Tennis elbow is an overuse condition that develops in the tendon that attaches to the outer part of the elbow.

What causes Tennis Elbow?

Some of the muscles in your forearm that extend or ‘bend back’ your wrist and fingers attach to the bone on the outside of your elbow.

When you continuously use these muscles over a prolonged period, small tears can develop in the tendon. This may occur when repetitive use of the wrist and hand in gripping activities such as backhands whilst playing tennis, or repetitive small movements of the fingers and hand such as typing, knitting or sewing for prolonged periods of time.

Eventually this results in irritation and subsequent pain where the tendon attaches to the bone.

Tendon tears can also develop suddenly without prolonged repetition, such as following a traumatic episode to the tendon. This may occur when hitting a hard back hand during tennis with too much dependence on the forearm or whilst lifting a heavy object.

The bone on the outside of your forearm is known as the lateral epicondyle, therefore tennis elbow is often referred to as lateral epicondylitis.

Signs and Symptoms

The pain that a person feels with tennis elbow can be reproduced when they extend or straighten their elbow or bend back their wrist, especially against some resistance. Commonly lifting an object with the palm facing down will aggravate pain.

Other symptoms associated with tennis elbow

  • Pain radiating from the lateral elbow to the forearm and wrist
  • Weakness of the forearm
  • Morning stiffness of the wrist and elbow
  • Tenderness on palpation of the tendon

If you begin to experience any of the above signs and symptoms, it is important to consult your physiotherapist. Through specialised testing, your physiotherapist will place the tendon under specific stress and assess for any subsequent pain.


Physiotherapy treatment begins with identifying the cause of the problem. Sports players with the condition will have their hitting technique closely assessed, whereas people working in manual handling or repetitive jobs their lifting technique reviewed and ergonomics assessed.

In the early stages, correction of technique may only give minimal relief and therefore total or partial rest from the aggravating activity may be required. Additionally, in the early phases of tennis elbow, inflammation contributes to the pain and therefore ice and ant-inflmmatory mediction may offer some relief.

Your physiotherapist will design a specific forearm stretching and strengthening program to optimally rehabilitate the tendon and thus reduce the risk of re-aggravation of the tendon. Additionally on return to sport or work, a brace or specific tennis elbow strapping may be advised by your physiotherapist to reduce the stress placed on the injured tendon.

In persistent and extremely painful cases of tennis elbow your physiotherapist may advise a cortisone injection, autologous blood injection or surgery.

Be sure to contact your closest Physiohealth clinic for further information and advice regarding the best management for this condition.