Knowledge Hub • Conditions • Tennis Elbow
The Complete Guide to Tennis Elbow
Understanding Tennis Elbow: Causes, Symptoms and Treatment
Quick Answer
Tennis elbow, also known as lateral epicondylalgia, is an overuse injury affecting the tendons that attach to the outside of the elbow. It typically causes pain when gripping, lifting or extending the wrist. Most people recover with conservative treatment, including activity modification, strengthening exercises and manual therapy.
Pain on the outside of the elbow can make everyday activities surprisingly difficult. Simple tasks such as lifting a kettle, carrying shopping bags, shaking hands or using a computer mouse may become painful.
One of the most common causes of outer elbow pain is tennis elbow. Despite its name, this condition doesn't only affect tennis players. It can develop in anyone who repeatedly grips, lifts or performs repetitive arm movements.
At Bornman Chiropractic, Dr Jaco Bornman provides comprehensive assessments to determine the cause of elbow pain and develop personalised treatment plans that reduce pain, improve strength and help patients return to work, sport and daily activities.
What Is Tennis Elbow?
Tennis elbow affects the tendons of the forearm muscles that help extend your wrist and fingers. These tendons attach to a bony prominence on the outside of the elbow called the lateral epicondyle.
Repeated loading over time can lead to small changes within the tendon, reducing its ability to tolerate everyday activities. Although the condition was once thought to be primarily inflammatory, current evidence suggests that long-standing cases are usually related to tendon degeneration rather than ongoing inflammation.
Common Symptoms of Tennis Elbow
Symptoms often develop gradually and may include:
- Pain on the outside of the elbow
- Pain when gripping objects
- Discomfort when lifting a kettle or shopping bag
- Pain while turning a door handle or key
- Weak grip strength
- Pain when using tools
- Tenderness over the outer elbow
- Pain during racquet sports or gym exercises
Symptoms are usually felt on the dominant arm but may occur on either side.
What Causes Tennis Elbow?
Tennis elbow develops when the forearm tendons are repeatedly overloaded.
Common contributing factors include:
Repetitive Work
Tradespeople, painters, mechanics, hairdressers and office workers may repeatedly load the forearm muscles during daily tasks.
Racquet Sports
Poor technique, inappropriate equipment or sudden increases in playing time can overload the tendons.
Gym Training
Heavy gripping during pull-ups, deadlifts or other strength exercises may contribute.
Gardening and DIY
Repetitive gripping and twisting movements can increase tendon strain.
Sudden Increases in Activity
Rapid changes in workload or training volume may exceed the tendon's capacity.
Risk Factors
You may be more likely to develop tennis elbow if you:
- Perform repetitive hand or wrist movements
- Work with tools
- Play tennis, padel or squash
- Lift weights regularly
- Spend long hours using a computer mouse
- Are between 35 and 55 years of age
- Have previously experienced tendon injuries
How Is Tennis Elbow Diagnosed?
Diagnosis is usually based on your symptoms and a physical examination.
Your assessment may include:
- Reviewing your medical history
- Identifying aggravating activities
- Assessing elbow movement
- Testing grip strength
- Performing resisted wrist extension tests
- Examining the neck and shoulder where appropriate
Imaging is rarely required unless another condition is suspected.
How Can Chiropractic Care Help?
Treatment focuses on reducing tendon overload while gradually restoring strength and function.
Your personalised management plan may include:
- Manual therapy where appropriate
- Soft tissue techniques
- Progressive strengthening exercises
- Grip training
- Activity modification
- Ergonomic advice
- Return-to-sport guidance
The aim is to improve the tendon's ability to tolerate everyday activities and sporting demands.
Other Treatment Options
Depending on your condition, treatment may also include:
- Physiotherapy
- Home exercise programmes
- Bracing in selected cases
- Pain-relieving medication
- Shockwave therapy where appropriate
- Corticosteroid injections (used selectively)
Surgery is uncommon and generally considered only after prolonged unsuccessful conservative treatment.
Preventing Tennis Elbow
Reducing excessive tendon strain can lower the risk of recurrence.
Helpful strategies include:
- Increase activity gradually
- Strengthen the forearm muscles
- Improve lifting technique
- Use appropriate sporting equipment
- Take regular breaks during repetitive work
- Improve workstation ergonomics
- Warm up before sport
Frequently Asked Questions
No. Most people with tennis elbow have never played tennis. Repetitive gripping activities are a much more common cause.
Not necessarily. Modifying activities while following a structured rehabilitation programme is often more beneficial than complete rest.
Recovery varies between individuals. Many people improve over several weeks to months with appropriate conservative treatment and progressive strengthening.
Early symptoms may involve inflammation, but persistent tennis elbow is generally considered a tendon overload condition rather than a purely inflammatory problem.
Arrange an assessment if elbow pain persists, affects your grip strength or limits your ability to work, exercise or complete everyday tasks.
Key Takeaways
Tennis elbow is a common tendon condition caused by repetitive loading of the forearm muscles. Although it can make everyday activities painful, most people recover well with conservative treatment, gradual strengthening and appropriate activity modification. Identifying the factors contributing to tendon overload is an important part of long-term recovery.
When Should You Book an Assessment?
If elbow pain is making everyday tasks difficult or preventing you from enjoying sport and exercise, a professional assessment can help identify the cause.
At Bornman Chiropractic, Dr Jaco Bornman provides comprehensive musculoskeletal assessments and personalised rehabilitation programmes for patients with elbow pain. By understanding how your elbow, shoulder and neck work together, we can develop an evidence-based management plan to help restore function and support your recovery.