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Everything You Need to Know About Tennis Elbow

What is Tennis Elbow?

Tennis elbow is a condition where the tendons on the outside of the elbow become inflamed or irritated, typically due to overuse or repetitive strain. It affects the extensor tendons that attach to the lateral epicondyle, the bony bump on the outer side of your elbow. Despite the name, you don’t have to play tennis to get it. It can happen to anyone who repetitively grips, lifts, or twists with the wrist.

An analogy…

Think of the tendon like a rope anchored to a rock. If you keep tugging on the rope over and over again without enough rest, it starts to fray and strain where it attaches, that’s exactly what happens in tennis elbow.

What are other names that tennis elbow can be called?

Lateral Epicondylitis, Tennis Elbow Syndrome, Extensor Tendinopathy, Extensor Carpi Radialis Brevis Tendinopathy

What causes tennis elbow?

The condition involves irritation or degeneration of the extensor carpi radialis brevis (ECRB) tendon, which helps extend the wrist and stabilise the elbow. Repetitive or forceful movements like gripping, wrist extension, or lifting can overload the tendon where it attaches to the lateral epicondyle, causing microtears, inflammation, and pain.

What are the signs and symptoms of tennis elbow?

  • Pain or tenderness on the outside of the elbow
  • Pain that worsens with gripping, lifting, or twisting
  • Weak grip strength
  • Stiffness in the elbow, especially in the morning or after activity
  • Pain may radiate down the forearm
  • Usually worsens with repeated use of the hand or wrist

What tests are used to diagnose tennis elbow?

Cozen’s Test: The patient makes a fist, extends the wrist, and the practitioner applies resistance while palpating the lateral epicondyle. A positive test is when this causes sharp pain on the outside of the elbow.

Mill’s Test: The practitioner stretches the forearm muscles by extending the elbow, pronating the forearm, and flexing the wrist. A positive test is when this movement produces pain over the lateral epicondyle.

How long does tennis elbow take to heal?

Mild cases may improve in 4 to 6 weeks with rest and treatment. Moderate or chronic cases often take 8 to 12 weeks or more, especially if tendon degeneration is present. If left untreated or poorly managed, tennis elbow can last several months and become a long-term issue.

How does tennis elbow happen?

  • Repetitive wrist and hand movements
  • Poor lifting or gripping technique
  • Tight forearm or shoulder muscles
  • Weakness in the rotator cuff or scapular muscles
  • Sudden increase in activity load without proper conditioning
  • Sports like tennis, golf, rowing, and weightlifting
  • Manual jobs

What treatment can help tennis elbow?

  • Rest from aggravating activities
  • Ice and anti-inflammatory medications for pain relief
  • Manual therapy (massage, joint mobilisation, and dry needling)
  • Tennis elbow strap or brace to reduce load on the tendon
  • Stretching and strengthening exercises for the wrist, forearm, and shoulder
  • Activity modification and ergonomic adjustments

What exercises or stretches can I do for tennis elbow?

  • Wrist extensor stretches
  • Eccentric wrist extension exercises
  • Isometric wrist holds for early tendon loading
  • Grip strengthening with putty or hand grippers
  • Postural and shoulder stability work

What products can help with tennis elbow?

Ball squeeze

Hold a ball in your hand. Squeeze the ball as hard as you can and hold. Allow your wrist to move in whichever direction feels natural.

PROM wrist extensors stretch

Extend your affected arm straight out in front of you with your palm face down, and drop your hand towards the floor. With your other hand, apply a gentle pressure to the back of your wrist and hold. You should feel this stretch down the back of your forearm

Eccentric wrist extension

Start in a seated position with your forearm resting on a table and your palm facing down. Using your other hand, lift your wrist up, keeping your forearm in contact with the table. Remove your other hand and then slowly lower your raised hand back down without support.

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