Tennis Elbow

peer review

This content has been reviewed and approved by Kathy Doubleday DPT, OCS.

Many people associate tennis elbow, or lateral epicondylitis, with tennis players, anyone can be affected by this condition. While up to 50% of all tennis players develop this condition due to various factors including poor technique and heavy equipment, tennis players only make up about 10% of the patient population that develop this condition. Tennis elbow is relatively common, with between 1% and 3% of people in the United States developing this injury each year, with the dominant hand more commonly affected. The good news is that the majority of people that suffer with tennis elbow experience symptom relief from conservative treatment options and rarely require surgery.

Tennis elbow is most often an overuse injury that commonly happens during activities that involve repetitive gripping and/or extension of the wrist. There is a single tendon that attaches the forearm muscles to the outside of your elbow, at the lateral epicondyle. Repetitive movements of the arm can cause the muscles in your forearm to become fatigued, and this single tendon takes on more of the load. This results in an overloading of the tendon, causing pain and inflammation (tendinitis). If the overloading of the tendon continues, it can lead to a degenerative condition (tendinosis). Tendinitis and tendinosis can further lead to tearing of the tendon. In some cases, tennis elbow can be caused by a sudden elbow or arm injury. In rare cases, the underlying cause of tennis elbow remains unknown; when this occurs, it is known as idiopathic tennis elbow.

Symptoms of tennis elbow tend to develop slowly, and progressively worsen over several weeks to months.

Symptoms may include the following:

  • Pain or a burning sensation of the outer elbow that may radiate to the wrist.
  • Pain when bending or twisting the arm or wrist.
  • Pain or stiffness when extending the arm or wrist.
  • Swelling of the elbow joint.
  • Tenderness of the elbow joint.
  • Decreased grip strength.

Symptoms of tennis elbow may improve with little to no treatment, but recovery can take up to 18 months. Conservative treatment options that can help to control symptoms and promote healing include:

  • Rest – decreasing or stopping physical activities that aggravate symptoms may be necessary for several weeks to allow tendons time to heal.
  • Ice – applying ice to the affected area for 10 to 15 minutes after physical activity can help to decrease pain and inflammation.
  • Non-steroidal anti-inflammatory drugs (NSAIDS) – ibuprofen or naproxen may help to decrease pain and inflammation.
  • Forearm counterforce straps – wearing this can help to decrease tension on the outside of the elbow.
  • Bracing with a cock-up wrist splint – wearing a supportive brace may help to decrease the load on the muscles and tendons allowing them time to heal.
  • Physical therapy – exercises that stretch and strengthen the muscles of the forearm and wrist, combined with other manual techniques can help to decrease pain and improve function of the arm.
  • Steroid injection – injection of corticosteroid into the join can help to decrease pain and inflammation.

Printable Tennis Elbow Exercises (pdf)

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