Phase 1 begins as soon as possible following injury. The aim of phase 1 is to reduce pain and inflammation.
Treatment
Can be done daily.
Rest
Complete rest, and limit lifting and gripping if possible.
Cold & compression
Apply ice or a cold compression wrap to reduce pain and inflammation, especially if your elbow is acutely painful.
Apply cold for no more than 15 minutes as the injured tissues are very close to the skin and do not need longer.
Ice should be wrapped in a wet tea towel to avoid ice burns, or better still use a commercially available cold therapy compression wrap.
Bracing
Wearing a counterforce brace (tennis elbow brace) can help reduce the strain on the tendon enabling healing to take place.
This works by applying compression around the upper arm which puts pressure on the injured tendon, changing the way forces are transmitted, and allowing the injured tissues to rest.
Mobility & stretching
Throughout the day, every day.
Lateral extensor stretch
Teaching point:
- Place your arm in front with your hand pointing down
- Keeping the arm straight, pull the hand towards your body to feel a stretch at the back of the wrist, forearm, and elbow
- Your forearm can be rotated inwards to increase the stretch. This will be felt more on the outside of the elbow
- The stretch can be held for 15-20 seconds and repeated up to 3 times per day
Note: As comfortable, don’t force the stretch.
Activation
To be done daily.
Shoulder blade squeeze
The aim of this exercise is to strengthen the muscles which stabilize the scapula or shoulder blades, during the early phase of a shoulder rehabilitation program.
Teaching point:
- In a sitting position with the elbows by the side, you squeeze the shoulder blades together, holding for 5 seconds
- Squeeze the shoulder blades or scapulae together while ensuring the elbows are kept down
- 3 sets of 8 reps (hold for 5 seconds)
Posture per day
Posture is really important when rehabilitating the shoulder.
Teaching point:
- Sit up nice and tall, and pull your shoulders back
- Squeeze your shoulder blades together
- Hold your head up, imagine that a balloon is tied to your head and is lifting it up
- Sit and maintain this position for 30 seconds
- 4 x 30 seconds
Conditioning
These are optional.
Lower limb strengthening
Work on your lower body/leg strength.
These are optional exercises to help maintain fitness.
Swimming
These are optional exercises to help maintain fitness.
Running
Running or cycling should be fine.
Move on to phase 2
Check if you are ready to move on:
Exit criteria
Move onto phase 2 when:
- Normal daily activities are pain-free
- This is likely to be at least 2 weeks