Tennis Elbow: What Causes It, Symptoms and Treatment

Tennis Elbow, also referred to as lateral epicondylitis, is an injury that occurs when tendons in the elbow are overused. The tendon is the part of the body that connects muscle to bone and structures. Tennis elbow affects the area where the tendons and muscles of the forearm attach to the outside of the elbow. While the injury is common among tennis players, people who engage in other types of sports and physical activities are also at risk of the condition. If your job involves the use of repetitive hand motions and arm movements, then you are also at risk of tennis elbow. Plumbers, carpenters, painters, and plasterers are among the professionals who are potentially at risk of this injury due to the nature of their jobs.

Symptoms of Tennis Elbow

The signs and symptoms of this condition typically develop gradually. Most individuals with tennis elbow will experience mild pain that can worsen as the injury gradually progresses over the course of a few weeks or months. Extreme tenderness can be felt on the outer side of the elbow, and this can radiate to areas near the elbow when you straighten the wrist against resistance, or when you try to bend your hand back while straightening the elbow. Other signs of tennis elbow include:

  • Weakness in the arms, which reduces grip strength
  • Slow gradual pain within the elbow and nearby areas
  • Soreness of the muscles in the forearm


Tennis elbow is typically diagnosed by your trusted physio who will perform a physical examination, which will evaluate a number of factors in making a diagnosis, including occupational risk factors, sports activities you actively participate in, and how your symptoms developed. During the consultation, be sure to tell your physio where on your arm you feel the most pain, and what activities worsen the symptoms.

Your physio will also assess your current range of motion by asking you to straighten your fingers and your wrist while keeping your arm straight.

Tennis Elbow - What Causes It, Symptoms and Treatment DiagnosisTreatment Through Physiotherapy

The good news about tennis elbow is that physiotherapy is the number one management tool you can undergo to help in the short- and long-term management of the injury. To determine which physiotherapy techniques are best applied to relieve your symptoms, your physiotherapist will assess your lifestyle and your symptoms.

Initial management of tennis elbow through physiotherapy may include the following methods:

Joint Mobilisation

This method can normalise joint function. Your physiotherapist will place you in a position of comfort to allow you to relax before he or she applies necessary force to the entire forearm to mobilise the joints of your elbow. Some of the benefits derived from this method are decreased muscle tension, reduced pain and improved joint mobility.

Soft Tissue Therapy

This method is used in physiotherapy because it is effective in breaking down muscle tension and reducing inflammation of the joints. Your trusted physiotherapist may use a variety of soft tissue techniques that differ in pressure and depth to target your ligaments, muscles and tendons.

Dry Needling

When used as a treatment for tennis elbow, dry needling can relieve pain and help improve muscle activation. This method involves inserting an acupuncture needle into a trigger point in the muscle to assist in managing pain from tennis elbow, helping you to recover from the injury. Trigger points are sensitive spots that can cause pain, which may radiate from one part of the body to different areas nearby. Pain felt at the back of the shoulder, for example, can refer pain to the wrist or the arm.

Tennis Elbow - What Causes It, Symptoms and Treatment Through PhysiotherapyRisk Factors

The repetitive motion of using your muscles during sports or work-related activities can result in aggravation of your tendons, which can in turn lead to pain and discomfort in the affected area. Here are some of the risk factors for this injury:


The development of the condition typically relates to the way athletes twist their muscles, and the way workers carry out their duties of reaching for objects, twisting their arms, and gripping tools. The risk of developing the injury is heightened when you carry out activities with excessive force and in awkward positions. When small tears develop in the tendons as a result of constant repetition of certain activities, it is best to allow the body to recover rather than continue doing tasks with extreme force.

Poor lifting technique

Doing repetitive movements with poor technique, lifting too heavy or progressing too fast can all placing excessive pressure on specific muscles and joints causing tennis elbow.

Not warming up before exercise

Carrying out warm up sets prior to lifting can prepare the muscles for the stress you will soon be putting it under.  Without warm-up exercises, muscle pulls and tear can occur, as the muscles are not prepared for the added load you are putting them through.

While the above factors may increase your risk of developing this injury, many individuals develop it for unknown reasons.

During your first sessions with your physiotherapist you will notice a reduction in pain, although repairing a tear inside the muscle could require additional time due to various factors such as length of the injury and severity of the tear.

If you are unsure which methods are best to manage your symptoms and require help with your rehabilitation, speak with our trusted team at Trained Physio and Fitness, and we will design a treatment plan specifically for your unique functional needs.