Manipulation May: Elbow Manipulation

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Manipulation May: Elbow Manipulation

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Elbow Manipulation


Tennis elbow is a prevalent musculoskeletal condition that is characterized by lateral elbow pain (outer elbow pain) often associated with gripping tasks. Although the most efficient management approach is varied, and can include ASTYM, active release techniques, eccentric exercises, and dry needling, there is a growing body of research reporting the effects and underlying mechanisms of joint manipulation for tennis elbow. Joint manipulation directed at the elbow and wrist, as well as the neck and thoracic spine can result in clinical alterations in pain and the muscle activation.


A manipulation is a small-amplitude and quick thrust performed to the elbow joint, with the goal of decreasing pain, increasing ROM, and improving function (like gripping). We like to think of the manipulation as a “reset” to the joint, and the exercises that are performed afterwards as the “save” button.  This usually is accompanied with a non-painful “pop” or what we call a cavitation, that feels good to the patient and affords greater symptom relief.


Why does this help? In reviewing the literature, there isn’t one clear-cut answer to the physiological mechanism that provides a good example. More likely, the most reasonable explanation is that joint manipulation results in a complex multi-system physiological response, meaning that the manipulation affects many of our body systems (musculoskeletal, immune, neurological) interact to produce this positive result.


If you are having persistent elbow pain, visit us at any of our clinic locations to be seen by a physical therapist.

Katie Peaslee, PT, DPT