Coping with Tennis Elbow: A Guide to Cold Therapy

The simple act of lifting a full coffee cup sends a sharp, nagging pain from the outside of your elbow down your forearm. Perhaps you feel it when turning a doorknob, shaking someone's hand, or trying to open a tight jar. This frustrating and often persistent discomfort, commonly known as tennis elbow, can disrupt the simplest of daily tasks, turning routine movements into painful challenges. While the name suggests a sporting injury, the reality is that this condition affects a wide range of people, from office workers and manual labourers to keen gardeners. If you are navigating the challenges of tennis elbow, you are likely exploring a variety of strategies to manage the pain and regain function. Alongside established medical advice and physiotherapy, many are now looking at supportive wellness applications, including whole-body cold therapy, as a component of their overall recovery plan.

What is Tennis Elbow, Really?

Despite its common name, tennis elbow is medically known as lateral epicondylitis. This technical term gives a clearer picture of what is happening. 'Lateral' refers to the outside of the joint, and the 'lateral epicondyle' is the small, bony bump on the outer side of your elbow where several muscles of your forearm attach via a common tendon. These are the extensor muscles, which you use to bend your wrist backwards and straighten your fingers.

For a long time, the "-itis" at the end of the word was thought to mean the condition was primarily one of inflammation. However, modern understanding has shifted. While some inflammation can be present, especially in the early stages, chronic tennis elbow is now seen more as a degenerative condition, or 'tendinosis'. This means the problem lies in wear and tear. Repetitive strain can cause tiny micro-tears in the tendon tissue. The body tries to repair these tears, but if the strain continues without adequate rest and recovery, the repair process can become disorganised and incomplete. Instead of strong, new tendon fibres, the body lays down weaker, disorganised tissue, leading to a chronically weakened and painful tendon. It is this combination of overuse, micro-trauma, and a failed healing response that characterises the condition.

The Common Culprits: Causes and Risk Factors

Only a small percentage of people with tennis elbow actually get it from playing tennis. The root cause is almost always repetitive stress on the forearm's extensor muscles and their shared tendon. Any activity that involves repeated gripping, twisting, or lifting with the wrist can be a trigger.

Consider these common scenarios:

• Occupational Strain: Jobs that involve forceful and repetitive arm movements are a primary risk factor. This includes painters, plumbers, carpenters, chefs, and assembly line workers. Even prolonged use of a computer mouse and keyboard with poor wrist posture can contribute significantly.
• Hobbies and DIY: Enthusiastic bursts of activity your body is not accustomed to can easily lead to overuse. Think of a weekend spent painting a room, extensive gardening and pruning, or using a screwdriver for hours on a flat-pack furniture project.
• Racket Sports: Of course, sports like tennis and badminton are a classic cause, especially if your technique is suboptimal or your equipment is poorly suited to you. An incorrect backhand stroke, for example, puts significant strain on the wrist and forearm extensors.
• Age: The condition is most common in people between the ages of 30 and 50. As we age, our tendons can become less flexible and more susceptible to injury.

The key takeaway is that tennis elbow is fundamentally an overuse injury. It develops gradually as the cumulative strain on the tendon outpaces its ability to repair and recover.

Recognising the Signs and Seeking a Diagnosis

The symptoms of tennis elbow typically develop slowly. You might first notice a mild ache on the outside of your elbow that appears after a strenuous activity. Over weeks or months, this can evolve into a more constant and sharper pain.

The most common symptoms include:

• Pain or a burning sensation on the bony bump on the outside of your elbow.
• The pain may radiate down your forearm towards your wrist.
• Weakened grip strength. You might find it difficult to hold a coffee mug, turn a key, or grip a pen.
• Pain that worsens when you perform actions that use the forearm muscles, such as lifting something, making a fist, or extending your wrist.

If these symptoms sound familiar, the first and most important step is to see a doctor or a qualified physiotherapist for an accurate diagnosis. It is crucial to rule out other conditions that can cause similar elbow pain, such as arthritis, nerve issues, or problems originating in the neck. A medical professional will typically diagnose tennis elbow based on your description of the symptoms and a physical examination. They will likely ask you to perform certain movements, apply gentle pressure to the affected area, and test your arm and grip strength. In some cases, they may recommend an ultrasound scan or an MRI to get a clearer picture of the tendon's condition and rule out other potential problems.

