If you are here, I am assuming you have read the previous blog on tennis elbow, also known as lateral epicondylitis and here to read part 2. Your symptoms have been reduced, or those exercises previously mentioned are too easy, and you are now ready to take the next step.

Time is generally not the best way to determine moving to the next stage of physical therapy. Factors to consider prior to progressing are the severity of inflammation, pain, disability, capacity to reduce aggravating movements, hobbies and occupation are likely to all impact, and unique from one person to the next.

Moving into the next phase, I would continue the previous exercises or vary and add others. Also, keeping in mind that the body is complex than often perceived. Examination of Musculoskeletal posture, strength, and mobility should be completed on a person by person basis by a professional. Attention to the scapula and shoulder should be included.

Exercises

Adequate thoracic rotational and flexion movements can improve mobility through the thoracic region, such as thread the needle and extension over a roller. Both of these exercises can, however, be a little too intense for some people as an initial exercise. Start slow, preferably in a standing position, then moving down to a variation completed on the floor.

Horizontal push (supine scapula/ Serratus Anterior punches) and pull (row) exercises can both be designated. Continued grip strength progressions such as farmers carry. However, this distraction (or pulling down force) at the elbow can be uncomfortable if implemented too soon. Another option is using an elastic band around the fingers and thumb, opening the fingers wide.

Implementing exercise directed at the forearm is required, with tolerance to the movements to be considered for the individual. Programming considerations include variations in resistance, sets, reps, and rest periods.