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Tennis Elbow

Tennis elbow is a tendinopathy of the muscles that extend the wrist, where they attach on the outside of the elbow. The name is misleading: most of the people we treat for it have never played tennis, and got it from a keyboard, a screwdriver or a heavy season of gardening. It is stubborn and can run for many months, but it does respond to loading done properly.

Related reading: the same problem on the inside of the elbow, neck-related arm pain it can be confused with and other causes of hand and grip symptoms.

What causes it

  • Repetitive gripping, twisting or lifting with the palm down
  • A sudden increase in manual work or DIY
  • Keyboard and mouse use over long hours
  • Weakness through the shoulder and upper back, increasing the load at the elbow
  • Racquet or tool technique that loads the wrist extensors heavily

What you might notice

  • Pain on the bony point at the outside of the elbow
  • Pain gripping — a kettle, a door handle, a handshake
  • Weak grip that is limited by pain rather than true weakness
  • Discomfort lifting with the palm facing down
  • Tenderness to press directly on the spot

How we treat it

  • Progressive loading of the tendon, which is the treatment with the best evidence
  • Isometric holds early on for pain relief while loading begins
  • Manual therapy and dry needling alongside the loading, not instead of it
  • Assessing the neck and shoulder, which often contribute and are often missed
  • Grip, tool and workstation changes to reduce the daily provocation
  • A brace or strap for symptom relief during the early phase

This page is general information, not a diagnosis. Symptoms overlap between conditions, so the right treatment depends on an assessment. If your pain followed a significant injury, is getting worse, or comes with numbness, weakness or unexplained weight loss, please see your GP.

Tennis elbow rarely settles by resting it

Six months of avoiding the aggravating activity usually leaves the tendon exactly as weak as it started. Loading it correctly is what changes it.

Book an elbow assessment Ask a question first

Or call us on (08) 7008 7566 — we see patients across Seaton, Modbury and Stepney.

Other arm conditions we treat

Golfer's Elbow Biceps Tendinopathy Elbow Bursitis Cubital Tunnel Syndrome

Back to all arm conditions