Tennis Elbow Explained

Tennis elbow is the common term for a condition known as lateral epicondylitis, which causes pain on the outer side of the elbow. Repetitive overuse of the forearm causes gradual inflammation of the tendons in the elbow joint and the characteristic pain and swelling of tennis elbow. This chronic inflammation eventually leads to elbow pain and weakness, which can make daily activities difficult to perform.

In mild cases, the symptoms can be alleviated with rest and painkillers, but in order to be sure that the injury is completely healed and will not reoccur, medical treatment and rehabilitation exercises are highly recommended. The symptoms of tennis elbow are similar to those of other elbow injuries, so it is important to receive a correct diagnosis and effective treatment at the onset of symptoms.


Symptoms of tennis elbow include tenderness, pain and weakness around the outside of the elbow. There will most likely be weakness in the wrist, and it can be difficult to do simple tasks like washing the dishes or opening the door. Attempting to straighten the joint, extending the fingers, or pressing slightly below the outside of the elbow usually exacerbates the pain.


The condition is often seen in people that repeatedly flex or extend the elbow, as with weight training and gripping heavy objects.

Despite the name, tennis elbow is not commonly found among tennis players unless poor backhand technique is used where the wrist is bent when striking the ball. In this case, force is applied to the tendon in the elbow rather than to the arm. If the grip is too small, this will also place a great force on the tendons.

Sudden onset occurs if there is sudden impact that strains the extensor muscles of the wrist. Late onset occurs within 24-72 hours after an extensive period of unaccustomed wrist extension. Avoiding constant repetitive movements of the elbow joint will prevent tennis elbow from occurring. If this is not feasible, make sure to rest and stretch the elbow as much as possible.


The severity of the injury will determine the length of time it will take to recover. The best plan for recovery is to combine different treatments over a period of time. The pain associated with tennis elbow will improve over time as long as the activities causing the condition are limited, but a broad treatment program will reduce discomfort and help with a full recovery. It is also important to identify stressors that are work or sport related and address those as soon as possible so they do not continue to aggravate the injury.

Rest the elbow to give the tissues a chance to heal. Avoid irritating the injury any further by refraining from activities that strain the joint, such as gripping objects and opening heavy doors.

Apply ice to the elbow six times a day for 15 minutes to reduce inflammation. Ice is especially effective in the initial stages of the injury, and it can be applied after rehabilitation exercises. Painkillers such as aspirin can help ease mild pain, and anti-inflammatories like ibuprofen may help decrease inflammation. A special brace can be worn around the forearm to support the tendon while it heals. The elbow brace applies pressure around the arm to change the direction of forces to reduce strain on the tendon. If the pain does not subside after rest, seek medical attention in order to determine an effective treatment plan.

Stretching and strengthening the elbow will help in the rehabilitation process and should be done once the pain subsides. Stretching exercises should be performed as soon as possible and can continue throughout recovery. Place the arm straight out front with the palm down and gently pull the hand towards you. Rotating the forearm inwards will increase the stretch. Hold this position for 20 seconds and repeat up to 5 times. Strengthening exercises usually start with static exercises where the muscles are contracting without moving the hand or wrist. Begin with the palm and forearm face down and without bending the wrist, attempt to lift the injured arm against the resistance of your other hand. Hold it here for five seconds and then rest. Repeat this motion 10-15 times. Dynamic strengthening should be incorporated next. This involves movement and includes wrist extension exercises with weights or resistant bands. The weight can be increased over time if there is no associated pain.

Prescription medications can be used to reduce inflammation. Massage therapy is another treatment option which includes techniques to treat localized knots in the forearm. Acupuncture is thought to change the way pain signals are transmitted between nerves by inserting needles into specific points on the body. Corticosteroid injections around the tendons are thought to provide short time relief but may wear off after a month. There is also an increased rate of recurring injury with the injection treatment. Surgery is an option if all else fails. Normally surgery will not be considered unless the pain has persisted for over a year.

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