Explanation of Diagnosis

Tennis elbow, or lateral epicondylitis, is caused by overuse of the forearm extensor tendons, which attach to the lateral epicondyle (outer elbow). It results from repetitive wrist extension, gripping, or twisting motions, leading to pain, tenderness, and weakness in the forearm and wrist. Despite its name, anyone who performs repetitive arm motions (e.g., typing, lifting, using tools) can develop tennis elbow.

Specific Work Modifications

• Avoid repetitive gripping, twisting, or wrist extension movements (e.g., using tools, typing, lifting heavy objects).
• Use ergonomic tools with larger grips to reduce strain.
• Take frequent breaks to stretch and rest the arm.
• Wear a forearm strap (counterforce brace) to reduce stress on the tendons.
• Modify workstation setup (ergonomic keyboard/mouse, proper desk height).

Specific Activity Modifications

• Avoid activities that involve repetitive wrist extension, gripping, or twisting (e.g., tennis, golf, weightlifting, playing an instrument).
• Modify workouts by reducing resistance on the affected arm and focusing on lower body or core strength.
• Use proper technique and equipment adjustments to reduce strain (lighter grip, proper wrist positioning).
• Gradually return to activities once pain decreases, starting with light resistance and proper warm-ups.

Recommended Supplements

• Collagen peptides (10 g daily) – Supports tendon repair.
• Vitamin C (500 mg daily) – Aids in collagen synthesis.
• Magnesium (300-400 mg daily) – Helps muscle relaxation and recovery.
• Omega-3 fatty acids (1000 mg daily) – Reduces inflammation.
• Turmeric (500 mg twice daily) – Natural anti-inflammatory.

Recommended Nutrition and Hydration

Diet Recommendations:

• Anti-inflammatory foods: Fatty fish (salmon, sardines), berries, nuts, turmeric, and leafy greens.
• Collagen-boosting foods: Bone broth, citrus fruits, and bell peppers.
• Protein-rich foods: Chicken, eggs, lentils, and dairy to support tendon healing.
• Limit processed foods and excessive sugar, which can worsen inflammation.

Hydration Tips:

• Drink at least 2–3 liters of water daily to maintain tendon hydration.
• Limit caffeine and alcohol, which can slow healing.

Home Exercise Prescription

Perform 2-3 times daily to improve mobility and strengthen the elbow safely:

1. Eccentric Wrist Extension Exercise

1. • Hold a light dumbbell (1-3 lbs) in the affected hand.
   • Slowly lower the wrist downward over 3-5 seconds, then use the other hand to bring it back up.
   • 10 reps, 2-3 times daily.

2. Wrist Extensor Stretch

1. • Extend the arm with the palm facing down.
   • Use the opposite hand to gently pull the fingers back.
   • Hold 20-30 seconds, repeat 3 times.

3. Forearm Supination/Pronation Exercise

1. • Hold a light weight (1-2 lbs) with your elbow bent at 90°.
   • Rotate the palm up and down slowly.
   • 10 reps, 2-3 times daily.

4. Grip Strength Exercise (if pain allows)

1. • Squeeze a soft stress ball for 5 seconds, 10-15 reps, 2 times daily.

5. Towel Twist Exercise

1. • Hold a towel with both hands and twist as if wringing water out.
   • Perform 10 reps in each direction, 2 times daily.

Avoid heavy lifting, repetitive gripping, or direct elbow pressure until symptoms improve.

Helpful Books

1. "Framework for the Shoulder: A Practical Guide to Preventing Injury and Returning to Activity" – Nicholas A. Dinubile, MD
2. "Rebuilding Milo: The Lifter’s Guide to Fixing Common Injuries and Building a Strong Foundation" – Aaron Horschig

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.