Understanding Tennis Elbow Symptoms and Effective Treatment Options for Everyone

Tennis elbow, medically known as lateral epicondylalgia, affects about 3% of people, mostly between 35 and 54 years old. Despite its name, only a small number of cases actually involve tennis players. The condition causes pain on the outer part of the elbow, especially when gripping, lifting, or extending the wrist. This blog explains why tennis elbow affects many people beyond athletes and offers practical advice on how to manage and treat it effectively.

Pain location on the outer elbow typical of tennis elbow

What Causes Tennis Elbow in Non-Tennis Players?

Tennis elbow is a tendinopathy, meaning it involves damage or irritation to the tendons that attach muscles to bone. The main tendon affected is the extensor carpi radialis brevis, which helps extend the wrist. This injury happens due to repetitive stress or overuse, not just from playing tennis.

Many people develop tennis elbow from activities such as:

• Repetitive gripping or lifting heavy objects

• Using hand tools like screwdrivers or hammers

• Typing or working at a computer without proper ergonomics

• Manual labor involving wrist extension and forearm use

  
  

Even desk workers can experience tennis elbow because poor posture and repetitive mouse use strain the forearm muscles and tendons. This explains why only about 5% of cases are linked to tennis players.

Recognizing the Symptoms

The main symptom is pain on the outside of the elbow, near the bony bump called the lateral epicondyle. This pain often worsens with:

• Gripping objects tightly

• Lifting items, especially with the palm facing down

• Extending or straightening the wrist

• Shaking hands or turning a doorknob

  
  

Some people also notice weakness in their grip or stiffness in the elbow. The pain can range from mild discomfort to sharp, persistent pain that limits daily activities.

Why Rest Alone Isn’t Enough

Unlike some injuries that heal with rest, tennis elbow tends to improve best with progressive loading of the affected tendons. This means gradually increasing the strength and flexibility of the forearm muscles through specific exercises. Resting completely can actually weaken the tendon and delay recovery.

Research supports physiotherapy as the first choice for treatment. A key study showed that corticosteroid injections, once common, lead to worse outcomes after one year compared to physiotherapy or even placebo injections. This highlights the importance of active rehabilitation rather than relying on quick fixes.

Effective Treatment Options

Physiotherapy and Exercise

A combination of manual therapy and targeted exercises produces the best results. Exercises focus on:

• Strengthening wrist extensors with controlled resistance

• Improving flexibility of the forearm muscles

• Gradually increasing load to rebuild tendon strength

  
  

Manual therapy may include massage and joint mobilization of the elbow and cervical spine. The neck is important because nerve irritation from the C5-C6 spinal levels can cause or worsen elbow pain.

Acupuncture for Pain Relief

Some studies suggest acupuncture can help reduce pain and improve function in tennis elbow. It is often used alongside physiotherapy to support recovery.

Activity Modification and Ergonomics

Changing how you perform daily tasks can reduce strain on the elbow. For example:

• Adjusting desk height and chair position to improve posture

• Using ergonomic keyboards and mouse devices

• Taking regular breaks during repetitive work

• Avoiding heavy lifting or gripping tasks during recovery

  
  

These adjustments help prevent further irritation and support healing.

When to See a Specialist

If pain persists beyond a few weeks or worsens despite home care, it’s important to consult a healthcare professional. A physiotherapist can assess your condition, rule out other causes, and design a personalised rehabilitation plan.

For those in South Kensington, Ali Momeni Pour at Physiome Kensington, Ethos Sports Centre, Imperial College London, offers expert assessment and physiotherapy for tennis elbow.