Tennis Elbow Treatment & Recovery

What is tennis elbow?

Tennis elbow, or lateral epicondylitis, is pain on the outside of the elbow where the tendons of the forearm muscles attach to a bony bump called the lateral epicondyle. Those muscles extend your wrist and fingers and steady your grip, so every time you grasp, lift or twist, they pull on that small attachment point.

When the load is more than the tendon can recover from, it becomes irritated and sensitive. Despite the "-itis" in the name, longer-lasting cases usually involve tendon overload and changes in the tendon tissue rather than ongoing inflammation, which is why many clinicians now call it lateral elbow tendinopathy.

Golfer's elbow: the inside-of-the-elbow version

Golfer's elbow, or medial epicondylitis, is the same kind of overuse problem on the inner side of the elbow, where the tendons that bend the wrist and turn the palm down attach. It's linked to gripping, throwing, golf swings and repetitive work with tools. It's assessed and treated in much the same way as tennis elbow, with exercises aimed at the muscles on the inside of the forearm instead.

Tennis elbow symptoms

Symptoms usually come on gradually and may start as a mild ache that you only notice after certain tasks. Over time it can become more constant. Common signs include:

• Pain or burning on the outside of the elbow that may spread into the forearm
• Pain when gripping, lifting with your palm facing down, shaking hands or turning a doorknob
• Difficulty opening jars or holding a coffee cup at arm's length
• A weaker grip than usual
• Tenderness when you press on the bony point on the outside of the elbow

What causes tennis elbow?

Tennis elbow is an overuse problem, and most people who get it don't play tennis. It typically follows a period of repeated gripping and wrist movement, especially if the activity is new, more intense than usual or done with poor technique or equipment.

• Racquet sports, particularly a backhand that relies on the wrist
• Golf, climbing and weight training
• Manual jobs such as painting, plumbing, carpentry and construction
• Long hours of mouse and keyboard work with the wrist held extended

It is most common in people in their 30s to 50s.

How we assess elbow pain

Your first visit includes a full orthopedic and neurological exam. We press on the tendon attachments, test grip strength and check which wrist and finger movements reproduce your pain. We also look at your neck and upper back, because irritation of a nerve in the neck can cause pain on the outside of the elbow that mimics tennis elbow — see neck pain for more on that link.

A physical exam is usually enough to identify tennis elbow. Imaging is only needed when something doesn't fit, such as a recent injury, a locking or catching joint, or symptoms that aren't improving as expected.

How our chiropractors treat tennis elbow

Our approach is part of our wider sports injury treatment care and usually combines:

• Load management — identifying which tasks aggravate the tendon and adjusting them for a while, rather than stopping everything
• Soft-tissue therapy and massage therapy for the forearm muscles, which are often tight and tender around the sore tendon
• The Deep Muscle Stimulator, a percussion tool used to relax dense forearm and upper-arm muscle
• Joint work at the elbow, wrist and upper back where motion is restricted
• Tennis elbow exercises that start with gentle isometric holds and build to slow, controlled wrist strengthening, so the tendon becomes more tolerant of load
• A tennis elbow brace or strap worn just below the elbow, which some people find eases pain during gripping

If your symptoms are severe or not responding, we'll talk with you about medical options and refer you. Injections and surgery are usually reserved for persistent cases. Our chiropractic treatment page explains how we build care plans more generally.

Recovery and what you can do at home

Tennis elbow commonly takes several weeks to a few months to settle, and longer-standing cases can take longer still. The tendon responds to steady, gradual loading, so consistency with your exercises matters more than intensity.

• Lift with your palm facing up when you can, and keep heavy objects close to your body
• Use a thicker grip on tools, racquets and pens
• Take regular breaks from repetitive tasks and keyboard work
• Use ice for 15 minutes after aggravating activity if it eases the ache
• Return to sport gradually and have your technique or equipment checked

When to seek urgent medical care

Get prompt medical attention if you have:

• Elbow pain after a fall or impact, with swelling, deformity or difficulty bending or straightening the arm
• A sudden pop at the front of the elbow while lifting, followed by bruising or a change in the shape of your upper arm, which can signal a biceps tendon rupture
• A red, hot, swollen elbow or a fever
• Numbness, tingling or weakness in the hand or fingers

For the gradual, nagging ache that's been building with work or sport, a chiropractic exam is a good place to start. Tennis elbow and golfer's elbow are among the many conditions we treat.