Tennis Elbow

Tennis elbow or lateral epicondylitis is a condition which brings about pain and discomfort on the outer side of the elbow. This is the part of the elbow where the extensor muscles of the forearm originate from humerus (bone) through a common extensor origin. The most commonly involved tendon is Extensor Carpi Radialis Brevis. Usually degeneration is noticed at the attachment of the tendon on the bone.Weakening of the attachment leads to greater stress in the area as there is a compromise on the tendon’s bony anchor point. Sports such as tennis or other activities requiring repetitive gripping, grasping or lifting activities are the usual culprits in the progression of tennis elbow.

Preponderance- It is commonly seen in the age groups of 30-50 and
relatively equal incidence in both gender groups.

Etiology/Causes of Tennis Elbow

Any activity leading to overuse of the extensor tendons of the forearm especially with the palm facing down can predispose an individual to micro tears and inflammation characteristic of Lateral epicondylitis/tennis elbow.
Some of these activities include:


Pain on the outer aspect of the elbow is the most pressing symptom. The bony point of tenderness is over the lateral epicondyle. Pain is aggravated by movements involving gripping, pushing and grasping. Patient may complain of pain limited to the lateral epicondyle but in some cases patients can be seen experiencing radiating pain down to the forearm.


Purpose of these tests is to maximally stretch and provoke the muscles of Extensor Carpi Radialis Longus and extensor carpi Radialis Brevis.


Usually History and Clinical examination are very suggestive but diagnosis can be confirmed by imaging such as Ultrasound or MRI of the elbow.


Conservative approaches include limitation of offending activity like typing or gripping.

Exercise Protocol for Tennis Elbow

Stretching and strengthening of the affected muscle groups forms a very important part of the rehabilitation regime. Exercises broadly include

extensor stretch

Eccentric wrist

extensors strengthening

Isometric wrist
extensor strengthening

Isotonic wrist

extensor strengthening

Treatment at Alleviate

FAQs - Tennis Elbow

What is Tennis Elbow or Lateral Epicondylitis?

Tennis elbow or lateral epicondylitis is a condition in which the outer side of the elbow will have pain and discomfort. The area between the elbow joint and the wrist (forearm) is usually degenerated and overused.

What causes lateral epicondylitis?
  • The major cause of lateral epicondylitis is due to overuse.
  • Any activity that involves stress in the tendon, the extensor muscles of the forearm can cause the disorder.
  • People who are involved in the occupation of the repetitive motions of the wrist and arms.
  • Sports related activities such as tennis, golf, or other activities like repetitive work, lifting, or gardening are usually the victims in the progression of the tennis elbow.
What are the activities that can lead to tennis elbow?

Following are the activities that a person can tennis elbow:

  • Tasks involving constant gripping such as riding a two-wheeler, sports or athletic activities like tennis, carrying or pushing heavy weights.
  • Occupation involving typing and use of tools
  • It can also affect due to trauma resulting in the direct impact to the elbow, which can cause inflammation resulting in degenerating tendon.
At what age can you get tennis elbow?

It is commonly seen in the age groups of 30-50 in both gender groups.

Is lateral epicondylitis worsen the condition?

Lateral epicondylitis gets worsens if not treated. It can lead to serious problems like loss of motion or function of the elbow and forearm. Even it can lessen the grip as the condition worsens.

What are the symptoms of Tennis Elbow/Lateral Epicondylitis?

The symptoms involving tennis elbow or lateral epicondylitis include:

  • Pain on the outer area of the elbow
  • Tenderness in the bony point over the lateral epicondyle
  • Pain can be aggravated by movements
  • Pain is limited to the lateral epicondyle but can radiate to the forearm in some cases.
How does the doctor determines lateral epicondylitis?
Based on the history and the clinical examination the lateral epicondylitis is determined. Doctors confirm after performing X-Ray, and imaging tests such as Ultrasound or MRI of the elbow.
What are the treatments available for lateral epicondylitis?

In most cases, non-surgical therapies yield a high success rate. Treatments involve for tennis elbow/lateral epicondylitis are:

  •  Conservative Treatment
  • Exercise
  • Surgery
What would be the conservative approach for lateral epicondylitis?

Anti-inflammatory Medications are offered to the patient. Tennis elbow splints or braces are used to reduce the strain on the elbow extensors.

Is physical therapy good for lateral epicondylitis?

Patient suffering from tennis elbow can get physical therapy sessions from an experienced physical therapist. It involves:

  • Manual Massage
  • Ice Massage
  • Ultrasound to stimulate healing and soothing effect
Is taping can be used for the tennis elbow?

Yes, taping can be done for the affected elbow in conjunction with other treatment approaches.

Should we have to alter lifestyle modification?

Limitation of offending activity like typing and gripping.

Does exercise helps for tennis elbow?

Yes, it helps. Stretching and strengthening of the affective muscle groups help in the rehabilitation regime. Below are the exercises involving stretching and strengthening:

  • Forearm extensor stretch
  • Eccentric wrist extensors strengthening
  • Isometric wrist extensor strengthening
  • Isotonic wrist extensor strengthening
Can Anti-Inflammatory Injection help recover lateral epicondylitis?

Corticosteroids are injected to help relieve the inflammation and the patient starts the rehabilitation process.

Will Platelet Rich Plasma (PRP) with Prolotherapy be effective for tennis elbow?

Treatment with Ultrasound guided Platelet Rich Plasma with Prolotherapy is an excellent procedure that elevates the healing process of the damaged tendon. Usually, 2 to 3 sittings of PRP with Prolotherapy are required. PRP treatment can be combined with regular exercise.

Does Stem Cell therapy effective for tennis elbow?

Stem cell injection can be tried for some chronic cases by injecting into the damaged tendon.

What are the techniques involved in the surgical process?

Arthroscopic or open surgery can be sued to remove degenerated tendons in chronic, cases not responding to the non-operative means.

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