Tennis Elbow (Lateral Epicondylitis): Causes, Symptoms & Treatment Options

Written By Integrative Physiotherapy & Wellness. Barrie

Tennis Elbow (Lateral Epicondylitis)

Tennis elbow, also known as lateral epicondylitis, is a common overuse injury that affects the tendons on the outside of the elbow. These tendons are responsible for wrist and finger extension, and when they become overloaded, irritation and pain can develop over time.

Despite its name, tennis elbow is not limited to tennis players. It is frequently seen in individuals who perform repetitive gripping, lifting, or wrist-based activities in both work and sport.

What Causes Tennis Elbow?

Tennis elbow develops due to repetitive strain and microtrauma to the forearm extensor tendons, most commonly the extensor carpi radialis brevis (ECRB).

Over time, small tears can develop where the tendon attaches to the outer elbow, leading to pain and reduced function.

Common contributing factors include:

  • Repetitive wrist and hand movements

  • Prolonged computer or mouse use

  • Manual work (construction, painting, cleaning, plumbing)

  • Racquet sports (tennis, pickleball, squash)

  • Sudden increase in activity or training load

  • Poor technique or biomechanics

Symptoms of Tennis Elbow

Symptoms typically develop gradually and may include:

  • Pain or burning on the outside of the elbow

  • Pain that may radiate into the forearm

  • Weak grip strength (difficulty holding objects)

  • Pain with lifting, gripping, or twisting movements

  • Tenderness over the lateral elbow

  • Discomfort with repetitive hand use

In more persistent cases, symptoms may begin to impact daily activities such as carrying groceries, opening jars, or typing.

How is Tennis Elbow Diagnosed?

Tennis elbow is typically diagnosed through a clinical assessment, which includes:

  • Review of symptoms and activity history

  • Physical examination of the elbow and forearm

  • Pain reproduction with resisted wrist extension or gripping

Imaging such as ultrasound or MRI is rarely required unless symptoms are persistent or not responding to treatment.

Treatment for Tennis Elbow

Tennis elbow is most commonly managed with conservative treatment, and early intervention leads to the best outcomes.

Activity Modification

Reducing or modifying aggravating activities is essential to allow the tendon to settle and begin healing.

Physiotherapy

Physiotherapy is a key component of recovery and may include:

  • Manual therapy to improve mobility and reduce tension

  • Progressive strengthening of the forearm muscles

  • Eccentric loading exercises for tendon rehabilitation

  • Postural and movement retraining

  • Return-to-sport or work progression planning

Pain Management Strategies

  • Ice after aggravating activities

  • Temporary use of supportive bracing (if appropriate)

  • Load management education

  • Dry needling or acupuncture

  • Shockwave therapy

  • Ultrasoung

Recovery Timeline

Recovery varies depending on the severity and duration of symptoms. Many individuals begin to notice improvement within 6–12 weeks of consistent treatment.

Chronic or long-standing cases may require a longer rehabilitation period, especially when tendon degeneration is present.

When to Seek Treatment

You should seek assessment if you experience:

  • Ongoing elbow pain lasting more than 1–2 weeks

  • Pain affecting work, sport, or daily activities

  • Weak grip strength or difficulty lifting objects

  • Symptoms that are progressively worsening

Early treatment improves recovery outcomes and reduces the risk of chronic tendon irritation.

Conclusion

Tennis elbow is a common but highly treatable condition when managed appropriately. With a combination of load management, physiotherapy, and progressive strengthening, most individuals recover fully and return to their normal activities without long-term limitations.

At Integrative Physiotherapy & Wellness, we focus on identifying the root cause of tendon overload and creating a structured, individualized rehabilitation plan to restore function and prevent recurrence.

References

Integrative Physiotherapy & Wellness. Barrie
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