Tennis Elbow

What is tennis elbow?

Tennis elbow is a common condition that causes pain on the outside of the elbow. It occurs when the tendon and muscles that extend the wrist and fingers become painful. This happens when the stresses and loads placed on the tendon, through various activities, have been more than than the tendon has been able to cope with.  

What are the symptoms?

  • Pain felt on the outside of the elbow, which can spread into the forearm. Often made worse on gripping or repetitive activities.
  • Stiffness felt around the elbow first thing in the morning or after periods of rest.

What are the causes?

It can be caused by any activity that places an increased demand on the tendon that is beyond what it can cope with (overload).  So any activity that uses the wrist and hand could be the trigger, eg, gardening, DIY projects, typing at a computer, twisting to open handles or jars.

There are several factors that can contribute towards it, including:

  • Sudden increase in a new activity, e.g. DIY project or gardening
  • Repetitive activities that continually overload the tendon.
  • Inactive lifestyle. Muscles and tendons that are not used enough can become deconditioned and much easier to overload.
  • It is more common aged 40-60 and it effects men and women equally.
  • Smoking.
  • Direct trauma to the tendon from a fall.

What can I do to help myself?

  • Stay positive, tennis elbow naturally resolves for 90% of people within a year.
  • Try to reduce or adjust specific activities that aggravate your symptoms.
  • Try lifting and carrying with your palm facing up and a bend in your elbow with the object close to your body.
  • Use Pain killers. It is recommended to try regular paracetamol and Anti Inflammatory gel’s in the first instance. If you are not sure if these are safe for you to use or they are not effective speak to your GP.
  • Some people find placing a support, known as a epiclasp, around the elbow helpful.
  • Start some strengthening exercise.
  • Self-refer to a see a physiotherapist.

What will physiotherapy do?

A physiotherapist with take a thorough history of your symptoms and will conduct a physical examination of the area to confirm the diagnosis.

The main aim of physiotherapy is to restore strength and function to the elbow and surrounding muscles. Treatment will be based on active rehabilitation, focusing on strength and flexibility.

Your physiotherapist will create an individual and progressive exercise programme to address your individual needs. We have included some gentle exercises for you to start trying. 

Acupuncture, electrotherapy and massage have not been shown to be helpful for tennis elbow and therefore not offered.

Current research is suggesting that steroid injections for tennis elbow may cause worse outcomes in the medium to long term, increasing the chances of it returning. It is important to discuss all the options with your GP or Physiotherapist. Due to the current coronavirus pandemic we will not be offering injections until further notice.

Symptoms to check

Click the plus sign to see a list of problems that could be a sign you may need to be checked urgently

Get advice from 111 now if your arm/elbow:

  • hurts when you exercise but the pain goes away when you rest
  • you are experiencing chest pain/tightness with your elbow pain
  • is swollen and you have a very high temperature or feel hot and shivery
  • is extremely painful and difficult to move
  • the pain is severe and started after an injury or accident, like a fall
  • you have pins and needles or numbness that won’t go away
  • has been injured and you heard a snapping noise or your arm has changed shape

111 will tell you what to do. They can tell you the right place to get help if you need to see someone.Go to 111.nhs.uk or call 111

Immediate medical advice is available by contacting NHS 111

Exercises & Resources area

Exercises & Resources

If you have already received a diagnosis from a medical professional you may find some the following links helpful:

Tennis Elbow 

5 star service. An outstanding service by all staff. They have identified my symptoms with great professionalism & empathy. Best health care and results I have ever had.

Excellent, supportive and professional approach. Could not achieve these results on my own! Thank you.

Everyone was so friendly and helpful. Wonderful experience.

Having formerly been a rugby player needed physiotherapy on a number of occasions I have never has as comprehensive a diagnosis and treatment as I have had from Alison Starkey. She was excellent.

Shafeeq Younus was very knowledgeable and courteous. Made me feel so much better mentally. Nothing could be improved.

Very helpful. Exercises really seemed to work for me.

Yohann & Diane are brilliant. Yohann was the only one who realised I had, had a mini stroke, if it hadn't been for him I don't know where I would be today. Diane was brilliant today, she really helped me and calmed me down.

Bart (Klimek) was great, feel like the exercises he gives are helping loads and I'm getting sorted.

Excellent service. Good follow up each time with the care given. All instructions for therapy were very clear.

Within days of attending I was doing exercises, more movement and less pain and everything was explained to me in great detail.

Referral Information

If your elbow pain persists then you can self-refer to see a physiotherapist who can help diagnose your problem and guide you on how best to help recovery.

Refer