The Established Path: Conventional Treatments

Once a diagnosis is confirmed, your doctor or physiotherapist will recommend a treatment plan. The primary goal is to reduce pain and allow the tendon to heal. Patience is key, as recovery can take several months.

The cornerstone of conventional treatment is a multi-faceted approach, usually starting with the most conservative methods:

• Relative Rest: This does not mean complete immobilisation. It means identifying and modifying or avoiding the activities that aggravate the pain. For an office worker, this might involve ergonomic adjustments to their workstation. For a manual worker, it might require a temporary change in duties.
• Physiotherapy: This is perhaps the most critical component of long-term recovery. A physiotherapist will guide you through a specific programme of exercises designed to first gently stretch the forearm muscles and then progressively strengthen them. Eccentric exercises, where the muscle lengthens under tension, are particularly effective for promoting healthy tendon remodelling.
• Braces or Straps: A counterforce brace or strap worn around the forearm just below the elbow can help to reduce the tension on the affected tendon, providing pain relief during daily activities.
• Pain Relief: Over the counter anti-inflammatory medications may be suggested for short term relief, particularly in the early, more inflammatory phase.

If these initial treatments do not provide sufficient relief after several months, your doctor might discuss other options, such as corticosteroid injections or, in very persistent and severe cases, surgical procedures to remove the damaged tissue.

Whole-Body Cold Therapy: The Experience in Memmingen

Within a comprehensive recovery strategy, you may consider supportive wellness modalities. Whole-body cold therapy is one such application. At our studio in Memmingen, you will experience a brief, controlled exposure to extremely cold, dry air. The process is straightforward and designed for your comfort and safety.

When you arrive for your session, you will first change into appropriate attire: minimal, dry clothing like shorts, a top or bathing costume, along with socks, gloves, and head protection to shield your extremities. You then step into a pre-chamber, which is set to a moderately cold temperature, to help your body acclimatise for about 30 seconds. From there, you enter the main chamber, where the air temperature is maintained at a constant -110 °C.

The cold is intense but, because the air is completely dry, it is not the biting, damp cold you might experience on a winter's day in the Allgäu. Instead, it feels like a deep, penetrating cold that envelops your skin. You will stay in the chamber for a short period, typically around three minutes. During this time, you can move around gently to help keep your circulation active. Our trained staff will be monitoring you and communicating with you throughout the entire session.

After your three minutes are up, you will step out, and the sensation that follows is often described as invigorating. Your skin will tingle as it rapidly warms up, and many people report feeling a sense of alertness and wellbeing. The entire experience, from changing to finishing the session, is quick and can be easily integrated into your daily routine. It is a wellness application, not a medical procedure, aimed at supporting the body's natural processes of recovery and revitalisation.

What the research shows

The use of cold to manage pain and inflammation is an age-old practice, but whole-body cold therapy is a modern application that is the subject of ongoing scientific investigation. It is important to approach the research with a clear understanding of what has been studied, what might be cautiously inferred, and what the limitations are. The studies available have not specifically investigated whole-body cold therapy for tennis elbow, which, as we have noted, is often a degenerative rather than a purely inflammatory condition. However, research into the general physiological effects of whole-body cold application provides some interesting context.

A primary area of interest is the body's inflammatory response. Some studies suggest that exposure to extreme cold may influence the levels of certain proteins involved in inflammation. For instance, one investigation in healthy men who underwent a series of ten whole-body cold therapy sessions observed changes in inflammatory markers like interleukin-6 (IL-6), a cytokine that plays a role in the inflammatory process [7]. A systematic review of various forms of cryotherapy in inflammatory rheumatic diseases also noted that cold applications are widely used with the aim of reducing inflammation and pain, although it highlighted the need for more robust, controlled trials [2].

Another focus of research has been the application of whole-body cold therapy in sports and athletic recovery. Because tennis elbow is an overuse injury, insights from this field are relevant. A review of literature on athletes suggests that cold application is used to manage exercise induced inflammation and muscle soreness [4]. The theory is that the intense cold causes vasoconstriction (narrowing of blood vessels) on the skin's surface, which may help limit local inflammation. Following the session, as the body re-warms, a process of vasodilation (widening of blood vessels) occurs, potentially increasing blood flow and the delivery of oxygen and nutrients to tissues. This review notes that cold therapy may influence perceived recovery in athletes [4].

