Serving Relief: How Physiotherapy Beats Tennis Elbow
Introduction
Tennis elbow, or lateral epicondylitis, is a common overuse injury that causes pain on the outside of the elbow. Despite its name, it is not limited to tennis players, it affects a wide range of people who perform repetitive arm, wrist, or hand movements. Tennis elbow impacts approximately 1-3% of the adult population and can significantly affect daily activities, work, and recreational hobbies.
Causes and Risk Factors
Common Causes:
Tennis elbow is typically caused by repetitive overuse of the forearm muscles and tendons, particularly those involved in gripping and wrist extension. This overuse can lead to microtears and irritation at the tendon’s attachment point on the outer elbow.
Risk Factors Include:
Repetitive manual tasks (e.g., typing, painting, carpentry)
Sports involving gripping or swinging motions (e.g., tennis, golf, pickle ball, weightlifting)
Poor wrist or shoulder mechanics
Weakness or imbalance in the forearm and upper limb muscles
Improper equipment use (e.g., incorrect racquet or paddle grip size)
Age group: commonly seen in adults aged 30-50
Symptoms
Early Symptoms May Include:
Localized pain on the outside of the elbow
Tenderness when pressing on the bony area of the elbow
Discomfort when lifting or gripping objects
Advanced Stages Can Present With:
Persistent pain even at rest
Decreased grip strength
Difficulty performing everyday tasks like pouring coffee or turning doorknobs
Pain radiating down the forearm
Diagnosis
Tennis elbow is typically diagnosed through clinical assessment by a physiotherapist or healthcare provider.
Common Assessments Include:
History taking: identifying repetitive activities or gripping tasks
Palpation of the elbow and surrounding structures
Resisted wrist extension and middle finger extension tests
Grip strength assessment
Range of motion testing at the wrist, elbow, and shoulder
Imaging (such as ultrasound or MRI) is rarely needed but may be used in chronic or complex cases.
Physiotherapy Approach
Physiotherapy is highly effective in managing tennis elbow, especially when started early.
Physiotherapy Techniques May Include:
Exercise therapy: Gradual, progressive strengthening of the forearm, wrist, and shoulder muscles
Acupuncture / Dry Needling: Helps to reduce pain, promote blood flow, and support the healing of irritated tendons
Eccentric loading exercises: Proven to promote tendon healing
Manual therapy: Soft tissue release and joint mobilization to reduce tension and improve movement
Activity modification: Adjusting movements to reduce strain on the elbow
Bracing or taping: May help offload the affected tendon during activities
Education: Understanding proper ergonomics and biomechanics for prevention
Patient Education and Self-Management
Tips for Managing Tennis Elbow at Home:
Gradually return to gripping and lifting activities
Perform home exercises as prescribed by your physiotherapist to rebuild strength
Use ice packs if pain worsens after activities
Avoid prolonged or repetitive gripping motions when possible
Consider adjusting equipment or workstation setup for better ergonomics
Remember: complete rest is not the solution—progressive loading is essential for recovery
Conclusion
Tennis elbow may seem like a small injury, but if left untreated, it can persist and impact quality of life. Early assessment and physiotherapy can significantly reduce recovery time and prevent chronic discomfort. If you’re experiencing persistent elbow pain, consult a physiotherapist to get a personalized treatment plan and start your path to recovery.
Call to Action
If you’re dealing with elbow pain or grip weakness, contact us at Integrative Physiotherapy and Wellness to schedule your physiotherapy assessment today. We’re here to help you get back to pain-free work, sport, and daily life.
Written By: Stacey Stys
References
Coombes, B. K., Bisset, L., & Vicenzino, B. (2009). Management of lateral elbow tendinopathy: One size does not fit all. Journal of Orthopaedic & Sports Physical Therapy, 39(4), 200–209.
Cullinane, F. L., Boocock, M. G., & Trevelyan, F. C. (2014). Is eccentric exercise an effective treatment for lateral epicondylitis? A systematic review. Clinical Rehabilitation, 28(1), 3–19.
Krogh, T. P., Fredberg, U., Ammitzbøll-Danielsen, M., Christensen, R., Jensen, P., Ellingsen, T., ... & Hróbjartsson, A. (2013). Treatment of lateral epicondylitis with corticosteroid injection, physiotherapy, or combined treatment: A randomized, double-blind, placebo-controlled trial. American Journal of Sports Medicine, 41(3), 625–635.
