Tennis elbow - a common complaint

Tennis elbow – what is it? Tennis elbow is a term used to describe a condition called lateral epicondylitis. It is specific to the outside of the elbow where the muscles and tendons attach to the bone. Tennis elbow is not exclusive to tennis players, anyone who does repetitive movements with their arms and forearms could get it, however it is estimated between 40-50% of tennis players will experience it sometime during their career.

Symptoms: Pain around the outside of the elbow, pain is worse during gripping tasks. Pain may also be present when the muscles are stretched. Pain when performing the movements that caused the injury e.g., forehand shot with wrist movement. Other elbow movements may be pain free.

What causes it? Tennis elbow results from either sudden or subtle injury to the muscles and tendons around the outside of the elbow, it commonly comes from overuse of the arm, forearm and hand muscles. Repeating the same movements over and over again can cause overuse. If you are a tennis player with tennis elbow, these factors may be contributing to it:

  • Excessive gripping or wringing of the racquet
  • Poor technique / stroke production
  • Weak forearm muscle strength or tight muscles.

Treatment: Tennis elbow treatment is most often successful. The most important part of treatment is tendon rest. A long rest from aggravating activity allows the small tears in the tendon to heal. Depending on how severe your condition is, you may need to rest your tendon for weeks to months. Surgery is a last resort if other treatment isn’t helpful.

Initial home treatment

Treatment for tennis elbow works best when it starts as soon as symptoms appear. If your condition is just starting, rest may be all you need. But in most cases, more treatment is needed to protect and heal the tendon.

You can treat your tennis elbow by:

Reducing the pain with the use of ice or cold packs for 10 to 15 minutes at a time, several times a day. Always put a thin cloth between the ice and your skin. Keep using ice as long as it relieves pain. Or use a warm, moist cloth or take hot baths if they feel good. Do what works for you. Talk to your pharmacist or doctor about pain relief medication.

Stopping or changing activities that may irritate the tendon. Learn new techniques for certain movements, and use different equipment that may reduce the stress on your forearm muscles.


Ongoing treatment

If the pain is severe and ongoing a correct assessment by your doctor or physiotherapist is required to establish the underlying cause and origin of your tennis elbow. An ultrasound scan or MRI are the best tests to identify any tendon tears or inflammation. X-rays are of little diagnostic benefit.

A significant percentage of tennis elbow sufferers may feel pain in the lateral elbow, but not actually be experiencing tennis elbow. There is a high incidence of lateral elbow pain that is referred to your elbow from a cervical spine (neck) injury. 

Once a correct diagnosis is made, professional treatment may include:

  • Rehabilitation (rehab). Physiotherapy treatment can include gentle mobilisation of your neck and elbow joints, electrotherapy, elbow kinesio taping, muscle stretches, neural mobilisations, massage and strengthening. 
  • An exercise program designed to increase flexibility and arm muscle strength and other physical therapy treatments to decrease pain and increase range-of motion.
  • Wearing a special counterforce brace. This strap, worn around your forearm just below the elbow, may spread pressure throughout the arm instead of putting it all on the tendon. With a counterforce brace, you may do some grasping and twisting activities. It won’t help, though, if you continue using a poor technique or the wrong equipment that originally caused your tennis elbow.
  • Working with an expert to see whether you need to change how you do an activity or what equipment you use. A sports trainer can help with sports activities and equipment.

How to avoid it: The best way to prevent tennis elbow is to stretch and strengthen your arm, shoulder and upper back muscles so that they are flexible and strong enough for your activities and to help take stress off of your elbow.

Other ways to prevent tennis elbow include:

Remember to warm-up and perform stretching exercises including the arms, shoulders and wrist before undertaking every tennis activity including practice sessions and social play.

Use the correct techniques and movements during activities. A qualified tennis coach can be helpful to check your grip and your stroke production.

Use a racquet that is appropriate for your ability, body size, and body strength. A too heavy or too light a racquet may be influencing stresses to the arm and shoulder muscles and joints. Also seek professional advice on string tension for your style of game.

Avoid over-repetition of any one type of shot. Practise a range of tennis strokes including ground strokes, serves, return of serves, overhead smashes and volleys.

Not overusing your arm with repeated movements in other daily activities that can injure your tendon. Try alternating hands during these activities, if possible.

If you suspect you have sustained an injury or are suffering prolonged pain in any part of your body please consult with your health care professional as soon as possible. Early treatment is the key to early recovery.

Happy hitting and cheers for now.


References, sources & further information at webmd.com, physioworks.com.au

Sandie Bennett is a qualified sports and remedial massage therapist with over 10 years experience. She is also a qualified personal trainer and sports trainer with 17 years experience. Sandie has previous experience as a sports therapist at events such as the Australian Ironman events; Australian Indoor Cricket; NSW Indoor Sports; and is also the trainer for Australia’s #1 female wheelchair tennis player, Janel Manns.

**The content of this article is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional health care provider.

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