Tennis/Golfer’s Elbow Release in Bath
The rehabilitation programme will need to be individualised for each patient, all exercises should be performed without pain and the details of any restrictions will be in the post-operative instructions. If you have not received these please ring the consultant’s secretary.
Emphasise to the patient the importance of allowing soft-tissue healing in the first 4-6 weeks. Alongside this we aim to regain active range of movement (AROM). The milestones may be used to assess whether you feel the patient is making good progress or not.
Phase 1 (1-14 days)
Goals:
- Management of pain and inflammation. – Analgesics, NSAID’s, ice and elevation with sling.
- Teach full range active elbow and radio-ulnar joint exercises – flexion/extension and supination/pronation.
- Teach gentle, active wrist exercises into full range – flexion/extension within pain free range, should only feel a mild stretch at end of range.
- Prevent muscle atrophy – sub-maximal, pain-free isometrics into flexion/extension with the wrist in neutral (<30% maximal voluntary contraction) as tolerated.
Precautions:
- Avoid any heavy loading/lifting.
- Sling usually for 3 days for comfort as required (continue to elevate once out of sling).
- Keep wounds clean and dry.
Milestones:
- Pain, inflammation and muscle inhibition well managed.
- Full active joint range
Phase 2 (day 15-6+ weeks)
Goals:
- Continue to manage and reduce pain, inflammation and muscle inhibition.
– As phase 1 plus alternate treatment strategies as appropriate e.g. manual therapy techniques, taping. - Once stitches have been removed begin scar massage.
- Gradually introduce and progress elbow, wrist and hand strengthening as tolerated/not into pain.
– Progress from sub-maximal isometrics in neutral to isotonic strengthening as tolerated/not into pain.
– Introduce and progress proprioceptive exercises. - Start to progress heavy loading from week 6 onwards (>2-3kg).
Milestones:
- Minimal pain, inflammation and muscle inhibition.
- Return to driving at 2 weeks.
- Return to light/sedentary work at 2 weeks, 6 weeks for heavy/manual work.
Return to sporting activities:
- Swimming from 6 weeks
- Racquet sports from 12 weeks
