Tennis Elbow: Treating, and Preventing Lateral Epicondylitis

Tennis elbow might sound like something only tennis players deal with, but the truth is, this common condition affects people from all walks of life.

Officially known as lateral epicondylitis, tennis elbow is a painful overuse injury that impacts the tendons and muscles of the forearm. It causes discomfort on the outside of the elbow, especially during activities that involve gripping or wrist extension. If you’ve ever felt a sharp twinge in your elbow when lifting something or struggled to hold a cup of coffee without wincing, you might already be familiar with its effects.

The interesting part is that most people who get tennis elbow aren’t athletes at all. It’s a condition that can develop in anyone whose work or hobbies involve repetitive arm and wrist movements. From painters and carpenters to office workers and musicians, tennis elbow doesn’t discriminate. This article dives into everything you need to know about tennis elbow, from its causes and symptoms to the best ways to treat it and prevent it from coming back.

What Is Tennis Elbow?

At its core, tennis elbow is an overuse injury that affects the tendons and muscles responsible for extending your wrist and fingers. The main tendon involved is the extensor carpi radialis brevis (ECRB), which helps stabilize your wrist during tasks like gripping and lifting. When this tendon is subjected to repetitive strain, it develops tiny tears in its fibers. Over time, these microtears can lead to inflammation, pain, and even degeneration of the tendon if the condition becomes chronic.

You don’t need to play tennis to develop tennis elbow. In fact, research shows that fewer than 10% of cases are related to racket sports. Most people who suffer from tennis elbow develop it through repetitive motions at work or in their hobbies. For example, someone who spends hours each day typing on a keyboard or gripping tools may unknowingly place significant stress on their forearm muscles and tendons. Similarly, activities like painting, playing a musical instrument, or gardening can also contribute to this condition.

What makes tennis elbow particularly frustrating is how it sneaks up on you. It’s not the result of a sudden injury, like a fall or collision. Instead, it develops gradually, often starting as a mild ache that gets worse over weeks or months. Left untreated, it can reach the point where even simple tasks become painful and difficult.

Recognizing the Symptoms of Tennis Elbow

The first sign of tennis elbow is usually a dull ache on the outside of the elbow, right around the bony bump known as the lateral epicondyle. As the condition progresses, the pain often radiates down the forearm, making it difficult to perform everyday tasks. Actions like lifting a kettle, turning a doorknob, or even brushing your teeth can trigger sharp, stabbing pain.

One of the hallmark symptoms of tennis elbow is weakness in grip strength. Many people notice they can no longer hold objects as securely as before. This weakness can be especially noticeable during tasks that require a strong grip, like shaking hands or carrying groceries.

Morning stiffness is another common complaint. The elbow and forearm muscles often feel tight and sore when you first wake up, though they may loosen up slightly as the day goes on. In advanced cases, the pain may persist even when the arm is at rest, interfering with sleep and overall quality of life.

The Hidden Role of Trigger Points

One of the lesser-known factors contributing to tennis elbow is the presence of trigger points—those tight, tender knots that develop in overused muscles. These trigger points often form in the extensor carpi radialis brevis and extensor digitorum muscles, which are heavily involved in wrist extension and finger movements.

Trigger points do more than just create localized pain. They can also refer pain to other areas, including the lateral epicondyle itself. This is why some people with tennis elbow feel like their entire arm is involved, even though the issue originates in a specific tendon or muscle. Trigger points can also increase muscle tension, placing additional stress on the affected tendon and delaying the healing process.

Addressing these trigger points is a key part of any effective treatment plan for tennis elbow. Techniques like trigger point therapy, myofascial release, and dry needling can help deactivate these knots, reduce pain, and restore normal muscle function.

Tennis Elbow vs. Other Elbow Conditions

Not all elbow pain is caused by tennis elbow, so it’s important to rule out other conditions that can mimic its symptoms.

Golfer’s elbow, or medial epicondylitis, affects the tendons on the inside of the elbow rather than the outside. It’s caused by repetitive wrist flexion and forearm pronation, which places strain on the wrist flexors. While tennis elbow involves pain during gripping or wrist extension, golfer’s elbow tends to flare up during actions like throwing or swinging a golf club.

