What is Tennis Elbow and How to Fix It

Award-Winning Tennis Elbow Physiotherapy Near You

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Lateral epicondylitis, or more commonly referred to as tennis elbow, is a common condition that affects many people, not just tennis players. It results from overuse of your forearm muscles and tendons, causing pain and tenderness on the outside of your elbow. It’s a simple condition – but is it simple to fix?

Whether you’re an athlete, construction worker, or an office warrior, the throbbing pain and limited mobility can be a frustrating setback. But thankfully, physiotherapy offers a path to recovery and renewed strength.

In this guide, we’ll delve into what tennis elbow is, its causes, and the symptoms to watch out for. We’ll also explore how physiotherapy can help you recover and prevent future flare-ups, including effective treatments and exercises. Whether you’re an athlete or someone experiencing elbow pain from daily activities, this guide will help you manage and overcome tennis elbow.

Not sure if your tennis elbow is actually golfer’s elbow? Read our Golfer’s Elbow Guide next.

What is Tennis Elbow?

Let’s recap.

Tennis elbow, officially known as lateral epicondylitis, is a condition characterised by pain and tenderness on the outside of your elbow. This occurs when the tendons in your elbow, which connect your forearm muscles to the bone, become overloaded, usually due to repetitive motions. 

What we call tennis elbow is actually a mess of mechanical stressors that wreak havoc on the tendons connecting the muscles in your forearm to the outer elbow. These tendons, specifically the extensor carpi radialis brevis tendon, are put under a lot of stress during repeated wrist and arm movements, leading to microscopic tears and inflammation. Ouch!

Despite the name, you don’t have to play tennis to develop this condition. It affects a wide range of people, especially those aged 35 to 54, according to the NHS. This overuse injury can stem from various activities, such as painting, typing, or using tools, all of which can strain the forearm muscles and tendons. 

Tennis elbow results in inflammation and microscopic tears in the tendons, leading to pain and reduced grip strength. This diagram shows the tendons impacted in this condition and how they connect the extensor muscles in your forearm to the lateral epicondyle in your elbow:

tennis elbow anatomy diagram

The primary culprit behind this condition is overuse or repetitive strain, where your forearm muscles are excessively stressed without any time for rest and recovery. Activities involving gripping, twisting, or lifting can increase the strain on these tendons, gradually weakening them over time.

Additionally, poor technique or accidentally misusing equipment can increase your chances of developing tennis elbow. Incorrect form during sports like tennis or improper ergonomics while performing manual tasks (even if it’s just cleaning the kitchen) can amplify the strain on your tendons, increasing the likelihood of injury.

 

That’s why rest and recovery is a huge part of the physio treatment plan for tennis elbow – more on this below.

 

Tennis Elbow Symptoms 

Tennis elbow doesn’t discriminate; it can affect people across various age groups and professions. However, at One Body we commonly see it affect adults aged between 30 and 50 who engage in repetitive arm movements, either for their work or pastime. Job roles that require gripping, twisting, or lifting, such as painters, plumbers, chefs, and assembly line workers, are particularly susceptible. Additionally, we see a lot of pro athletes who participate in racquet sports, golf, or weightlifting who also experience tennis elbow.

Tennis elbow comes on gradually, so you may initially brush off some of the symptoms. Tennis elbow usually presents with:

     

      • Pain and tenderness on the outer part of the elbow.

      • Difficulty gripping objects or performing simple tasks.

      • Weakness in the affected arm.

      • Stiffness and limited range of motion in the elbow.

      • Pain and stiffness in the morning or after a period of rest.
    •  
      • Keep you awake at night.

    You might also feel some tenderness and swelling around your outer elbow – this is caused by the inflammation of the tendons.

    If your pain is in the inner elbow, you may have golfer’s elbow. If your elbow pain is focused on the joint and doesn’t move to your forearm, you may have arthritis. The best way to find out exactly what ails you is to book an appointment with a physiotherapist – we can assess your symptoms and provide a diagnosis.

