Tennis elbow, or lateral epicondylitis, is a common condition that causes pain and discomfort in the outer part of the elbow. Despite its name, it isn’t necessarily caused by playing tennis. It can affect anyone who engages in repetitive arm, wrist, or hand movements, such as painters, carpenters, chefs, and office workers. This condition can be debilitating so timely treatment is essential.
What Causes It?
Tennis elbow is an overuse injury. Repetitive movements of the forearm muscles that extend your wrist back towards your forearm can overload the tendons that attach to the lateral epicondyle (the bony prominence on the outer elbow). Repetitive motions such as gripping, twisting, or lifting can cause small tears in the tendons, leading to inflammation and pain. In some cases, poor technique in your lifting or sports can contribute to the problem as well as poor work ergonomics.
Symptoms of Tennis Elbow
Common symptoms of tennis elbow include:
· Pain or burning sensation on the outer part of the elbow
· Weak grip strength
· Discomfort when shaking hands, lifting objects, or making a fist
· Increased pain with wrist or forearm movements
Diagnosis
Diagnosing tennis elbow is usually through a clinical examination where you may be asked to extend back your wrist towards your forearm and pinpoint the location of pain. Some scans like x-ray or MRI can be useful to rule out other problems such as arthritis.
Who is at risk?
Factors that increase the risk of tennis elbow include:
· Age: although tennis elbow can affect all ages, it is most common in adults between 30 and 60.
· Work: people with jobs that involve repetitive motions of the wrist and arm are more at risk such as electricians, plumbers and mechanics etc.
· Sports: playing racquet sports such as tennis and squash can increase your risk. Not having proper equipment or poor form can also increase the risk.
The role of physiotherapy
Physiotherapy plays a crucial role in managing and treating tennis elbow. A physiotherapist designs a tailored rehabilitation program to reduce pain, restore function, and prevent recurrence. Tennis elbow can clear up on its own, however this can take anywhere from 6 months to 2 years, so it is important to see a physiotherapist for treatment to significantly speed up recovery. The key components of physiotherapy for tennis elbow include:
1. Pain Management - tennis elbow can be very painful especially in the early stages so reducing pain and inflammation is a priority. Treatment options include ice, manual therapy, dry needling, and taping or bracing can help reduce swelling and support affected tendons.
2. Stretching and Strengthening Exercises - once pain subsides, a physiotherapist will introduce gentle stretching and strengthening exercises to improve flexibility and muscle endurance. These may include wrist extensor stretches, strengthening the extensor muscles through controlled, slow movements, and grip-strengthening exercises.
3. Manual Therapy and Soft Tissue Techniques - Hands-on therapy such as massage, joint mobilisation, and needling can help release muscle tension, improve blood flow, and promote tendon healing.
4. Ergonomic and Activity Modifications - A physiotherapist will assess your daily activities and sports techniques to identify any movements that may contribute to the condition. This may include adjustments to workstation setup, proper grip techniques or use of ergonomic tools to reduce strain.
5. Gradual Return to Activity - Returning to sports or work should be gradual to prevent re-injury. Physiotherapists guide patients through a structured progression, ensuring they regain strength and endurance safely.
Conclusion
Tennis elbow can be a painful and limiting condition, but with the right physiotherapy approach, full recovery is achievable. Early intervention, proper exercises, and ergonomic modifications play a vital role in preventing recurrence. If you’re experiencing persistent elbow pain, consulting a physiotherapist can help you get back to your normal activities pain-free.
Return to sport testing
Here at our clinic, we have access to state-of-the-art technology that is used worldwide to measure an individual’s precise elbow and forearm strength, power, movement, asymmetry and more. These can help empower the client as well as help our physios make more accurate data-informed decisions regarding return to play.
By
Cathal O’Kane
Senior Physiotherapist
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