What is Tennis Elbow (Lateral Epicondylalgia)? The Symptoms & Treatment Options

Written by Leon Mao
Physiotherapist, University of Melbourne
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on March 17, 2022
Contributed by Jamie Page
Physiotherapist, Salford University

Man playing tennis, clutching at elbow in pain

Tennis elbow is thought to affect between 1-3%[1] of the population in Australia. It usually occurs between the ages of 40 and 50 years.[2]

Despite its name, athletes are not the only people who develop tennis elbow. However, tennis players often develop the condition because it stems from repetitive muscle use. Half of all tennis players will develop tennis elbow in their career.

Read on to understand what you should know about tennis elbow; the risk factors, treatment options and expected recovery time.

What is Tennis Elbow?

Tennis elbow (lateral epicondylitis) is a painful condition when the tendons in your elbow are overloaded, usually from repetitive motions of the wrist and arm. Over time, the tendon can break down if it continues to be exposed to too much load.

What are the symptoms of tennis elbow?

The symptoms of tennis elbow are usually tenderness and pain on the bony part of the outside of your elbow. This bony landmark is where all your tendons connect to the bone. Although the injury is in the elbow, you may experience pain in the upper or lower arm and will likely hurt when you use your hands.

Common symptoms of tennis elbow

  • Elbow pain that gets worse when using your wrist

  • Weak grip

  • Increase in pain when squeezing or lifting an object

  • Intermittent or burning pain at the outer part of the elbow extending to the forearm and wrist

  • Stiffness of the elbow joint

  • Forearm Pain.

What causes tennis elbow?

Tennis elbow is primarily caused by repeated stress on the elbow tendons from repeated use of the elbow muscles, most commonly during sports or the use of certain tools. Tennis elbow sometimes occurs following trauma to the elbow.

You can develop tennis elbow by doing any activities that involve repeated twisting and bending of your wrist for a prolonged period.

Common causes of tennis elbow

  • Playing racket sports or sports which require high activity of your wrist.

  • Prolonged use of computer

  • Using plumbing tools

  • Activities that involve repeated bending of the elbow for an extended period (playing the violin).

Sports that increase the risk of tennis elbow

  • Tennis

  • Badminton

  • Squash

  • Javelin Throw

  • Swimming

How is tennis elbow diagnosed?

There are several different options when it comes to the diagnosis of tennis elbow. One of the more common, and the one that is most referred by Australian GPs, is an assessment from a physiotherapist.

Tennis elbow is a painful injury, but one that physiotherapists come across frequently, and the diagnosis process is relatively straightforward.

Like most pain or injuries that physiotherapists treat, the process of diagnosis starts with a consultation. This is a bit like an interview where you can discuss the history of your injury and any other relevant information with the physiotherapist.

Once the physiotherapist has established the background of your injury, it’s time to move to a hands-on assessment. This part of the session will look at how you move, specific tests related to the elbow and any other particular movements that need to be looked at. This will help the physio determine the type of injury you have and rule out any other conditions.

Following your initial assessment, Your physiotherapist will provide you with a tailored treatment plan based on your condition.

From here, your physiotherapist will outline the details of your treatment program; this will include:

  • Number of treatment sessions

  • List of exercises you need to do at home

  • Strategies to manage the pain and to prevent worsening of the condition

  • Timeline of your full recovery.

How is tennis elbow treated?

Tennis elbow can affect your routine and participation in sports. In fact, tennis elbow is one of the most common upper limb sporting injuries.

There are several options when it comes to treating tennis elbow. One of the more common, and the treatment option that is referred by Australian GPs the most, is physiotherapy.

Tennis elbow is an injury that physiotherapists come across regularly, and the process of treating it is straightforward. Following an initial consultation, the physio will be in the best position to determine your treatment plan.

A combination of manual therapy, modalities, and specific movement exercises will be given to you by your physiotherapist. Physiotherapists are experts in dealing with pain and musculoskeletal conditions.

Depending on the severity of your tennis elbow, a physiotherapist may provide you with a combination of the following types of treatments:

  • Therapeutic Exercises - Exercises to strengthen your muscles and correct impairments that may be causing your injury.

  • Manual Therapy - Hands-on physiotherapy to relieve muscle tension and pain.

  • Stretching Exercises - Stretching exercises to improve range of motion and relieve tension.

  • Dry Needling - Acupuncture-like treatment to reduce muscle tension and spasms.