Cubital tunnel syndrome is a nerve-related condition caused by compression of the ulnar nerve as it passes through the cubital tunnel on the inner side of the elbow. People with cubital tunnel syndrome often experience numbness or tingling in the ring and pinky fingers, along with occasional weakness in the hand.

Olecranon bursitis involves inflammation of the bursa located at the back of the elbow. Unlike tennis elbow, this condition often presents with visible swelling and is usually caused by trauma or prolonged pressure on the elbow.

If you’re unsure what’s causing your elbow pain, it’s always best to consult a healthcare professional for a proper diagnosis.

How Massage and Manual Therapy Help Tennis Elbow

Massage therapy is one of the most effective ways to manage tennis elbow. By targeting the muscles and connective tissues in the forearm, massage can relieve pain, reduce muscle tension, and promote healing. One of the most powerful techniques for tennis elbow is trigger point therapy, which involves applying pressure to the knots in the extensor muscles to deactivate them and relieve referred pain.

Another helpful technique is myofascial release, which focuses on releasing restrictions in the fascia, the connective tissue that surrounds and supports the muscles. This approach helps improve mobility and reduces tightness in the forearm.

Cross-fiber friction massage is particularly effective for addressing the tendon itself. By applying pressure perpendicular to the tendon fibers, this technique stimulates blood flow, breaks down adhesions, and promotes the healing of damaged tissue.

Manual therapy complements massage by addressing joint restrictions and improving the overall mechanics of the arm. Techniques like joint mobilizations help restore normal movement in the elbow and wrist, reducing compensatory patterns that place extra stress on the affected area.

Rehabilitation Through Physical Therapy and Strengthening

While massage and manual therapy provide relief, long-term recovery depends on restoring strength and flexibility to the affected muscles and tendons. Eccentric strengthening exercises are a cornerstone of physical therapy for tennis elbow. These exercises involve slowly lowering a weight as your wrist extends, which strengthens the tendon and helps it adapt to load.

Stretching exercises are equally important. Gently stretching the wrist extensors can improve flexibility and relieve tension in the forearm. For example, extending your arm with your palm facing down and using your other hand to pull your fingers back toward your body can provide a deep stretch to the extensor muscles.

Once the pain has subsided, transitioning to a strength and conditioning program is essential for preventing recurrence. Building up the muscles in your forearm, shoulder, and core ensures that your arm can handle the demands of daily activities without overloading the tendons. Functional training, which mimics the movements you use in your work or sport, is particularly helpful for preparing your body to return to normal activities.

Preventing Tennis Elbow in the Future

Preventing tennis elbow is all about reducing repetitive strain and maintaining healthy muscle function. If you’re an athlete, improving your technique can go a long way in minimizing stress on your tendons. For example, adjusting your grip or swing can reduce the strain on your forearm during racket sports or golf.

For office workers, ergonomics are key. Positioning your keyboard, mouse, and desk at the right height can prevent overloading your forearm muscles. Tools with ergonomic handles can also make a big difference for people who work with their hands.

Regular stretching and strengthening exercises are your best defense against tennis elbow. By keeping your forearm muscles flexible and strong, you reduce the risk of overuse injuries. And don’t forget the importance of rest—giving your muscles time to recover between repetitive tasks is just as important as the work itself.

Conclusion

Tennis elbow is a common but treatable condition that affects more than just athletes. Whether you’re a musician, an office worker, or a weekend gardener, understanding the causes and treatment options for tennis elbow can help you manage symptoms and get back to doing the things you love.

If you’re a therapist looking to expand your skills, the NAT Trigger Point Therapy Online Diploma course is an excellent resource for learning how to address conditions like tennis elbow effectively. By combining early intervention, targeted therapies, and preventive strategies, most people can achieve a full recovery and prevent the condition from coming back.

Recovery from tennis elbow takes time, but with the right approach, you can rebuild strength, improve mobility, and return to your daily activities pain-free.