Tennis Elbow Information, Answers and Self-help Strategies
What is Tennis Elbow?
Tennis elbow is a condition that affects the tendons on the outside of the elbow with pain over the bone usually felt. In this condition, the tendons involved are usually overloaded through an increase in activities that involve repetitive twisting or gripping (eg painting and decorating, playing racquet sports, typing on the keyboard).
Tennis elbow affects men and women equally between 35 and 55 years. However, developing symptoms of this condition outside of this age bracket is not uncommon.
What are the symptoms?
Gradual onset of outer elbow pain
Pain experienced during stretching the wrist downwards or actively bending the wrist backwards
Elbow pain during gripping
Worse in the morning and moving the elbow after periods of inactivity
Bending and straightening your elbow may also cause pain
What to look out and speak to a healthcare professional for?
Sudden onset of pain and weakness with a heavy or forceful activity
Elbow pain following a fall on your hands
Feeling of elbow instability
Tingling or numbness around your forearm/hand
Progressive worsening of outer elbow pain and swelling
What are the treatment options?
Natural resolution: Around 90% of people will improve without any treatment within a year.
Relative rest: Reducing the time spent doing repetitive elbow / hand movements eg short breaks during manual or desk-based jobs. It is important to balance rest with exercise as too much rest could weaken the tendon further.
Pain relief: Simple pain relief or anti-inflammatories can help with the symptoms in the early stages. Always check with your GP or pharmacist before taking new medication.
Orthotics: You can try using an elbow clasp if you do repetitive manual jobs or are involved in desk work.
Lifestyle: Smoking and obesity are two lifestyle factors which have been found to increase the risk of developing tendon issues. Diabetes or high sugar diets can also impact the risk of developing and prolonging tennis elbow. Please discuss with your healthcare professional or check out the ‘Managing My Musculoskeletal Health’ information leaflet.
Exercises: These can be done within your pain limits however they should not increase your pain. If you experience severe pain which lasts more than 30 minutes, reduce the force or frequency with which you are performing them. Choose a weight that is challenging without being painful.
Resisted wrist and finger extension
1 Bend your painful arm to a right angle or 90 degrees.
2 With the opposite hand, apply pressure to the fingers. Aim to keep the fingers and wrist straight (Hold the position for ten seconds and repeat six times) slowly rotate your hand in circles, both clockwise and then anticlockwise.
Unsupported wrist extension with bent elbow
1 Using a challenging weight with the painful arm (eg dumbbell, bottle of water, can of beans): slowly bend your wrist upwards and gently lower it back down to its neutral position parallel to the floor.
2 Aim to do between 8-15 reps following the advice above regarding exercising and pain. Do this twice with 60-90 sec rest in between.
Tip: You can slow down the movement in order to reach fatigue quicker.
Adapted bicep curl
1 Start standing with elbow straight with your hand facing forward.
2 Bend the elbow, bringing the hand towards your shoulder and bending the wrist towards the shoulder.
3 Turn the hand over so the palm is facing upwards and slowly straighten your elbow back to the starting position, bending the wrist backwards.
4 Turn the hand over once again and repeat exercise as many times as fatigue or pain allows. Repeat 2 to 3 times with 90 seconds rest in between.
Tip: You can slow down the movement in order to reach fatigue quicker.
Important considerations
It is currently advised to avoid corticosteroid injections into the area as a first point of treatment as although these may improve your symptoms in the short term (weeks) they may actually worsen your symptoms in the long term.
5% to 10% of people with Tennis Elbow may experience more longstanding pain and may require further treatment such as more tailored exercises, Shockwave Therapy or a referral to Orthopaedic team for review.
Visit our webpage on Tennis Elbow if you wish to access further information about this condition and videos of the exercises shown.
If you can access online resources, our physiotherapists recommend you use the self-help section of our website for information and support with specific MSK conditions and injuries
Our free NHS Mid and South Essex getUBetter app for an easy, safe and effective way to help you self-manage your MSK condition or injury.
If you feel symptoms have not improved within 6-8 weeks of this supported self-management and you wish to see a physiotherapist, please complete our online self-referral or be referred by a healthcare professional.
If you have any questions please contact the Care Co-ordination Centre on:
