Tennis Elbow

Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse. Not surprisingly, playing tennis or other racquet sports can cause this condition. However, several other sports and activities can also put you at risk. It typically effects people from ages 30-50 but can happen to anyone.

Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.

There are many treatment options for tennis elbow. In most cases, treatment involves a team approach. Primary doctors, physical therapists, and, in some cases, surgeons work together to provide the most effective care.

Anatomy of the Elbow:

Your elbow joint is a joint made up of three bones: your upper arm bone (humerus) and the two bones in your forearm (radius and ulna). There are bony bumps at the bottom of the humerus called epicondyles. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle. Tendons, muscles and ligaments cross and support the elbow joint.
Tennis elbow or lateral epicondylitis, is an overuse injury of the extensor tendon of the forearm. The tendon attaches on the lateral epicondyle. The tendon that is usually involved in tennis elbow is called the Extensor Carpi Radialis Brevis (ECRB).
tennis elbow photo ap

Tennis elbow symptoms typically develop over time. In most cases, the pain begins as mild and slowly worsens over weeks and months. Often a sudden change in activity to the forearm muscles can be a contributing factor to getting symptoms.

Common signs and symptoms of tennis elbow:

  • Pain or burning on the outer part of your elbow
  • Weakened grip
  • The symptoms are often worsened with forearm activity, such as holding a racquet, turning a wrench or door handle, or shaking hands. The dominant arm is often the most affected; however both arms can be affected.

Initial Rehab Advice

1. Reduce Flare Ups:

Try avoiding any activity that aggravates your symptoms. You are able to continue training and work once your pain doesn’t flare above a 4 out of 10 during or after activity. If pain goes above this number that’s when you need to modify activity.

2. Be more body aware:

Often times when people are in pain they stiffen as a natural instinct to protect the area of pain. This constant activation of the forearm muscles leaves them sore and overworked. Having more relaxed arm movements regularly during the day can help reduce tension.

3. Self-Massage and Regular Movement:

Regular self massage to the muscles of the forearm can really help reduce excessive tension on the tendon.
There is no perfect technique, just knead into the forearm muscles with your fingertips and the heel of your hand.
Try 30seconds every 1hour or as often as you can fit time for it in your day.

Mid Stage Rehab Advice

1. When symptoms have calmed down then we can introduce more load into the tendon of the elbow.
2. Start with isometric ball squeezes:
– Hold the squeeze for 10-15second
– Try 2sets twice a day
– Start day on, day off
– The exercise doesn’t have to be pain free once the pain doesn’t go above a 4/10 in the elbow
– Observe the technique as shown in the video
– Monitor symptoms during and after activity
– Avoid flare ups
– The exercises should not make your pain worse

Mid to late stage rehab for tennis elbow ??

The following rehab can be used in the mid to late stages of rehab.

  • Elbow and wrist at 90degrees
  • Use a resistance band
  • Resistance should be applied in the opposite direction to where you are moving the wrist.
  •  Start off with 10-12 reps twice daily
  • Avoid flare ups
  • Gradually start to increase dosage (reps, sets, times per day)
  • Watch the technique as shown in the video
  • These exercises should not be making your symptoms worse
  • A slight ache during the exercises is ok, once pain doesn’t exceed 4/10 during or after


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