Effective Tennis Elbow Treatment in Victoria, BC: Expert Physiotherapy & Chiropractic TIPS

May 28

Tennis elbow, or lateral epicondylalgia (LET), is a common overuse injury affecting athletes and the general public alike. Whether you're a weekend warrior, a professional athlete, or simply experiencing elbow pain, understanding the latest evidence-based management strategies can help you recover faster and prevent future episodes. If you’re looking for a tennis elbow specialist in Victoria, at Pursuit Physiotherapy, we specialize in sports therapy and evidence-based physiotherapy to support your path to recovery. In this post, we’ll explore effective assessment methods, treatment options, and practical tips grounded in current research.

Common symptoms of Tennis Elbow

Pain localized to the outside of the elbow but can radiate down the forearm
Pain with squeezing or gripping
Pain with lifting (especially when your hand is palms down)

Evidence-Based Treatments

When a sufficient amount of research has been collected on a topic, a special type of synthesis paper is done called a meta-analysis. Rather than looking at individual patients as is done in your typical paper, a meta-analysis uses all the data from quality papers to hopefully capture a greater sense of the truth of a matter.

The inspiration for today’s topic comes from reading such a meta-analysis. Below you will see the results of the paper and the corresponding quality of evidence for that particular treatment (1). Just like school grades, A indicates the best and D indicates the worst, arguably failing.

  
      Intervention
      Evidence Grade
      Key Points
    
      Strengthening Exercises
      A
      Strong evidence supports resisted wrist extensor exercises, whether it is done with eccentric loading or just slow movement. All options are effective for pain relief and building up the tendons' capacity. Best as part of a multimodal approach.
    
      Shoulder and Scapular Stabilizer Training
      B
      Moderate evidence indicates that addressing proximal weaknesses can improve elbow function.
    
      Manual Therapy & Spinal Manipulation
      B
      Joint mobilizations/mobilizations of neck, thoracic, or elbow joints may provide short-term pain relief and improved grip strength, especially when combined with exercise.
    
      Dry Needling
      B
      Short-term pain reduction and functional gains shown, useful as an adjunct to exercise therapy.
    
      Orthoses & Taping
      B
      Counterforce braces and kinesiology taping can provide immediate pain relief and grip strength improvements; long-term benefits less certain.
    
      Cryotherapy
      B
      Helps reduce pain during flare-ups, providing short-term relief.
    
      Ultrasound, Iontophoresis, Laser Therapy
      C
      Limited or conflicting evidence; these should be considered adjuncts rather than primary treatments.

The key takeaway from the above is that a quality treatment plan for tennis elbow should definitely include strengthening exercises and a blend of manual therapy, dry needling and generalized arm strengthening. While there isn’t anything bad about ultrasound or laser, it probably is just a waste of your time compared to other treatments available.

Tennis elbow specialist Victoria — Rehab exercises for tennis elbow in Victoria, BC

Practical Tips for Managing Tennis Elbow

Gradual Return to Activity:

Increase activity load gradually, listening to pain as a guide. Note that it is okay for the pain to increase a bit, but it should definitely subside in the hours after the task back to baseline.

Tip: We often use a 24-hour rule with our patients. Load as you like so long as it is not more sore the next day.

Ergonomic Adjustments FOR ELBOW PAIN:

Modify work or activity setups. Evidence suggests ergonomic changes help when combined with exercise.

Tip: We’re not talking necessarily about a great posture here, but rather that activities that involve a lot of gripping and/or palms down movement tend to be more strenuous on the affected tendon.

ReHAB Exercises FOR TENNIS ELBOW:

Regular exercise is strongly linked to better outcomes. Research supports the idea of performing your strengthening exercises daily and under a decent level of resistance (2)

To start with, we recommend beginning with banded or weighted wrist extensions. With the forearm supported and palm down, extend the wrist up and down slowly (3 seconds per direction) under resistance for 10 reps 3 sets a day.

Tip: Don’t neglect the rest of your body during rehab. Continue to exercise in ways that don’t stress the elbow.

Pain Management:

Use ice or cryotherapy during flare-ups for short-term relief.

Tip: The ice is purely for pain relief, not to reduce inflammation (see this blog post for more on that)

Promoting Long-Term Recovery & Prevention

Address Underlying Causes:

Strengthening wrist extensors, improving technique, and activity modification are supported strategies.

Once you have completed your rehab, perform the targeted exercise for the wrist extensor muscles twice a week for 4 sets to ensure optimal health and prevent reinjury.

Seek Professional Help:

Individualized physiotherapy plans based on current evidence produce the best results. As with any plan of care, it is more than just a recipe for recovery, the plan should consider your needs and goals with exercises that reflect this.

Conclusion:

Managing tennis elbow effectively involves a comprehensive approach—assessment, targeted exercises, manual therapy, and lifestyle modifications—all supported by the best available evidence. As a sports injury clinic in Victoria, BC, we are dedicated to providing evidence-based, personalized care. If you're experiencing elbow pain or want to prevent future episodes, contact us today!

Looking for further help from a physiotherapist in Victoria? Reach out now! Our experienced team is here to help you recover, strengthen, and return to activity safely.

References:

1. Lucado AM, Day JM, Vincent JI, et al. Lateral Elbow Pain and Muscle Function Impairments. J Orthop Sports Phys Ther. 2022;52(12):CPG1-CPG111. doi:10.2519/jospt.2022.0302

2. Pavlova AV, Shim JSC, Moss R, et al. Effect of resistance exercise dose components for tendinopathy management: a systematic review with meta-analysis. Br J Sports Med. 2023;57(20):1327-1334. doi:10.1136/bjsports-2022-105754

Dana Tostenson, MPT

With a passion for people and health, physiotherapy has been a natural fit for Dana.

He enjoys working with clients through a holistic approach; incorporating manual therapy, tailored exercise prescription, and evidence informed education to help his patients overcome their pain, improve performance, and enhance their overall health.

Victoria, BC physiotherapist Dana is excited to help people return to the activities they love, approaching any issue, big or small, with enthusiasm and compassion. As a former varsity athlete and now a recreational competitor, his passion for sports and performance optimization makes him a great fit for injured athletes or weekend warriors hoping to return to and excel in the game.

Dana is a graduate of the University of British Columbia (Masters of Physical Therapy), the University of Alberta (Bachelor of Science in Nutrition), and has completed his Transitional Doctorate in Physical Therapy. He has advanced training in Functional Dry Needling, joint manipulation, chronic pain management, nutrition, as well as vestibular and TMJ disorders.

Outside the clinic you can find Dana on the jiu-jitsu mats, taking in the island’s natural beauty, or tending to his admittedly too many house plants (which have now spilled into the clinic).