Tennis Elbow

Tennis elbow, medically known as lateral epicondylitis, is a common condition that involves pain and inflammation in the tendons that join the forearm muscles to the outside of the elbow. Despite its name, it’s not exclusive to tennis players and can affect anyone who repeatedly uses their wrists or forearms in a way that puts stress on the tendons.

Tennis elbow (lateral epicondylitis) is primarily associated with overuse and strain of the tendons in the forearm, but it can be related to or occur in conjunction with other conditions:Golfer’s Elbow (Medial Epicondylalgia: Similar to tennis elbow but affects the tendons on the inside of the elbow.

  • Carpal Tunnel Syndrome: Repetitive hand and wrist movements can contribute to both tennis elbow and carpal tunnel syndrome.
  • Cubital Tunnel Syndrome: Compression or irritation of the ulnar nerve, near the elbow, can be related to similar repetitive movements.
  • Radial Tunnel Syndrome: Compression of the radial nerve near the elbow, which may be confused with tennis elbow due to similar symptoms.
  • Inflammatory conditions: Arthritis including osteoarthritis and rheumatoid arthritis can affect all joints including the the elbow and can increase the risk of developing tendon related issues such as tennis elbow or generate symptoms which feel like tennis elbow.
  • Bursitis: Inflammation of the bursa in the elbow may occur with or resemble tennis elbow.
  • Shoulder Injuries: Problems in the shoulder can sometimes lead to issues in the elbow, including tennis elbow, due to compensatory movements or imbalances in the muscles.
  • Neck injuries: Problems in the lower neck or upper back involving nerves can sometimes generate symptoms in the arm and around the elbow which can masquerade as tennis elbow due to the location of the symptoms.

The symptoms of tennis elbow, or lateral epicondylitis, primarily include:

  • Pain and Tenderness: Often felt on the outside of the elbow, the pain might also radiate down the forearm.
  • Stiffness: The elbow might feel stiff, especially in the morning or after periods of inactivity.
  • Weakness: There may be a noticeable weakness in the forearm, affecting the ability to grip objects.
  • Worsening with Activity: Pain and other symptoms often become more pronounced with activities that involve gripping, lifting, or repetitive use of the forearm and wrist, such as turning a DIY, shaking hands, or lifting a heavy object.

Tennis elbow, or lateral epicondylitis, is caused by overuse and strain of the tendons that join the forearm muscles to the lateral epicondyle, or the outer part of the elbow. Here’s what contributes to this condition:

  • Sudden Increase in Activity Level: Jumping into an activity without proper conditioning or a sudden increase in intensity can cause strain on the tendons.
  • Activities Requiring Gripping and Twisting: Playing tennis, particularly with poor technique, or engaging in other sports and occupations that require constant gripping, lifting, or twisting, such as using tools, painting, and carpentry.
  • Repetitive Motions: Continual strain from repetitive hand, wrist, or forearm movements can cause small tears in the tendons, leading to inflammation and pain.
  • Previous Injury to the Area: A history of injury or strain to the elbow or forearm can make the tendons more susceptible to tennis elbow.
  • Improper Equipment or Technique: In sports like tennis, using the wrong racket, incorrect grip size, or poor technique can contribute to tennis elbow.
  • Age: It’s more common in adults between 30 to 50 years old, possibly due to reduced tendon elasticity as people age.

The best treatment for tennis elbow (lateral epicondylitis) typically involves a combination of rest, physiotherapy to strengthen the muscles, over-the-counter pain relievers to manage discomfort.

In more persistent cases, corticosteroid injections may be considered, and the approach should be individualised with the guidance of a physiotherapist or injection-qualified healthcare professional.

For tennis elbow, you should initially consult with a physiotherapist, who will assess and create a rehabilitation program to improve your symptoms and get you back to the things you enjoy doing. 

Specific exercises guided by a physiotherapist are beneficial for tennis elbow, as they can help strengthen the muscles and tendons in the forearm, promote healing, and alleviate symptoms.

Surgery for tennis elbow is typically considered a last resort, used only when conservative treatments fail, and it can be effective in chronic or severe cases; however, it carries risks and requires careful consideration with an orthopaedic specialist.

Chews Health top tip for tennis elbow

The top tip for managing tennis elbow is to engage in a targeted physiotherapy rehabilitation program coupled with relative rest and avoiding activities that exacerbate the condition, to strengthen the forearm muscles and tendons.

Tennis elbow can be very slow and stubborn to rehabilitate as the affected tissues don’t have a great blood supply and therefore take longer to respond to treatment.  In some cases this can be 6-12 months before pain is fully resolved.  However, the treatment process of focal strengthening and conditioning of the elbow is a worth-while process, as it’ll help reduce the risk of future episodes of pain an improve your preparedness for it if it occurs again.