    Causes

    Tennis elbow doesn’t just happen to tennis players. At One Body, we see patients from all walks of life present with this condition. Some common activities that can result in tennis elbow include:

        • Repetitive use of hand tools (e.g. screwdrivers and hammers).

        • Playing racquet sports (e.g. tennis, squash and badminton).

        • Painting, especially with repetitive arm movements.

        • Typing or using a computer mouse extensively.

        • Playing certain musical instruments.

        • Frequent lifting or carrying heavy objects.

        • Gardening and other manual labour tasks.

      It’s the repetitive motion of these activities that can lead to tennis elbow. Through repetitive motions, the muscles and tendons are strained and overworked. This leads to microscopic tears in the tendon fibres that usually stabilise your wrist. It’s these tears that cause the pain and inflammation you are feeling.

      Importantly, if left untreated, the tendons can continue to degenerate. This makes it harder for your body to recover naturally and it will weaken your arm significantly. Thankfully, you don’t have to live with the pain or long-term consequences – tennis elbow can be easily treated!

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      Can Physiotherapy Help?

      Yes, it can!

      Physiotherapists can be instrumental in helping patients with elbow conditions, including tennis elbow. In the UK, physiotherapists are licensed with the Health and Care Professions Council (HCPC) and trained medical professionals. This means that we are skilled in diagnosing and treating musculoskeletal issues. 

      We can perform a comprehensive assessment to provide an accurate diagnosis and create a tailored treatment plan, all from the convenience of one of our state-of-the-art physiotherapy clinics in London. This means you don’t need to endure long NHS wait times to get the care you need. 

      We’ll explore the exact treatments we frequently recommend for tennis elbow below. Find out more about how you can use your private health insurance to cover physiotherapy for tennis elbow.

      How Physiotherapy Can Help

      Physiotherapy for tennis elbow treatments always begins with plenty of rest and over-the-counter painkillers like paracetamol or ibuprofen to help with any pain. However, to truly get to the root cause and promote healing, physiotherapy plays a super important role. Physiotherapists specialise in using targeted exercises to help you rebuild strength and restore a full range of motion in your arm. We’ll also help you understand how best to move your arm correctly to avoid future injury and reduce repetitive strain.

      All in all, it’s a quick process. In most cases, a combination of rest and physiotherapy can effectively heal your tennis elbow within two to four weeks. However, if your symptoms persist, your healthcare provider may also recommend steroid injections and other invasive procedures to reduce inflammation and provide additional relief. 

      But before we get to that point, there are some very simple and effective ways physio can help you heal.

      Physiotherapy Treatments for Tennis Elbow

      As physiotherapists, we use a range of modalities to help our patients. Deep tissue massage hits those deep knots just right, strength and coordination training is perfect for neurophysio, and acupuncture is surprisingly good for chronic pain and migraines.

      But for tennis elbow, our main modalities are focused on reducing pain, improving strength, and restoring flexibility. We start with education, teaching you how to:

      • Rest and recover: when to rest your elbow to aid healing.
      • Reduce inflammation: techniques to reduce inflammation effectively and manage your pain.
      • Understand causes: identifying activities or movements that led to the condition.
      • Prevent pain: we’ll talk about how to avoid triggers in the future by adjusting your movements.
      • Use proper technique: understanding your body mechanics and the right technique during activities that involve repetitive arm movements can significantly reduce the strain on your tendons.
      • Remember to warm up: you need to prepare the muscles and tendons for activity and prevent overuse injuries like tennis elbow – even if the activity is just working at your desk.
      • Check your equipment: from tennis rackets to paintbrushes, we can help you choose more ergonomic tools to reduce stress on your elbow.
      • Make lifestyle changes: this may include stress management techniques, talking to your boss about more regular breaks, and even weight management to reduce strain.

        Treatment for tennis elbow begins with patient education – we don’t just jump straight to stretching and exercises!

        It’s very important that you listen to your physiotherapist. You might be eager to start exercising and get back to your normal life, but if you aren’t properly resting your arm and giving it a chance to recover, you could exacerbate the condition.

