A Detailed Analysis of Four Rehabilitation Modalities for Tennis Elbow

This report focuses on the rehabilitation of tennis elbow injuries, a common problem among athletes, particularly cricketers. It outlines four key modalities designed to restore function and minimize pain, and describes the sequential phases of recovery. The modalities include immediate motion to reduce inflammation and maintain range of motion; intermediate stretching to enhance endurance and muscular strength; advanced strengthening to increase power and neuromuscular control; and return to activity, which prepares the athlete for a safe return to sports. The report emphasizes the importance of a comprehensive approach, ensuring the athlete is pain-free and has regained optimal function before returning to play. The report also references key studies and research in the field of exercise science and sports medicine, highlighting the importance of a systematic approach to rehabilitation to prevent re-injury and promote full recovery.

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EXERCISE SCIENCE

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Contents
Introduction......................................................................................................................................3
The Four Modalities........................................................................................................................3
1. Immediate Motion................................................................................................................3
2. Intermediate level stretching.................................................................................................4
3. Advanced Strengthening.......................................................................................................5
4. Return to activity..................................................................................................................6
References........................................................................................................................................7

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Introduction
The sportsperson has to perform various activities during their overhead sport, in
particular during cricket, the elbow joints have to produce a large force during their gameplay.
The tennis elbow injury and its pain can offer the athlete a large amount of pain that can be all
due to the large forces generated during the act of playing cricket, throwing the ball or catching
it. The tennis elbow injury occurs due to the repetitive overuse of elbow that can lead to
permanent tissue failure. The rehabilitation of the tennis elbow injury becomes quite vital the
person so that they can restore to full normal function in return to play cricket as safely as
possible. In this assignment, we will see the four rehab modalities that can help in restoring the
tennis elbow injury with full neuromuscular control and muscular strength so that the tissues can
heal up gradually over time.
The Four Modalities
The rehabilitation on tennis elbow injury can be followed with multiphase modules or
approach. Some phases listed below for the rehabilitation program that will help to ensure the
athlete with proper progression for a tennis elbow injury (Renstrom, 2018). By this rehabilitation
the athlete is to achieve full functional potential level.
1. Immediate Motion
The immediate motion regarding rehabilitation of tennis elbow emphasis to
minimize the effects of retard muscular atrophy, immobilization, inflammation, pain

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along with inflammation and achieve in providing non-painful motion range (Carlisi et
al., 2019).
Immediate motion activities can be performed by the athlete to nourish the
collagen tissue, alignment and articulate cartilage. The non- painful range of motion for
the injury of tennis elbow can be performed leading to prevention of the formation of
adhesions (Aagaard, 2016).
The stretching techniques can be taken in constant to heal constrains tissues in the
elbow. For the patient, who feels a decrease in their hand or elbow motion and feels high
pain can consider taking stretching techniques. If a patient is experiencing pain that
comprises with gentle or slow stretching then glen humeral joint mobilizations can be
taken into considerations (Frydmun et al., 2018).
The immediate motion can also be given with voluntary and retarding muscular
atrophy. The submaximal and sub painful isometrics can also be performed with
supinator, flexor, extension, pronator muscle groups. The shoulder isometrics can also be
perfume din immediate motion phase so that the external and internal pains could be
minimized (Arais- Buria et al., 2019).
2. Intermediate level stretching
When the full throwing, tenderness and minimal pain is initiated in tennis elbow
pain with immediate motion, then the intermediate phase can be initiated. This phase is
an emphasis on the rehabilitee techniques that include enhancing/maintaining the upper
extremity of the elbow by improving its inner endurance and muscular strength. The re-
establishment of neuromuscular pains can also be conducted that can control the
complexity of pains (Altun, Incel, Cimen & Sahin, 2018)

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Stretching exercises can also be induced to maintain the full elbow rotation. The
strengthening exercise may include the progression of isotonic contractions. The full
stretching exercises can be given that should be emphases on elbow extension, wrist
stretching and rotation, forearm suspiration (Patel, 2018).
The emphasis on stretching can be made by rotating the shoulder muscles.
According to the tennis elbow reports of patients, it is seen that there is a high rate of
relief is seen when the strengthening exercises are included in the recovering time. The
strengthening exercise can help in advancing the upper extremity of the shoulder as well
as of the elbow. Recently, the crickets with tennis elbow injury are seen to increase their
throw with stretching techniques (Stracciolini, Jackson & d’Hemecourt, 2019)
3. Advanced Strengthening
Advanced strengthening involves the progression to prepare the athletes to
participate in sports. The major goal is to increase the power, strength, elbow’s
neuromuscular control as well as in body so that they can be prepared for the gradual
return. The criteria can also be met by entering into the phase that includes the internal
and non-internal rotation of elbow that can result in no pain and can help in strengthening
the 70% of elbow activities (da silva et al., 2019).
The advanced strengthening activities can include higher resistance, plyometric
activities, functional movements and eccentric contractions. The elbow exercise can be
progressed with advanced stretching that can include the activities of gradual resistance,
plyometric activities, and eccentric contraction and on the functional movements. The
elbow stretching can be performed with an elastic tube by doing fast and slow

