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Research-Based Massage for Tennis Elbow (2 CE Hours)

This course is approved by the Texas Department of State Health Services DSHS for Continuing Education for Massage Therapists CE0009 and by the NCBTMB for Nationally Certified Massage Therapists for 2 CE Hours.

This article reviews the latest clinical research that has reported the effectiveness of massage therapy for the treatment of tennis elbow (lateral epicondylitis). 

Learning Objectives: After reading this course, you will...

  1. be able to describe the anatomy associated with tennis elbow.
  2. be able to identify the research-based types of symptoms associated with tennis elbow that can be influenced positively by massage therapy.
  3. be able to list specific massage therapies that have evidence to support their use on tennis elbow, according to the research.
  4. be able to explain the research efficacy of massage therapy in the treatment of symptoms of tennis elbow.
  5. be able to describe what type of massage is best in the treatment of tennis elbow, according to the research.


Introduction to Research-Based Massage for Tennis Elbow

Lateral epicondylitis (aka tennis elbow) is a common cause of lateral elbow pain.  It affects 1-3% of adults each year and is considered one of the most common upper extremity disorders.(1)  It may affect up to 15% of workers who perform repetitive tasks with their hands and up to 50% of tennis players.(2,3)  Symptoms include pain (lateral epicondylagia) around the lateral epicondyle of the humerus, which is often provoked by gripping actions and especially the tennis backhand, and weakness, especially when gripping objects.  Most patients report functional limitations in activities of daily living (especially gripping objects), work-related activities requiring gripping objects or using the wrist, and leisure activities, especially tennis or any activity that requires gripping or wrist extension.(4)  Patients with lateral epicondylitis typically present with 1) pain on palpation of the lateral epicondyle, 2)  pain with gripping, 3) pain with passive wrist flexion (elbow in extension) and 4) pain with resisted wrist extension. (5)

Research-Based Anatomy, Etiology and Epidemiology of Tennis Elbow

Lateral epicondylitis appears to be a chronic overuse injury of the common wrist extensor group at the lateral epicondyle of the humerus.(6)  Since it is seen so prevalently in tennis players, it took on the name tennis elbow. The Extensor Carpi Radialis Brevis is the most common tendon cited, although the neighboring Extensor Digitorum Communus and Externsor Carpi Radialis Longus can also be involved.(5) There is no clear consensus on the actual cause or pathological process of this disorder.  Histological studies have revealed that lateral epicondylitis is a chronic degenerative process where the localized connective tissue (collagen) of the common extensor tendon becomes disorganized.(5)  Biochemical studies have shown the presence of neurokinin 1 (substance P), but a lack of chemicals associated with the inflammatory process, like bradykinins, leukotrienes, and histamine.(7)  This has led to clinicians renaming the condition  lateral epicondylalgia or lateral epicondylosis, which are more generalized terms of pathology that do not necessarily involve inflammation.(5)  

Please, click here to read this article as part of the content of this course.

Tennis Elbow (aka Lateral Epicondylitis)


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