Condition
Tennis Elbow.How we help.
Tennis elbow is pain on the outer side of the elbow. Despite the name, most people who get it have never played tennis. It usually comes from overuse or repeated gripping, like wringing out clothes, carrying heavy bags home from a Jaipur sabzi mandi, long hours using a computer mouse, or daily kitchen work such as rolling rotis and handling a heavy kadhai. The pain can feel sharp when you grip or lift, and the area may feel tender to touch.
How we help
- A careful check-up to understand what is straining your elbow and how it started
- Hands-on manual therapy to ease pain and stiffness, where suitable
- A gradual exercise plan to slowly build strength in the forearm and grip
- Dry needling may be considered where clinically appropriate, and your physiotherapist will decide if it suits you
What to expect
Your first visit begins with a detailed look at your elbow, grip, arm movement and daily activities. From there, we explain in plain language what may be causing your pain and build a simple plan for you. We also suggest small changes to your daily tasks so the elbow gets a chance to settle and recover.
What tennis elbow actually is
Tennis elbow is pain around the lateral epicondyle, the bony point on the outside of the elbow, where the tendons of the wrist extensor muscles attach. The tendon most often involved is the extensor carpi radialis brevis, though other structures can contribute.
It is often described as tendon inflammation. That is not quite right. Persistent tennis elbow is better understood as tendon pain, altered tendon structure and a reduced ability to tolerate load, rather than ongoing inflammation. This matters, because it changes what actually helps.
Your wrist and forearm muscles do the work every time you grip, lift or turn your hand, and the force travels through the tendon attachments at the elbow. If the demands on those tissues exceed what they can currently tolerate, particularly after a sudden increase in activity, symptoms develop. Onset can be sudden, though it usually builds gradually.
Diagnosis is mainly clinical. An ultrasound or MRI is not routinely needed for a straightforward presentation, though a doctor may consider imaging if the diagnosis is uncertain, symptoms persist or another condition is suspected.
What causes it
Tennis elbow develops through the interaction between repeated loading and the tendon's ability to tolerate that load. Common contributors include:
- Repetitive gripping. Frequent gripping, carrying or squeezing loads the wrist extensor tendons.
- Repeated wrist movement. Activities involving repeated extension or rotation of the wrist and forearm.
- Racquet and overhead sports. Tennis, badminton and squash place substantial demands on the forearm.
- A sudden increase in activity. Adding gym training, sport or workload too quickly can exceed what the tendon currently tolerates.
- Manual work. Carpenters, mechanics and tradespeople who repeatedly grip or use tools are more susceptible.
- Reduced forearm conditioning. Lower forearm strength or endurance affects tolerance to repetitive loading.
- Previous elbow or forearm problems. Earlier injury or a period of reduced activity influences tissue capacity.
Tennis elbow is rarely caused by one movement or by technique alone. The volume, intensity and frequency of loading, alongside your physical capacity and recovery, usually matter more.
Signs and symptoms
The characteristic symptom is pain around the outside of the elbow, though it can extend into the forearm. People commonly notice:
- Pain over the outer aspect of the elbow
- Tenderness around the lateral epicondyle
- Pain when gripping objects
- Discomfort lifting a cup, a bag or a tool
- Pain with wrist extension
- Difficulty with repetitive hand or forearm activities
- Reduced grip strength, or reduced confidence in the grip
- Pain during racquet sports or gym training
- Stiffness or discomfort after a period of activity
Symptoms are usually aggravated by anything that makes the wrist and fingers work against resistance.
Tennis elbow does not generally cause widespread numbness or tingling. If you have significant neurological symptoms, pain extending well beyond the elbow, or marked weakness unrelated to pain, your neck and the nerves of the arm may need assessing too. Persistent or severe symptoms after a significant injury should be seen by a doctor to rule out other elbow injuries.
How we build your programme
We treat tennis elbow as more than a painful spot on the elbow. The question worth answering is why the elbow has become less able to tolerate what you are asking of it.
Your assessment covers symptoms, grip and forearm strength, movement, activity levels, your work or sporting demands, and any recent change in physical workload. That is what the programme is built around.
If you work with tools, rehabilitation focuses on tolerance to repetitive gripping and lifting. If you play tennis, it progresses towards racquet-specific loading, grip demands and return to play. For desk work, it looks different again. Your programme may start with managing symptoms before moving through targeted strengthening, tendon loading, grip conditioning and functional rehabilitation.
Physiotherapy addresses the movement and loading side of tennis elbow. Diagnosis of any other elbow problem, and any decision about injections or surgery, sits with your doctor. If your assessment suggests you should see one, your physiotherapist will tell you.
Common questions
Do I need to stop all my daily work?
Not always. Often it is about changing how you do certain tasks rather than stopping everything. Your physiotherapist will guide you on what to adjust and for how long.
Why does it hurt when I grip or lift things?
Gripping and lifting load the muscles on the outer elbow, and when they are irritated this can feel painful. Your physiotherapist will assess your grip and design exercises to slowly rebuild strength.
How long will it take to feel better?
This varies from person to person and depends on how the elbow responds to treatment. Your physiotherapist will give you a clearer idea after your first assessment. You are not asked to buy a package up front. Sessions are booked as you go, your physiotherapist reviews your progress with you as you continue, and you can stop at any point.
Should I see a physiotherapist for tennis elbow?
Yes, if elbow pain persists, affects your grip, or limits work, sport or daily activities. A physiotherapist can assess what is driving the symptoms and guide the rehabilitation.
What does physiotherapy for tennis elbow involve?
Usually modifying the activities that aggravate it and gradually strengthening the affected forearm tendons, so they tolerate load better. Your physiotherapist sets the starting point and the progression after assessing you.
Do I need surgery for tennis elbow?
That decision belongs to your doctor or an orthopaedic surgeon, not to us. What we can tell you is that most people are looked after without surgery, through activity changes and progressive exercise, and that recovery takes time because tendons adapt gradually. If your assessment suggests you should see a doctor, we will say so.
Can strengthening exercises help?
Progressive strengthening of the wrist and forearm can improve how much load the tendon tolerates and reduce symptoms over time, when the exercises are progressed appropriately for you.
Related treatments
Related conditions
This page is educational and does not replace a proper assessment. Outcomes vary by individual; Trivayu Physio Center makes no guarantee of specific results.
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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