuted this term since there is not actually a chronic inflammatory process occurring.
So what is happening?
The affected tendon (usually ECRB) develops a dense population of cells called fibroblasts and has a disorganized framework of collagen fibers, but no inflammation so tendinopathy or epicondylalgia are more appropriate terms. Ok, done geeking out about the science stuff. Here’s what you can do about the pain:
Elbow mobilizations
Wrap a compression band (i.e. voodoo floss) around your affected elbow and bend your elbow all the way with your palm facing up. Next turn your palm so it is facing away from you and extend your elbow all the way down. Repeat 10x.
Eccentric Wrist Extension
Eccentrics have a ton a research backing them for tendinopathies. If you could do one thing, do this. Sit with your hand hanging off the edge of a table. With a weight or elastic band in your hand, use your opposite hand to extend the wrist up and slowly lower it down for a 3 count. Repeat 3x10 twice per day. This one may be painful but research shows that as long as the pain is under 3/10 you’re good to go.
Mulligan self mobilization
Stand with your arm up against the edge of a wall and your elbow just in front of the wall edge. With your opposite hand, push the inside part of your forearm perpendicularly to the plane of the wall edge while you flex and extend your wrist. Repeat 10x. This should be pain free.
Lateral Epicondylalgia or Epicondylitis: What's in a Name? by Esther J. Waugh, BScPT, MSc