How to Tackle Tennis Elbow: Prevention and Treatment Strategies

Whether you play tennis, spend long hours typing on a computer, or work with your hands, understanding and recognizing tennis elbow, its prevention, and treatment can help you alleviate pain and get back to your daily activities pain-free.

Tennis elbow, medically known as lateral epicondylitis, is one of the most common overuse injuries affecting the elbow. Despite its name, only 5% of people with tennis elbow actually play tennis. The condition can affect anyone who performs repetitive arm and wrist movements, making it a significant concern for office workers, tradespeople, and athletes alike.

In this comprehensive guide, we'll explore the common causes of tennis elbow and provide you with practical strategies to prevent and treat this frustrating condition.

Understanding Tennis Elbow

What is Tennis Elbow?

Tennis elbow is a painful condition caused by inflammation and micro-tears in the tendons that attach to the lateral epicondyle (the bony prominence on the outside of the elbow). These tendons, primarily the extensor carpi radialis brevis, are responsible for extending the wrist and fingers.

Anatomy Involved:

Key Structures:

• Lateral epicondyle: Bony attachment point on the outer elbow
• Extensor tendons: Connect forearm muscles to the elbow
• Extensor carpi radialis brevis: Primary tendon affected
• Common extensor origin: Where multiple tendons attach

The Injury Process:

Tennis elbow develops through a process called tendinosis, which involves:

1. Repetitive stress on the extensor tendons
2. Microscopic tears in the tendon fibers
3. Failed healing response leading to degeneration
4. Chronic pain and dysfunction

Common Causes and Risk Factors

Occupational Causes:

Office Workers:

• Prolonged computer use and typing
• Poor ergonomic setup
• Repetitive mouse clicking
• Inadequate wrist support

Manual Workers:

• Repetitive gripping and twisting motions
• Use of vibrating tools
• Heavy lifting with poor technique
• Prolonged overhead work

Sports and Recreation:

• Tennis (backhand technique issues)
• Golf (grip problems)
• Rock climbing
• Weightlifting with poor form

Risk Factors:

Demographic Factors:

• Age: Most common between 30-50 years
• Gender: Slightly more common in women
• Occupation: Jobs requiring repetitive arm movements
• Previous injuries: History of elbow or arm problems

Biomechanical Factors:

• Poor technique in sports or work activities
• Muscle imbalances in the forearm
• Weakness in shoulder and core muscles
• Limited flexibility in forearm muscles

Equipment Factors:

• Improper tennis racket size or string tension
• Poor workplace ergonomics
• Worn or inappropriate tools
• Lack of proper protective equipment

Recognizing the Symptoms

Primary Symptoms:

Pain Characteristics:

• Pain on the outside of the elbow
• Gradual onset (usually develops over weeks or months)
• Pain worsens with gripping activities
• Aching or burning sensation

Functional Limitations:

• Difficulty lifting objects
• Pain when shaking hands
• Weakness in grip strength
• Stiffness in the elbow, especially in the morning

Specific Pain Triggers:

• Gripping activities: Holding a coffee cup, opening jars
• Wrist extension: Lifting with palm down
• Resistive movements: Turning doorknobs, using tools
• Prolonged activities: Extended computer use, playing tennis

Progressive Stages:

Stage 1: Pain only after activity Stage 2: Pain during and after activity Stage 3: Pain with daily activities Stage 4: Constant pain, even at rest

Professional Diagnosis

Clinical Assessment:

At M.O. Therapy, our comprehensive evaluation includes:

Physical Examination:

• Palpation of the lateral epicondyle
• Range of motion testing
• Strength assessment
• Neurological screening

Specific Tests:

• Cozen's test: Resisted wrist extension
• Mill's test: Passive wrist flexion with elbow extension
• Middle finger test: Resisted middle finger extension
• Grip strength measurement

Functional Assessment:

• Work-related movement analysis
• Sports technique evaluation
• Ergonomic assessment
• Daily activity limitations

Differential Diagnosis:

It's important to rule out other conditions that can mimic tennis elbow:

• Radial tunnel syndrome
• Posterior interosseous nerve entrapment
• Cervical radiculopathy
• Arthritis of the elbow joint

Treatment Strategies

Phase 1: Acute Management (0-2 weeks)

Goals:

• Reduce pain and inflammation
• Protect healing tissues
• Maintain function where possible

Conservative Treatment:

Rest and Activity Modification:

• Avoid aggravating activities
• Modify grip techniques
• Use proper ergonomics
• Take frequent breaks

Pain Management:

• Ice therapy: 15-20 minutes, 3-4 times daily
• Anti-inflammatory medications (as directed)
• Gentle massage
• Protective splinting if needed

Phase 2: Early Rehabilitation (2-6 weeks)

Goals:

• Restore pain-free movement
• Begin gentle strengthening
• Address contributing factors

Manual Therapy:

• Soft tissue mobilization
• Joint mobilization
• Trigger point therapy
• Cross-friction massage

Gentle Exercises:

• Pain-free range of motion
• Gentle stretching
• Isometric strengthening
• Nerve mobilization techniques

Phase 3: Progressive Strengthening (6-12 weeks)

Goals:

• Build tendon strength and endurance
• Improve functional capacity
• Prevent re-injury

Eccentric Strengthening: Research shows eccentric exercises are particularly effective for tennis elbow:

• Wrist extensor eccentric exercises
• Gradually increasing resistance
• Pain-guided progression
• Daily exercise routine

Comprehensive Strengthening:

• Forearm muscle strengthening
• Shoulder and scapular stabilization
• Core strengthening
• Grip strength training

