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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. Try the suggestions below;

Easy exercises for tennis elbow

Moderate exercises for tennis elbow

Advanced exercises for tennis elbow

  • Self-refer to a see a physiotherapist if you are still struggling after following the above advice.

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. 

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 

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.