Tennis Elbow

01

What Is Tennis Elbow?

Tennis elbow is a condition characterised by pain around the lateral epicondyle, the bony prominence on the outside of the elbow, associated with the tendons of the wrist extensor muscles.

The tendon most commonly involved is the extensor carpi radialis brevis (ECRB), although other structures can also contribute to symptoms.

Despite sometimes being described as "tendon inflammation", persistent tennis elbow is better understood as a problem involving tendon pain, altered tendon structure and reduced capacity to tolerate load, rather than simply ongoing inflammation.

The wrist and forearm muscles play an important role in gripping, lifting and controlling the hand. Every time these activities are performed, forces are transmitted through the tendon attachments around the elbow. If the demands placed on the tissues exceed their current capacity, particularly following a sudden increase in activity, symptoms may develop.

Tennis elbow can be acute or gradual in onset, although many cases develop progressively over time.

A diagnosis is primarily clinical. Imaging such as ultrasound or MRI is not routinely required for straightforward presentations but may sometimes be considered when the diagnosis is uncertain, symptoms are persistent or another condition is suspected.

02

What Causes Tennis Elbow?

Tennis elbow usually develops through an interaction between repeated loading and the tendon’s ability to tolerate that load.

Common contributing factors include:

• Repetitive gripping: Frequent gripping, carrying or squeezing activities can repeatedly load the wrist extensor tendons.
• Repeated wrist movements: Activities involving repeated extension or rotation of the wrist and forearm may contribute.
• Overhead or racquet sports: Tennis, badminton, squash and other racquet sports can place substantial demands on the forearm.
• Sudden increases in activity: Increasing gym training, sporting activity or occupational workload too quickly may exceed the tendon’s current capacity.
• Manual occupations: Carpenters, mechanics, tradespeople and other workers who repeatedly grip or use tools may be more susceptible.
• Reduced muscular conditioning: Lower forearm strength or endurance can affect the ability to tolerate repetitive loading.
• Previous elbow or forearm problems: Earlier injury or periods of reduced activity may influence the tissue's capacity.

Importantly, tennis elbow is not necessarily caused by one particular movement or by poor technique alone. The volume, intensity and frequency of loading, together with the person's physical capacity and recovery, are often more relevant.

03

Common Signs & Symptoms

The most characteristic symptom is pain around the outside of the elbow, although symptoms can extend into the forearm.

Common symptoms include:

• Pain over the outer aspect of the elbow
• Tenderness around the lateral epicondyle
• Pain when gripping objects
• Discomfort when lifting a cup, bag or other object
• Pain when using tools
• Pain with wrist extension
• Difficulty performing repetitive hand or forearm activities
• Reduced grip strength or confidence
• Pain during racquet sports, gym training or other activities involving gripping
• Stiffness or discomfort after periods of activity

Symptoms are often aggravated by activities that require the wrist and fingers to work against resistance.

Tennis elbow generally does not cause widespread numbness or tingling. If you experience significant neurological symptoms, pain extending well beyond the elbow or marked weakness unrelated to pain, assessment of the cervical spine and peripheral nerves may also be appropriate.

04

Trivayu's Approach

At Trivayu, we view tennis elbow as more than simply an area of pain around the elbow.

The important question is: why has the elbow become less able to tolerate the demands being placed upon it?

Our assessment considers your symptoms, grip and forearm strength, movement, activity levels, work or sporting demands and recent changes in your physical workload.

This allows us to develop a rehabilitation programme around your actual requirements.

For someone who works with tools, rehabilitation may focus on building tolerance to repetitive gripping and lifting. For a tennis player, it may progress towards racquet-specific loading, grip demands and return-to-play requirements. For an office professional, the focus may be different again.

Your programme may begin with appropriate symptom management before progressing through targeted strengthening, tendon loading, grip conditioning and functional rehabilitation.

Tennis elbow physiotherapy in Jaipur at Trivayu Physio Center is focused on reducing pain and progressively rebuilding forearm strength, tendon capacity and function.

07

See It Explained

Filmed at our physiotherapy clinic in Vaishali Nagar, so you can see what we look for before you book.

• Tennis elbow explained by our physiotherapist
• Tennis elbow: hands-on forearm treatment