        Once we have talked about what your physiotherapy will involve, we’ll create a schedule for you to follow at home and book future sessions to come into the physiotherapy clinic. These sessions might involve both massage therapy and targeted exercises.

        But the real heart of physiotherapy treatments for tennis elbow is exercise.

        Physio Exercises

        After your first session with a physiotherapist, where they’ll provide an assessment and diagnosis, we move onto exercises. Part of our role in your recovery is prescribing specific exercises to strengthen the muscles around your elbow and improve flexibility.

        This is incredibly important as it does more than just encourage your elbow to heal – it can actually help prevent future episodes of tennis elbow. 

        The exercises we will guide you through usually target the forearm, wrist, and shoulder muscles along with the elbow to enhance overall arm stability and resilience. We teach you these exercises at our clinic so you can do them independently at home – your regular sessions with your physio will monitor the progress.

        Over time, we will guide you through gradually increasing the intensity, duration, and frequency of the exercises, to build strength while avoiding sudden spikes in tendon stress that can lead to injury.

        Here are three exercises that we often use for our patients with tennis elbow:

        Forearm pronation and supination

        This exercise involves holding a light weight, such as a dumbbell or even just a can of tomatoes from the kitchen. It’s simple to do: with your elbow bent at 90 degrees, rotate your forearm to move your palm from facing down (pronation) to facing up (supination). This helps strengthen the muscles and tendons in the forearm, contributing to improved stability and function of the elbow joint.

        Wrist flexor stretch

        This stretch is super easy to perform – you don’t even need any equipment. To perform this stretch, extend your arm in front of you with your palm facing up. Use your other hand to gently bend your wrist backward, until you feel a stretch in the forearm muscles. Hold the stretch for 15 to 30 seconds and repeat several times throughout the day (or as your physiotherapist recommends) to help reduce tension and improve flexibility in the wrist and forearm.

        Eccentric wrist extension exercise

        This exercise is a classic. Start by sitting comfortably in a chair and rest your forearm on a table, palm down. Hold a light weight, such as a dumbbell or another can from the kitchen, in your hand with your wrist in a neutral position. Slowly lift the weight by extending your wrist upward, moving against gravity. Once your wrist is fully extended, slowly lower the weight back down to the starting position.

        These three exercises are all about slow control, not pushing through exercises as fast as you can. You need to control the descent of the weight or stretch, holding it, and then repeating. Your physiotherapist will let you know how many reps and sets are best for your strength levels and severity of tennis elbow. The aim is to gradually increase the weight or number of reps to strengthen the arm and support the tendons to help your tennis elbow heal.

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        Rest

        We’ve already mentioned stress as a key component of treating tennis elbow, but it’s worth repeating.

        The key to starting down the road to recovery is to rest. This means reducing the load (no more weight lifting) and stopping any repetitive motions. If you decide to keep on using your arm, ignoring the pain and stiffness, you will worsen your symptoms.

        As physiotherapists, we will teach you how to rest properly between sessions. It’s important that you follow this advice or the exercises you are doing will be ineffective. We can also give you advice on icing, taping or using braces to help reduce your pain and provide support at home.

        Massage Therapy

        Massage therapy can effectively manage tennis elbow symptoms by reducing pain, improving flexibility, and enhancing blood flow to the area to stimulate healing. 

        In physiotherapy, we regularly use massage therapy to treat a whole range of musculoskeletal ailments. Regularly massaging an area helps to break down scar tissue and increase circulation, promoting faster recovery. For tennis elbow, we will massage the wrist, forearm and elbow area. It’s always best to get a massage from a professional physiotherapist – don’t attempt to massage any injury on your own!

        In addition, we may recommend anti-inflammatory painkillers and ice or heat packs to help reduce pain and swelling. This combination of therapies provides a good approach to managing and alleviating the discomfort you might feel when you get your tennis elbow diagnosis.

        Once you are on the road to healing, we will explore stretches and exercises.

        Exercises

        Exercises for tennis elbow involve stretching and releasing the muscles in your forearm. This is typically done by flexing the wrist and gradually increasing the load by adding weights.