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contractions. The resistance can also be applied manually with the elbow flexors’s
eccentric contractions (Bateman, Whitby, Kacha & Salt, 2019).
4. Return to activity
Final phase of rehabilitation of elbow will allow the athlete to come to its original
potential along with a progressive return. Rehabilitation modules or phases mentioned
above will allow the person to perform actions with high performance (Martin et al.,
2019). The athlete with rehabilitation modules will feel pain-free with optimum
stretching and resting techniques. Before going back to the field, the athletes may have to
go through the routine tests that may be up to running or throwing a ball up to 100 and
180 degrees per second.
The data has indicated that after the rehabilitation techniques and phases, the
athlete that has the tennis elbow injury is seen to move their elbows stronger. However,
for safety concerns, the athletes must be well evaluated for their pain and the quality of
movement they have after their recovery process (Eraslan, Yuce, Erbilici & Baltaci,
2019).
Conclusion
Tennis elbow injury is a well known problem affecting many cricketers. It is all due to
the receptive movements and due to high forces that induce a micro traumatic injury in the
elbow. The elbow tennis may result in staying as a permanent injury too. The rehabilitation of

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tennis elbow injury can be progressed with sequential phases that can ensure its healing and so
that it does not overstress the tennis elbow injury. The rehabilitation program can also restore the
neuromuscular strength with stretching and resting so that the athletes can successfully return to
its previous level of game function as safely as possible. Apart from the rehabilitation of tennis
elbow injury, the athletes must also include their entire chain of hand, shoulder, legs and hips to
be well maintained so that they can be returned back to their sport with a high level of
participating.
References
Altun, R. D., Incel, N. A., Cimen, O. B., & Sahin, G. (2018). Efficacy of ESWT for Lateral
Epicondylitis Treatment: Comparison with Physical Therapy Modalities. Journal of
Musculoskeletal Research, 21(01), 1850001.
Renstrom, P., & Ackermann, P. W. (2018). Pathophysiology of Tendinopathy: Implications for
Tennis Elbow. In Tennis Medicine (pp. 263-275). Springer, Cham.
Aagaard, P., & Andersen, J. L. (2016, November). 13 Eccentric training as treatment of muscle
—tendon injury. In Science and Football VIII: The Proceedings of the Eighth World
Congress on Science and Football (p. 119). Taylor & Francis.
Bateman, M., Whitby, E., Kacha, S., & Salt, E. (2019). Current physiotherapy practice in the
management of tennis elbow: a service evaluation. Physiotherapy, 105, e73-e74.

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Carlisi, E., Cecini, M., Di Natali, G., Manzoni, F., Tinelli, C., & Lisi, C. (2019). Focused
extracorporeal shock wave therapy for greater trochanteric pain syndrome with gluteal
tendinopathy: a randomized controlled trial. Clinical rehabilitation, 33(4), 670-680.
da Silva, M. P., Tamaoki, M. J., Blumetti, F. C., Belloti, J. C., Smidt, N., & Buchbinder, R.
(2018). Electrotherapy modalities for lateral elbow pain. Cochrane Database of
Systematic Reviews, (6).
Eraslan, L., Yuce, D., Erbilici, A., & Baltaci, G. (2019). Response to the letter to the editor:
Comment on “Does Kinesiotaping improve pain and functionality in patients with newly
diagnosed lateral epicondylitis?”. Knee Surgery, Sports Traumatology, Arthroscopy, 1-3.
Frydman, A., Johnston, R. V., Smidt, N., Green, S., & Buchbinder, R. (2018). Manual therapy
and exercise for lateral elbow pain. Cochrane Database of Systematic Reviews, (6).
Martin, J. I., Atilano, L., Merino, J., Gonzalez, I., Iglesias, G., Areizaga, L., ... & Andia, I.
(2019). Platelet-rich plasma versus lidocaine as tenotomy adjuvants in people with elbow
epicondylopathy: a randomized controlled trial. Journal of orthopaedic surgery and
research, 14(1), 109.
Patel, P. (2018). The Effects of Shockwave Therapy Compared to Therapeutic Activity on Pain
and Grip Strength in Patients with Lateral Epicondyle Tendinopathies: A Meta-
Analysis (Doctoral dissertation).
Stracciolini, A., Jackson, S. S., & d’Hemecourt, P. (2019). Musculoskeletal Ultrasound in
Treating and Preventing Upper Extremity Injuries in Young Athletes. In Upper Extremity
Injuries in Young Athletes (pp. 209-230). Springer, Cham.