Load Management For Tennis Elbow Pain
When considering the most common issues occurring with elbow pain, we have to discuss the tissue/s involved. On either side of the elbow, muscles come together to create a common tendon region anchoring to the distal humerus or proximal radius/ulna. There are other tissues around this area like the ulnar nerve, ligaments, and vessels, but for the sake of this conversation we are focusing on tendons.
I had put out a post on tennis elbow and how this is a load intolerance problem at the tendon. Let’s dive deeper into that and discuss what a load intolerance problem can actually look like.
All areas of the body respond to load. We will categorize load as external resistance. Bones, cartilage, muscles, tendons and ligaments all react to load. When we exceed the bodies current capacity for load, or chronically under load an area, this is where issues can arise. Managing load comes down to steady progressive training, minimizing peaks and valleys in specific activity. For example, if a tennis player plays 3 set matches 5 days a week, then take two months off, and attempts to return to 5 days a week again, this was a ‘valley’ of lack of activity that decrease the load demand of the body. At the level of the elbow, it has not participated in nearly as much activity as it did before, so it has become deconditioned to that specific stimulus. Due to the lack of load management during the time off, returning to a high demand (‘peak’ in activity), the body will be more prone to NOT tolerate that load.
So what do we do in this situation? Load management is on a continuum. Even in the off-season, we should maintain some level of stimulus, as to not see a significant valley of training. Whether this be specific tennis elbow exercises or general upper body strength training, something needs to be done. If nothing is done, then we need to make sure that when the season is back on, it is a ramp-up and progressive process to get back to full return to activity. A steady progress such as 2 days a week, then 3 two weeks later, than 4 two weeks after that, gives the body progressive time to react to the load changes and adequately respond to managing it.
This topic can get much more complex, but I wanted to provide somewhat of a breakdown to hopefully help the understanding of load management. If more assistance on the topic is needed or questions arise, I am happy to discuss it all even further and in more depth specific to what may be going on!
Have more questions about how physical therapy can help elbow pain? I would be happy to chat further about how Loon State Physical Therapy can be your teammate in getting you back to moving and feeling your best! We have convenient Minneapolis and Edina physical therapy locations to best help you get out of pain. Call us at (612) 405-8503 or book with us online at www.loonstatephysicaltherapy.com for an in-person or virtual appointment.
Until next time!
Andrew Eccles
Owner and Physical Therapist at Loon State Physical Therapy