Phase 4: Return to Activity (12+ weeks)

Goals:

• Safely return to full activities
• Maintain improvements
• Prevent recurrence

Progressive Loading:

• Gradual return to aggravating activities
• Technique modification
• Equipment adjustments
• Ongoing maintenance exercises

Specific Treatment Techniques

Physiotherapy Interventions:

Manual Therapy:

• Deep tissue massage: Reduces muscle tension and improves circulation
• Joint mobilization: Restores normal elbow mechanics
• Dry needling: Targets trigger points and promotes healing
• Ultrasound therapy: May help with tissue healing

Exercise Therapy:

• Eccentric strengthening: Gold standard for tendon rehabilitation
• Progressive loading: Gradually increases tendon capacity
• Functional training: Prepares for return to activities
• Movement retraining: Corrects faulty patterns

Advanced Treatments:

Shockwave Therapy:

• Promotes tissue healing
• Breaks down scar tissue
• Stimulates blood flow
• Particularly effective for chronic cases

Injection Therapies:

• Corticosteroid injections (short-term relief)
• Platelet-rich plasma (PRP)
• Prolotherapy
• Botox injections (in select cases)

Surgical Options: Reserved for severe cases that don't respond to conservative treatment:

• Arthroscopic debridement
• Open surgical release
• Tendon repair or reconstruction

Prevention Strategies

Workplace Ergonomics:

Computer Setup:

• Monitor at eye level
• Keyboard and mouse at elbow height
• Wrist rests for support
• Frequent position changes

Tool Use:

• Choose tools with larger, cushioned grips
• Use power tools when possible
• Alternate hands during repetitive tasks
• Take regular breaks

Sports and Recreation:

Tennis-Specific Prevention:

• Proper racket size and string tension
• Two-handed backhand technique
• Professional coaching for technique
• Adequate warm-up and cool-down

General Sports Guidelines:

• Gradual progression in training
• Proper equipment selection
• Regular technique assessment
• Cross-training for muscle balance

Exercise and Conditioning:

Preventive Exercises:

• Regular forearm stretching
• Eccentric strengthening exercises
• Shoulder and core stability training
• Overall fitness maintenance

Daily Routine:

• Morning stretching routine
• Workplace exercise breaks
• Post-activity stretching
• Regular massage or self-massage

The M.O. Therapy Approach

Comprehensive Assessment:

We don't just treat the elbow – we evaluate the entire kinetic chain:

• Neck and shoulder function
• Wrist and hand mechanics
• Core stability and posture
• Work and sport demands

Integrated Treatment:

Physiotherapy:

• Evidence-based manual therapy
• Progressive exercise programs
• Movement re-education
• Ergonomic assessment

Massage Therapy:

• Soft tissue mobilization
• Trigger point therapy
• Stress reduction
• Enhanced recovery

Chiropractic Care:

• Spinal and peripheral joint assessment
• Joint mobilization
• Soft tissue techniques
• Lifestyle modifications

Education and Prevention:

• Proper technique training
• Ergonomic modifications
• Home exercise programs
• Long-term management strategies

Recovery Timeline and Expectations

Typical Timeline:

Acute cases: 6-12 weeks with proper treatment Chronic cases: 3-6 months with comprehensive rehabilitation Severe cases: 6-12 months, may require advanced interventions

Factors Affecting Recovery:

• Duration of symptoms before treatment
• Severity of tendon damage
• Compliance with treatment program
• Ability to modify aggravating activities
• Overall health and fitness level

Signs of Successful Recovery:

• Gradual reduction in pain
• Improved grip strength
• Return to normal activities
• Absence of morning stiffness
• Ability to perform work tasks without pain

When to Seek Professional Help

Early Warning Signs:

• Persistent elbow pain lasting more than a few days
• Pain that worsens with activity
• Weakness in grip strength
• Stiffness in the elbow
• Difficulty performing daily tasks

Red Flags Requiring Immediate Attention:

• Severe pain following an injury
• Complete loss of elbow function
• Numbness or tingling in the arm or hand
• Signs of infection (fever, redness, warmth)
• Pain that doesn't improve with rest

Living with Tennis Elbow

Activity Modifications:

At Work:

• Use ergonomic equipment
• Take frequent breaks
• Modify gripping techniques
• Consider job task rotation

At Home:

• Use two hands for heavy lifting
• Choose tools with better grips
• Avoid repetitive activities when possible
• Apply ice after aggravating activities

Long-term Management:

• Maintain a regular exercise routine
• Continue preventive strategies
• Monitor for early signs of recurrence
• Regular check-ups with healthcare providers

Success Stories

Many of our patients at M.O. Therapy have successfully overcome tennis elbow and returned to their favorite activities. The key factors in their success include:

1. Early intervention
2. Consistent adherence to treatment programs
3. Proper modification of aggravating activities
4. Addressing underlying biomechanical issues
5. Ongoing preventive measures

Take Action Today

Tennis elbow doesn't have to be a permanent limitation. With proper understanding, treatment, and prevention strategies, you can overcome this condition and return to pain-free function.

Ready to tackle your tennis elbow? Book a comprehensive assessment with our expert team at M.O. Therapy. We'll identify the root cause of your problem and develop a personalized treatment plan that gets you back to doing what you love.

Don't let tennis elbow control your life. Whether you're dealing with early symptoms or chronic pain, our multidisciplinary team has the expertise to help you achieve lasting relief and prevent future occurrences.

Take the first step toward recovery today – your pain-free future is waiting.