However, it is crucial to acknowledge the limitations of the current body of research. A critical appraisal of the evidence points out that many studies on whole-body cold therapy have involved small numbers of participants, lacked control groups, or had short observation periods [3]. This makes it difficult to draw firm, generalisable conclusions. Furthermore, the physiological response, such as the degree of skin cooling, can vary between individuals based on factors like body composition [8]. Therefore, while the existing research provides a plausible basis for why cold application might feel beneficial for conditions involving pain and recovery, it does not constitute proof of effectiveness for tennis elbow specifically. The use of whole-body cold therapy in this context remains a supportive measure, based on its potential systemic effects on pain perception and inflammatory pathways.

Integrating Cold Therapy into Your Recovery Plan

If you decide to try whole-body cold therapy, it should be seen as one part of your broader, medically guided recovery strategy, not a standalone solution. It works in concert with, not in place of, physiotherapy, appropriate rest, and ergonomic changes.

Think of it as an addition to your self-care routine. You might schedule a session on the same day as a physiotherapy appointment to potentially help manage any post-exercise discomfort. Or you could use it on a rest day as a way to focus on your body's overall state of recovery. Consistency can be beneficial; some guests find that a series of sessions, for example, two or three times a week for a few weeks, aligns well with their recovery goals.

Always communicate with your healthcare providers. Let your doctor and physiotherapist know that you are considering or using whole-body cold therapy. They can help you assess if it is appropriate for your specific situation and ensure it complements your primary treatment plan. At our studio, we always emphasise that we provide a wellness and recovery service, and our role is to support you, not to treat or diagnose your condition.

Safety First: Contraindications and Precautions

While generally well-tolerated, whole-body cold therapy is not suitable for everyone. Your safety is our highest priority, and it is essential to be aware of the contraindications. You should not use the cold chamber if you have any of the following conditions:

• Uncontrolled high blood pressure
• Heart attack within the last six months or other severe cardiovascular disease
• Unstable angina pectoris
• Pacemaker
• Peripheral arterial occlusive disease
• Deep vein thrombosis (DVT) or a history of blood clots
• Acute respiratory conditions
• Severe anaemia
• Cold allergy (cold urticaria)
• Raynaud's syndrome
• Seizure disorders
• Bacterial or viral skin infections
• Pregnancy

This list is not exhaustive. Before your first session, you will be required to complete a health questionnaire and discuss any concerns with our trained staff. If you are ever in doubt, please consult your doctor before booking a session.

Frequently asked questions

What is the main difference between whole-body cold therapy and a simple ice pack?

An ice pack provides localised cold to a specific area, primarily affecting surface tissues. Whole-body cold therapy exposes the entire body's skin surface to extremely cold, dry air, triggering a systemic, or body-wide, physiological response. The goal is to influence the nervous, circulatory, and endocrine systems as a whole.

How might whole-body cold therapy support someone with tennis elbow?

The application is not a direct treatment for the tendon itself. Instead, it is being studied for its potential systemic effects, such as influencing the body's general inflammatory response and altering pain perception [2, 7]. Many guests report a feeling of reduced soreness and general wellbeing, which can be a positive psychological component of a long recovery process.

How often should I use the cold chamber for supportive care?

This varies greatly from person to person. Some individuals find a short series of sessions helpful when starting their recovery plan, while others use it periodically for general wellness. We can discuss a schedule that fits your routine and goals, but it should always be considered alongside your primary medical treatment.

Is the -110 °C cold dangerous or painful?

The cold is intense but generally not described as painful because the air is extremely dry, which prevents the biting sensation of damp cold. The session is very brief, lasting only about three minutes, and you are monitored by our staff the entire time. Most people tolerate the session very well.

Do I need a referral from my doctor to visit the cold chamber?

No, a medical referral is not required to book a session at Kältekammer Memmingen, as it is a wellness service. However, we strongly recommend that you discuss using whole-body cold therapy with your doctor, especially if you are using it to support recovery from a specific condition like tennis elbow.

Can cold therapy cure my tennis elbow?

No. There is no evidence to suggest that whole-body cold therapy can cure tennis elbow. It is a supportive wellness application that may help you manage symptoms like pain and support your overall sense of recovery, but it must be part of a comprehensive treatment plan supervised by a medical professional.

Are there any specific preparations for a session?

The main preparation is to ensure your skin is completely dry and free of any lotions or oils. You should also remove all jewellery and metal piercings. We provide the necessary protective wear for your hands, feet, and ears.

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