Tennis Elbow

Published: 17 Oct 2022

Tennis Elbow

Guess What?

You don’t have to be a tennis player to develop tennis elbow as ONLY 5% OF PEOPLE WITH TENNIS ELBOW RELATE THE INJURY TO TENNIS.

What is it?

Tennis elbow, also known as lateral epicondylalgia, is an overuse injury to a tendon within the forearm. A tendon is what connects muscle to bone (looks a bit stringy in the picture)

An overuse injury to the extensor tendons in the forearm.

. The forearm extensors all originate on the lateral epicondyle, which is the distal humerus. Tennis elbow stems from performing upper extremity activities that require repeated contractions of the wrist extensor muscles. Repetitive microtrauma causes maladaptations to the tendon structure creating an imbalance between normal breakdown of the tendon and the repair following over-use, resulting in increased pain.

Who usually gets tennis elbow?

  • Heavy lifting manual laborers – e.g. brick laying, gardeners, painters, carpenters, electricians
  • Performing activities over a long period of time – e.g. typing: desk job
  • Recently started activity – not accustomed to load

What are the symptoms to look out for?

  • Difficulty lifting and gripping – pain and/or weakness
  • Increase in load or workload over time
  • Pain present during activity but intensifies after ceasing activity
  • Pain after the provoking activity.
  • Tender on palpation at the origin of forearm extensor muscles

Extending your wriste will reproduce the pain you experience with this condition. This exercise may also be part of your rehab.

How is it treated?

An appointment with a physiotherapist is required in order for an assessment to be performed to determine an accurate diagnosis to help tailor the best treatment to recover. There has been extensive research conducted on tendon rehabilitation and how they should be loaded. In tendon rehabilitation, especially tennis elbow, there is a specific framework to follow for strengthening exercises in order to desensitize and reduce their symptoms but also improve the capacity and strength of the tendon.

There are other numerous treatment methods to assist with tennis elbow rehabilitation, these are as follows:

  • Education around avoiding aggravating movements
  • Education around relative rest
  • Taping/Bracing
  • Shockwave therapy: check out our recent blog post about shockwave therapy
  • Manual therapy
  • Platelet rich plasma injection

Tendon management is an interesting area of research, and our ability to manage these injuries and gradually rehabilitate them has improved dramatically over the last ten years.  The most important this is that you listen carefully and understand that improvement will be gradual, and not linear (two steps forward one step back at times).

If you do require tailored information around tennis elbow or need a physiotherapy assessment, feel free to book in with me or any of our qualified physiotherapists at The Healthy Body Company.


Cook, J., Rio, E., Purdam, C. and Docking, S., 2016. Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research?. British Journal of Sports Medicine, 50(19), pp.1187-1191. doi: 10.1136/bjsports-2015-095422

Lapner, P., Alfonso, A., Hebert-Davies, J., Pollock, J., Marsh, J. and King, G., 2022. Nonoperative treatment of lateral epicondylitis: a systematic review and meta-analysis. JSES International, 6(2), pp.321-330. doi: 10.1016/j.jseint.2021.11.010

Physiopedia. 2022. Lateral Epicondylitis. [online] Available at: <> [Accessed 7 August 2022].

Sims, S., Miller, K., Elfar, J. and Hammert, W., 2014. Non-Surgical Treatment of Lateral Epicondylitis: A Aystematic Review of Randomized Controlled Trials. HAND, 9(4), pp.419-446.
doi: 10.1007/s11552-014-9642-x

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