Tennis Elbow Treatment

What Is Tennis Elbow?

Tennis elbow, medically known as lateral epicondylitis, is a condition involving pain and tenderness on the outer part of the elbow, caused by overuse-related changes to the tendons that attach the forearm extensor muscles to the elbow. Despite its name, tennis elbow affects far more people from repetitive work and daily activities than from tennis itself — anyone whose activities involve repeated gripping, wrist extension, or forearm rotation can develop it.

Recent understanding of tennis elbow has shifted from viewing it purely as "inflammation" to recognizing it as a tendinopathy — a condition involving structural changes within the tendon from repetitive overload, which is why modern treatment focuses heavily on progressive loading rather than just rest.

Symptoms & Causes

Common symptoms include:

• Pain and tenderness on the outer (lateral) side of the elbow
• Pain that worsens with gripping, lifting, or twisting movements
• Weakness in grip strength
• Pain that may radiate down the forearm
• Symptoms that build gradually over time rather than appearing suddenly
• Discomfort with simple tasks like shaking hands, lifting a cup, or turning a doorknob

Common underlying causes:

• Repetitive gripping or wrist extension activities — manual work, computer use, racquet sports, or repetitive lifting
• Sudden increase in activity involving the forearm and wrist
• Poor technique in sport or work-related tasks placing excess strain on the tendon
• Age-related tendon changes, most commonly affecting people between 35-55
• Insufficient recovery time between repetitive activities

How We Assess It

Assessment focuses on confirming tennis elbow as the diagnosis and understanding your specific contributing factors:

• Palpation and provocation testing — identifying the specific tender area at the lateral elbow and reproducing symptoms with resisted wrist extension and grip testing
• Grip strength assessment — measuring current strength deficits compared to your unaffected side
• Activity and movement analysis — understanding what specific tasks, sports, or work activities are driving the repetitive strain
• Screening for other causes — ruling out nerve-related or referred pain from the neck that can sometimes mimic tennis elbow symptoms

This helps confirm the diagnosis and identify the specific activities that need to be addressed as part of your recovery and prevention plan.

Our Treatment Approach

Modern tennis elbow treatment centers on progressive tendon loading rather than rest alone:

• Progressive loading exercises — a structured program of eccentric and isometric strengthening exercises, gradually increasing tendon load in a controlled way to promote genuine tendon healing and adaptation
• Manual therapy — soft tissue release and joint mobilization to address associated stiffness and muscle tension in the forearm and elbow
• Activity modification guidance — practical adjustments to work, sport, or daily tasks to reduce excessive strain while remaining as active as possible
• Grip and forearm strengthening — building overall forearm strength and endurance to support long-term tendon health
• Bracing or taping guidance — where appropriate, to help manage symptoms during the early stages of treatment or return to activity

Complete rest is generally not recommended, since some controlled loading is important for genuine tendon recovery — your therapist will guide you on the right balance.

Benefits of Treatment

• Reduces elbow pain and tenderness
• Restores grip strength and forearm function
• Addresses the underlying tendon loading issue, not just symptoms
• Supports safe return to sport, work, or daily activities
• Reduces recurrence through activity modification and ongoing strength maintenance
• Avoids the prolonged, incomplete recovery that can result from rest alone without proper loading

Who Should Consider This / Contraindications

Physiotherapy is highly effective for most cases of tennis elbow, particularly with the modern progressive loading approach. It's approached with medical evaluation first in cases of:

• Suspected fracture or acute traumatic injury to the elbow
• Signs of nerve involvement (numbness, tingling, significant weakness) that may suggest a different underlying cause
• Symptoms not responding to a reasonable course of appropriate treatment, where further investigation may be warranted

Our therapists will confirm tennis elbow as the correct diagnosis before beginning treatment, since several other conditions can present with similar elbow pain.