Understanding Tennis Elbow: Symptoms, Diagnosis, and Physiotherapy Treatment

April 1, 2025

Understanding Tennis Elbow: Symptoms, Diagnosis, and Physiotherapy Treatment

Tennis elbow, or lateral epicondylitis, is a common condition that affects the outer part of the elbow, causing pain and discomfort. Despite its name, tennis elbow is not exclusive to tennis players – anyone can develop it, particularly those who engage in repetitive arm and wrist motions. In this blog post, we’ll explore the symptoms, diagnosis, and physiotherapy treatments for tennis elbow to help you understand and manage this condition effectively.

…it’s important to give your elbow time to heal…

What is Tennis Elbow?

Tennis elbow occurs when the tendons that attach to the outer side of the elbow (lateral epicondyle) become irritated or inflamed. The condition is often caused by repetitive motions that strain the forearm muscles, leading to microtears in the tendons. Over time, this can result in pain, swelling, and reduced strength in the affected arm.

Symptoms of Tennis Elbow

The symptoms of tennis elbow can vary from mild to severe, depending on the extent of tendon damage. Here are some common signs to watch out for:

Pain on the outer elbow: The most prominent symptom is pain on the outer part of the elbow. This pain can be mild at first but typically worsens with continued activity.
Pain during gripping or lifting: Activities like shaking hands, holding a cup, or lifting objects may trigger pain.
Weakness in the forearm: As the tendons become inflamed, you may notice weakness in your forearm and wrist, making it difficult to perform tasks that require grip strength.
Tenderness around the elbow: The area around the lateral epicondyle may feel tender or sore when pressed. This is a tell-tale sign of tennis elbow.
Pain radiating down the forearm: In some cases, the pain may extend from the elbow down to the forearm or even to the wrist, especially when performing repetitive tasks.

Tennis Elbow Causes and Risk Factors

Tennis elbow is often caused by repetitive motion or overuse of the forearm muscles, leading to wear and tear on the tendons. Some common risk factors include:

Repetitive activities: Occupations or hobbies that require frequent gripping, twisting, or lifting (such as playing tennis, painting, carpentry, or using a computer mouse) can put a strain on the elbow.
Age: Tennis elbow is more common in individuals aged 30 to 50, as the tendons lose some of their elasticity with age.
Improper technique: In sports like tennis, poor form or improper technique can contribute to increased strain on the elbow.

Diagnosis of Tennis Elbow

If you suspect you have a tennis elbow, it’s important to seek professional evaluation. A physiotherapist or healthcare provider will conduct a physical examination, assessing your range of motion, strength, and tenderness around the elbow. Diagnosis is simple and can be confirmed by tests used in current practice.

Physiotherapy Treatment for Tennis Elbow

Physiotherapy plays a crucial role in the management and recovery of tennis elbow. The primary goals of physiotherapy are to reduce pain, improve flexibility, and strengthen the forearm muscles to prevent further injury. Here are some common physiotherapy treatments for tennis elbow:

Rest and Activity Modification

Initially, it’s important to give your elbow time to heal. Resting the affected arm and avoiding activities that exacerbate pain (such as lifting heavy objects or excessive gripping) is key to reducing inflammation.

Ice Therapy

Applying ice to the affected area can help reduce swelling and alleviate pain. Try icing the elbow for 15-20 minutes several times a day, especially after activities that cause discomfort.

Stretching and Strengthening Exercises

A physiotherapist will guide you through specific exercises aimed at stretching and strengthening the muscles and tendons of the forearm. These exercises can help improve flexibility, restore function, and prevent future injuries. Common exercises include:

Eccentric strengthening: This involves controlled lengthening of the muscle, which has been shown to help reduce tendon pain and promote healing.
Wrist extensor stretches: Stretching the wrist extensor muscles can help reduce tension around the elbow and improve mobility.

Manual Therapy

Your physiotherapist may use hands-on techniques like massage or joint mobilizations to improve blood circulation, reduce pain, and promote healing in the elbow joint.

Elbow Straps and Bracing

Your physiotherapist may recommend using a forearm brace or elbow strap. These devices can help offload stress from the tendons and provide support while you heal.

Ultrasound or Laser Therapy

In some cases, modalities like therapeutic ultrasound or laser therapy may be used to stimulate healing and reduce inflammation in the affected tendons.

Shockwave therapy

Shockwave therapy is based on generating a very intense energy in a very short period of time. It creates a mechanical pressure over the affected tissues that leads to an increased cellular permeability, thus increasing the microcirculation and the cellular metabolism. Therefore, the healing process is accelerated. This is a highly effective treatment for tennis elbow.

Activity Modification and Ergonomic Adjustments

Learning how to modify your activities or adjust your posture can help prevent re-injury. For example, if you play a sport like tennis, your physiotherapist may advise you on improving your technique to reduce strain on the elbow.

When to Seek Medical Help

If your symptoms persist despite self-care or physiotherapy treatment, or if the pain is severe, it’s important to consult with a healthcare professional. In rare cases, when conservative treatments fail, further interventions such as corticosteroid injections or even surgery may be necessary.

Conclusion

Tennis elbow can be a frustrating condition, but with the right physiotherapy treatment, most people recover and return to their normal activities. Early intervention, along with proper rest and rehabilitation, is key to managing this condition effectively. If you’re experiencing symptoms of tennis elbow, it’s important to consult a physiotherapist who can create a personalized treatment plan to help you recover and prevent further injury.

Remember, whether you’re an athlete, a worker, or simply someone experiencing elbow pain, physiotherapy offers a comprehensive, non-invasive approach to healing and restoring function to your arm.

Reference:

Lapner P;Alfonso A;Hebert-Davies J;Pollock JW;Marsh J;King GJW; ;, P. and Alfanso, A. (2021) Nonoperative treatment of lateral epicondylitis: A systematic review and meta-analysis, JSES international. Available at: https://pubmed.ncbi.nlm.nih.gov/35252934/ (Accessed: 08 March 2025).

Rogoveanu, O.C. et al. (2018) The effectiveness of shockwave therapy in patients with lateral epicondylitis, Current health sciences journal. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6421473/ (Accessed: 08 March 2025).

For More Help:

For more information and help, please contact Chante at the Paarl Branch.

Chante Hamman

Physiotherapist