        Your physiotherapist will take you through the exercises and show you how to perform them. You can then do these at home, following the schedule your physiotherapist gives you.

        Common exercises include:

        • Forearm pronation and supination
        • Wrist flexor stretch
        • Eccentric wrist extension exercises

        Exercise is an effective treatment during the recovery stage. It ensures that your arm retains strength and mobility as your tendons heal. We will also take you through exercises that encourage you to use your arm with proper technique.

        Adapting how you move your arm to avoid placing strain on your elbow will not just help your elbow heal, but also prevent future flare ups and recurrences of tennis elbow.

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        Do you need surgery?

        Surgery for tennis elbow is considered a last resort if the conservative therapies we recommend have been ineffective. Before considering surgery, we might recommend other therapies such as:

        • Shockwave therapy – using sound waves to promote healing,
        • Ultrasound therapy – using sound waves to improve blood flow and reduce inflammation,
        • Dry needling – using thin needles to relieve muscle tension,
        • Corticosteroid shots – injecting steroids to reduce inflammation.

        You have quite a few options to explore. However, if surgery appears to be the best way forward, the procedure you will need is called lateral humeral epicondylectomy. This involves cutting away the damaged tendon to remove any scar tissue and damage, then reattaching the tendon and waiting for your arm to heal. It’s a quick procedure – it can be completed in a half hour – but it will require a trip to your nearest hospital. We can’t perform surgery at the physio clinic!

         

        Physiotherapy Tennis Elbow Treatment at One Body

        In summary, physiotherapy should be the cornerstone of your journey toward overcoming tennis elbow. By combining rest with targeted exercises and expert guidance from a physiotherapist, you can expedite your recovery and prevent future flare-ups. With One Body, accessing top-tier physiotherapy care is super easy, bypassing the lengthy NHS waiting lists too. Our team offers prompt assessments, accurate diagnoses, and tailored treatment plans so you can have total peace of mind throughout your rehabilitation journey.

        Sounds good? Let’s get started.

        Conveniently located across London, One Body’s state-of-the-art clinics have helped thousands in recovering from tendon and overuse injuries. Plus, you have the option to use your private health insurance to cover session costs. 

        Don’t let tennis elbow limit your active lifestyle or career any longer – take the first step toward relief and book your London physiotherapy session with One Body today.

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        Tennis Elbow Treatment FAQs

        To cure your tennis elbow you need to allow the tendons to heal. With the help of a physiotherapist and plenty of rest, it should heal by itself. However, to ensure your tennis elbow doesn’t come back or flare up, you’ll also need to make adjustments to your lifestyle.

         

        On average, it will take several months. 3 to 6 months is totally normal with conservative treatments like physiotherapy. If your elbow has not healed or improved in several months, your physiotherapist or doctor may recommend surgery.

        The best exercise for tennis elbow involves stretching and twisting the wrist to target the wrist extensor muscles that are attached to the damaged tendon in your elbow.

        Absolutely. Physiotherapy is ideal for managing and rehabilitating your tennis elbow. Through targeted exercises, education and manual therapy, our physiotherapists can alleviate your pain, improve the range of motion in your arm, and most importantly, promote healing.

        While various therapies can help, physiotherapy is often the best approach for tennis elbow. Physiotherapists specialise in teaching you the right exercises and techniques to address the root cause of the condition and promote long-term recovery – we aren’t just about quick fixes!

        Several exercises can help you with the symptoms of tennis elbow, but one of the most effective is the eccentric wrist extension exercise. This involves slowly lowering a weight (such as a dumbbell) with the wrist extended, which helps strengthen the muscles and tendons involved in tennis elbow while minimising strain.

        author avatar
        Kurt Johnson CEO
        Kurt is the co-founder of One Body LDN, the founder of the acclaimed London clinic Osteo LDN and a seasoned professional in health and fitness. Kurt has worked as a London Firefighter and strength and conditioning coach and was a top 10 UK-ranked professional K1 kickboxer.