  • Progressive Resistance Exercises - Used in the later stages of recovery, increasing strength is vital for a long-lasting outcome.

Typical physiotherapy treatment will last anywhere between 30 and 60 minutes. It is not uncommon for patients to feel better in just one session.

Next step - Creating a treatment plan made for you

Following your initial appointment, your physiotherapist will craft a tailored treatment plan that will highlight the course of action required, including what exercises you need to do at home and provide you with a timeline for how long it should take for a full recovery.

Self-care for tennis elbow

When it comes to treating tennis elbow, physiotherapy is the obvious choice for professional help. However, that does not mean there are not things you can do to help accelerate your recovery.

If you think you have tennis elbow, here are the best things you can do and avoid

Things to do

  • Cold Compress

A cold compress will help minimise the swelling and control the inflammation around the site of injury. Apply for 10 to 15 minutes every 2 hours.

  • Rest

Tennis elbow is tricky and can take several weeks to recover. Tone down your activities and avoid things that would put additional stress on your elbow.

  • Optimise your diet

Recovering from a muscle injury requires tons of nutrition to support the healing process. Consider incorporating more protein to your diet to enhance your body’s natural tissue repairing process and muscle building.

Things to avoid

  • Avoid activities that worsen the pain

This might seem obvious but take it easy and consult a physiotherapist as soon as possible. Reduce high load activities for at least a couple of weeks or as stated by your physiotherapist.

Do I need a specialist or even surgery?

It is best to communicate with your physiotherapist to discuss other options and to further assess if symptoms persist after a series of physiotherapy sessions.

MRI’s and X-rays are the most common procedures used to rule out other factors. While most tennis elbow cases do not require diagnostic imaging, additional scan tests may be done to rule out other possible causes of arthritis and bone fracture symptoms.

After a course of well-performed physiotherapy, patients with persistent pain are candidates for clinical re-evaluation and surgery.

A good surgeon will always collaborate with your physiotherapist to develop the best possible solution to your condition and coordinate treatment goals even after the surgery.

What is the recovery time / prognosis for tennis elbow?

Ultimately, recovery time is dependent on your proactiveness to seek professional treatment and the severity of your elbow pain and injury.

Depending on the severity of the injury, it can take anywhere from 6 weeks, up to 6 to 12 months to recover from tennis elbow. Symptoms may persist for years if left untreated. Physiotherapy can help you recover faster and help you manage the symptoms of tennis elbow.

The key to your recovery is being patient and staying consistent with your treatment programs. Your body has its natural way of healing itself, and although it may seem slow, you are still improving gradually every day by complying with your home exercise programs.

Important factors in recovery include:

  • Sticking to your rehabilitation program and regularly exercising

  • Resuming your sports activity gradually

  • Paying attention to your pain, and resting as necessary.

Can tennis elbow be prevented?

These tips can double as things to prevent tennis elbow from occurring as well as helping reduce symptoms if you already have tennis elbow.

  • Exercise: Strengthening your forearm muscles will make your tendons more resistant to stress and tension, thus preventing muscle strains from occurring.

  • Stretch regularly: Stretching will help you maintain the flexibility of your muscles and the normal range of motion of your joints.

  • Avoid prolonged activity: Phase your activities and divide them into segments with rest intervals. Take regular short breaks in between your activities and allow your muscles to recover.

Outlook and the main takeaways

If there is one main takeaway from this article, it is that there are many causes, symptoms and severities of tennis elbow. The most important thing you can do is listen to your body. Pain is just a signal reminding you to take action, so take the first step to living without tennis elbow and book an initial assessment with a local physiotherapist today.

Anatomy of the elbow

Your elbow joint comprises three different bones: the upper arm bone (humerus) and the two bones of your forearm (radius and ulna). At the bottom of the humerus, you will find bony bumps called epicondyles, where tendons and several forearm muscles are attached. The outer part of the epicondyle of the elbow is called the lateral epicondyle.

Tennis elbow or lateral epicondylitis primarily affects the Extensor Carpi Radialis Brevis (ECRB). The ECRB isthe muscle responsible for extending and raising your wrist and it is attached to the tendon on the lateral epicondyle of the elbow.

Written by Leon Mao
Physiotherapist, University of Melbourne
Published on March 17, 2022
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on March 17, 2022
Contributed by Jamie Page
Physiotherapist, Salford University
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Last medically reviewed on March 17, 2022
BookPhysio.com has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our contect is accurance and current by reading our editorial policy.
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