Our Specialists

Melanie Clarke
Melanie Clarke
We’ll be forever grateful to Chews, the guys are the absolute BEST IN CLASS when it comes to a fully tailored recovery plan. Our son is a young elite competitive acrobatic gymnast who sadly had a high impact fall at gymnastics dislocating and fracturing his elbow and needed surgery, for a gymnast that trains many hours over 4 days week it was devastating blow, especially with GB competitions coming up. Once out of cast (wk 4 post opp) we started 2 x weekly physio sessions with Richard Saxton (who specialises in child’s physio), he was thorough, diligent and his amazing assessments fully supported the coaches at our sons gym to help build a safe recovery plan. The sessions with Richard and Sanford were fun, engaging and they took great care to help improve full mobility and strength. At week 7 post op our son was doing skills we thought would have taken 4mths to achieve, by week 10 he was back to full impact training, even our hospital follow up with the senior elbow consultant was blown away by the physio support we’d had and the rapid recovery. If it wasn’t for Chews we 100% would not be back training this quickly and not have had the reassurances it was safe to do so…..we’ve definitely found a physio for life. Thank you from the bottom of our hearts Team Chews. From Mel & JJ x x
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Have waited a few months post-treatment to write a review - just to be certain! Quite simply, I can't recommend these guys highly enough. I went to them with two badly damaged knees (miniscus tears). Having had three arthroscopes over the years, I was completely resigned to needing surgical intervention again. The Chews team had different ideas. After showing me the latest research findings, they assured me my knees could be rehabilitated without a scalpel. I had just a handful of sessions with them and am delighted to report that, six months on, my knees are great! I'm running 5k twice a week (don't laugh, I loathe running and am no spring chicken) without any pain and have taken up tennis. Everyone at Chews is passionate about their subject, knowledgeable, reassuring and friendly. I wouldn't go anywhere else.
Dave Stuart
Dave Stuart
I have had a chronic back condition to varying degrees for many years which more recently has forced me to have weeks off work at a time. I was recommended Chews Health by a colleague having tried other physios in the past. However, I always felt that something was missing from the plan. My back muscles would on occasion go into spasm, or my disk to impinge on my nerve, affecting my mobility and effectively setting me back to square one. I came to Chews health a bit wary and was considering surgery due to how much my back was affecting my quality of life and mental health. It has not been a straight forward recovery, but i have made significant progress through having a thorough history taken, my ongoing concerns listened to, and being provided with a clear explanation of not only the exercise plan but additionally explaining why my body was responding in varying ways. This has educated about my condition and provided me with the tools to self manage my condition more effectively should it deteriorate again.. It has not been plain sailing, but I have absolute faith in Jack and his team.
I had to attend Chews Health for help with pain in my elbow and they have been a fantastic help. I am now back to 100%.
The S
The S
I can thoroughly recommend Chews Health physio. Sessions from diagnosis to rehabilitation are stimulating as well as therapeutic. Jack’s holistic, insightful approach goes beyond fixing the initial problem - he builds the confidence and self-knowledge to help maintain fitness and avoid strains and niggling injuries in the future. His message that the body needs exposure to regular challenges has inspired my journey towards optimum health.
Sam Butler
Sam Butler
Excellent physiotherapy. After ACL and meniscus surgery I contacted Chews Health to find out about how they could help me feel more confident about returning to more intense sport after my injury. I felt listened to and we worked on a series of different of exercises that tested my knee. Very helpful and I now feel much more confident in my abilities.
feralie Bennett
feralie Bennett
I saw Richard Saxton for a chronic pain in my achillies. 2 visits, with massage and exercises: clear concise instruction, both written and verbal to do at home were realistic & adapted for my ability - I now no longer require pain relief & can walk the dogs pain free & even manage a few hills. A follow up call to review my progress was also appreciated. The clinic was clean & well equipped. Would highly recommend.
Philip Conroy
Philip Conroy
When I had severe back pain I was seen within 24 hours. The problem was resolved after 3 weeks of physiotherapy and exercises. I subsequently took up the annual gym membership package which includes regular reviews by the Physiotherapists. I feel this has benefitted me greatly as I had no previous experience of gyms and ensured I was using the equipment in the correct manner. At all times the staff have been very friendly and professional.
Maureen Morris
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Cecilia Wright
Cecilia Wright
I had been suffering from plantar fasciitis for some months and went Chews Health in the summer for shockwave treatment, after my podiatrist said she had heard good reports about it. Until then I had been resting, exercising it, icing it, using insoles etc., none of which had made much difference. I booked six treatments at the start (recommended) and by the time of the last treatment It was hardly noticeable, so much better! I’ve had two further treatments over the last month, just to be on the safe side, and I’m doing some exercises now to build up the strength in my calf and foot. Chews Health comes with heartfelt recommendations from me, they are friendly, very knowledgeable and best of all - they have fixed my sore foot!