Tennis Elbow: Causes, Treatment, and Prevention

Tennis elbow, also known as lateral epicondylitis, is a common condition that affects many tennis players and athletes who engage in repetitive arm movements. Despite its name, tennis elbow is not exclusive to tennis players—it can affect anyone who overuses the forearm muscles, leading to pain and discomfort on the outer part of the elbow. This blog will explore what tennis elbow is, its causes, treatment methods, and preventive exercises to keep your arms healthy and pain-free.

What is Tennis Elbow?

Tennis elbow is an overuse injury that involves inflammation or microtears in the tendons that attach to the lateral epicondyle, the bony prominence on the outside of the elbow. These tendons connect to the muscles that control wrist and finger extension, meaning they are heavily involved in gripping and lifting motions.

The primary symptom of tennis elbow is pain on the outer part of the elbow, which can radiate down the forearm. The pain often worsens when performing activities like gripping a racket, shaking hands, lifting objects, or even typing. Some people also experience stiffness, weakness in the wrist, or a burning sensation around the elbow.

What Causes Tennis Elbow?

Tennis elbow is primarily caused by repetitive stress on the forearm muscles and tendons. Common causes include:

• Overuse of the Forearm Muscles: Repetitive wrist and arm motions, such as swinging a tennis racket, can strain the tendons.

• Poor Technique in Tennis: If your stroke mechanics are inefficient, especially with backhand shots, the excessive strain can increase the risk of developing tennis elbow.

• Incorrect Equipment: Using a racket with the wrong grip size, excessive string tension, or a stiff frame can put unnecessary stress on the forearm muscles.

• Occupational Strain: Jobs that involve repetitive arm movements—such as painting, carpentry, typing, or even playing musical instruments—can contribute to the condition.

• Sudden Increase in Activity: If you suddenly start playing tennis more frequently or engage in new upper-body workouts, your tendons may not have time to adapt, leading to injury.

How to Treat Tennis Elbow

1. Rest and Recovery

Yes, rest does help! Since tennis elbow is an overuse injury, giving your arm time to heal is crucial. Complete rest is not always necessary, but avoiding activities that aggravate the pain can significantly speed up recovery. In mild cases, reducing activity for 2 to 3 weeks may be enough. In more severe cases, it may take 6 to 12 weeks for symptoms to improve.

2. Ice Therapy

Applying ice to the affected area for 15–20 minutes at a time, 3–4 times a day can help reduce inflammation and pain. Using an ice pack or a bag of frozen peas wrapped in a towel works well.

3. Pain Management

Over-the-counter pain relievers like ibuprofen (Advil) or naproxen (Aleve) can help reduce pain and swelling. However, they should only be used temporarily.

4. Stretching and Strengthening Exercises

Once the pain starts to subside, gentle exercises can help speed up recovery and prevent future injury. Here are some key exercises:

Stretching Exercises

• Wrist Extensor Stretch

1. Extend your injured arm straight in front of you, palm facing down.

2. Use your opposite hand to gently pull your fingers down towards the floor.

3. Hold for 15–30 seconds, then release.

4. Repeat 3 times per session, twice a day.

• Wrist Flexor Stretch

1. Extend your arm with your palm facing up.

2. Use the other hand to gently pull your fingers back towards your body.

3. Hold for 15–30 seconds, then release.

4. Repeat 3 times per session, twice a day.

Strengthening Exercises

• Wrist Extensor Strengthening (Eccentric Wrist Curl)

1. Hold a light dumbbell (1-2kg) in your injured hand with your palm facing down.

2. Rest your forearm on a table or your knee, letting your hand hang off the edge.

3. Slowly lower the weight down, then use your other hand to lift it back up (eccentric movement).

4. Perform 3 sets of 10 reps daily.

• Grip Strengthener Exercise

1. Squeeze a soft ball or a rolled-up towel in your hand.

2. Hold for 5 seconds, then release.

3. Repeat 15 times, twice a day.

• Forearm Pronation and Supination (Rotational Strengthening)

1. Hold a light dumbbell (or a hammer) with your elbow bent at 90 degrees.

2. Slowly rotate your palm up and then down.

3. Perform 3 sets of 10 reps on each arm.

4. Wearing a Tennis Elbow Brace

A tennis elbow brace or forearm strap can help reduce strain on the affected tendon. Wearing one during activities that involve repetitive wrist motion can be beneficial.

6. Physical Therapy

If symptoms persist for several months, a physical therapist can create a tailored rehabilitation program that includes manual therapy and advanced strengthening exercises.

Preventing Tennis Elbow

If you’ve had tennis elbow before or want to avoid it altogether, these preventive measures can help:

1. Strengthen Your Forearm Muscles

Regularly performing the strengthening exercises mentioned above can improve the resilience of your forearm tendons.

2. Improve Your Tennis Technique

If you play tennis, work with a coach to ensure you have proper stroke mechanics. A well-executed backhand with the correct grip can reduce strain on the elbow.

3. Use the Right Equipment

• Choose a racket with a comfortable grip size that suits your hand.

• Avoid overly tight string tension—opting for a softer string can reduce vibrations.

• Consider using a shock-absorbing dampener to minimize the impact on your arm.

4. Warm Up Before Playing

Always warm up your arms and shoulders with dynamic stretches and light exercises before hitting the court.

5. Avoid Overuse

If you start feeling elbow discomfort, take a break or modify your activities to prevent further irritation.

6. Use Proper Ergonomics

If your job involves repetitive hand movements, make sure your workspace is ergonomically friendly to reduce unnecessary strain.

Final Thoughts

Tennis elbow can be a frustrating condition, but with the right approach, it is manageable and preventable. Rest, proper exercises, and modifications to your playing technique or daily activities can help alleviate pain and keep your elbows healthy. If symptoms persist despite these interventions, it may be worth consulting a medical professional or physical therapist for personalized treatment. By taking proactive steps, you can enjoy playing tennis—or any other activity—without being sidelined by injury.