Tennis elbow manifests itself when healing cannot outpace the rate of damage (see diagram). Your tennis elbow strategy will build itself around this. All we have to do is list the healing factors, and optimize them, and then list the damage factors and minimize them.

1. Optimal Body Positioning, "OBP" at rest
2. Optimal Body Positioning "OBP" in use.
3. Other Tennis Elbow Remedies

Get to Know your Body Exercise 1: Positioning "at Rest" This one assumes you have a "sore tennis elbow"; but if you haven't, try it anyway.

Note the positioning of your wrist as you hold the steering wheel of the car (or as you rest your hand on the computer key board, or on the mouse)! Chances are, (and if you are anything like me!), the wrist of your tennis elbow arm is not in neutral, but rather is in extension or dorsi-flexion. The position pictured to the right constitutes a "DSM" of the wrist joint. A "DSM" is a Directional Susceptibility of Movement. Professor of Physiotherapy Shirley Sahrmann describes it thus:- "The impairments of soft tissues induced by repeated movements and sustained postures eventually causes a joint to develop a susceptibility to movement in a specific direction..." (Ref 4, page 4). In fact, wrist dorsi-flexion is probably the main DSM associated with tennis elbow.

The resting position of the "tennis elbow" wrist. (Dorsi-flexion)This constitutes the major "DSM" of Tennis Elbow.

1. Constantly pulls the broken ends of the ECRB tendon apart making it difficult for the tendon to pull together and heal.
2. Constantly increases the pressure within the healing area, making it harder for the blood to flow into the healing area.
3. Enhances the "splinting effect": This is when muscles around a broken or painful bone tend to go into spasm in an attempt to stabilize the fractured bone. This is something I observe when pinning a dog's leg. The same sort of "splinting effect" can happen when tendinous and joint capsule attachments to the bone become inflamed and painful. "Splinting" certainly occurs when a dog dislocates its hip, or when a human dislocates the shoulder, and also occurs in the ECRB and neighbouring muscles when there is tennis elbow pain. I already stated that surgical repair of the ECRB tendon immediately removes tennis elbow pain and encourages normal forearm function. This suggests that surgery not only removes the damaged "jelly like" material in the tendon, but that it also removes increased or overactive pain receptors from the area, thus also removing the "splinting" stimulus.

"Get to Know your Forearm" Exercise 3: Finding the least tense positioning of the forearm and wrist:-
(1) Place your right hand over the muscles of your left forearm.
(2) Put the left wrist through its full range of flexion and extension. Note when the muscle become tense!
(3)Put your left wrist through its full range of medial and lateral flexion (see diagram). Note when the muscles become tense!
(4)Finally put your wrist through its full range of pronation and supination. Again, note when the muscles become tense!

Defining optimal middle Range of Flexion for the Wrist.
Diagram: Angle of Wrist Flexion	Graph: Depicts the degree of forearm muscle tension from 90 degrees of flexion to 45 degrees of extension
The wrist flexion range from -15 degrees to 45 degrees is the range of minimum muscle tension: I.e. the "OBP" of wrist flexion.

(B) When the wrist and forearm is at OBP during use, the muscles are at their strongest.

• At the comfortable middle range, a muscle is able to generate its greatest degree of force, whether that force is used for bracing or for moving. (see diagram below).
• At its comfortable middle range, the muscle is best able to maintain control by use of the least amount of tension.
• More important however is that for a given load, the muscle at middle range is using the least percentage of its full power, and is therefore least likely to tire with repetition, and eventually buckle under the load, thereby stretching to beyond its optimal length and putting greater strain on itself and its neighbouring muscles joints and ligaments.