Tennis elbow may sound like a minor inconvenience, but for those dealing with it, the persistent pain and limitation can make even simple tasks feel overwhelming. Lateral epicondylitis, more commonly known as tennis elbow, is a condition rooted in tendon overuse and inflammation, often triggered by repetitive wrist movements. While it’s famously associated with tennis players, anyone who frequently engages in gripping or wrist-extending activities can develop this painful condition. In this blog, we’ll break down what tennis elbow is, how it’s assessed, why it happens, and most importantly, how physiotherapy for tennis elbow can provide lasting relief and recovery.
Understanding Tennis Elbow
Tennis elbow is a common term used to describe a condition known as ‘lateral epicondylitis’. To dissect what this means: “lateral” refers to the outside part of your elbow when the palm is facing forward, and “epicondylitis” refers to inflammation of a specific part of the bone structure located on the outside of the elbow joint.
This condition is primarily caused by inflammation or strain of the common extensor tendons. Whenever these tendons become overused, inflamed, or strained, they can lead to a painful condition where almost any movement involving wrist extension reproduces discomfort. In more complicated cases, the bone itself — known as the lateral epicondyle — can become extremely sensitive to touch, making even simple tasks painful.
Understanding the anatomical structures involved is important for targeting treatment effectively and ensuring a full, lasting recovery.
Common Causes of Tennis Elbow
While tennis elbow is commonly associated with racquet sports, it can develop from a variety of repetitive activities that strain the extensor tendons of the forearm. The reason why it’s called tennis elbow is that it’s a common injury when playing tennis, specifically while repeatedly using your backhand to strike the ball.
Common causes of tennis elbow include:
- Repeated Backhand Motions in Tennis: This particular movement causes a lot of tension and pull along the extensor tendons, which may eventually lead to inflammation and the condition known as lateral epicondylitis.
- Racquet Sports Beyond Tennis: Sports like pickleball, squash, racquetball, and badminton also involve frequent wrist extension movements that can strain the tendons over time.
- Repetitive Occupational Activities: Jobs that involve frequent wrist movements — such as carpentry, plumbing, painting, typing, or using hand tools — can place repeated stress on the extensor tendons, leading to overuse injuries.
- Daily Activities with Poor Mechanics: Activities like gardening, lifting heavy groceries, or carrying children with poor wrist or elbow mechanics can similarly overload the tendons and trigger inflammation.
Essentially, anything that puts a lot of strain on the extensor tendons of the wrist could potentially lead to tennis elbow. Recognizing these patterns is crucial for both effective treatment and long-term prevention strategies.
How Physiotherapy Helps Treat Tennis Elbow
Proper assessment and a structured rehabilitation plan are key to managing tennis elbow effectively. The most important role of the physiotherapist is to properly identify that the client has tennis elbow. Once this has been confirmed, therapy becomes very specific to improving the capacity and tolerance of the extensor tendon.
Treatment generally follows a staged approach:
- Pain Modulation: The initial stages of therapy will involve pain modulation, or improving the pain experience for the client. This may include manual therapy, activity adjustments, or therapeutic modalities aimed at calming the irritated tissues and reducing discomfort.
- Tendon Strengthening and Capacity Building: The second stage of rehabilitation would be to improve the strength and capacity of the above-mentioned tendons. Gradual, controlled strengthening exercises help the tissues better tolerate stress and rebuild resilience over time.
- Movement Education and Load Management: Physiotherapists also educate clients on how to move efficiently, manage workload, and avoid activities or techniques that place excessive strain on the injured tissues, promoting lasting recovery.
By addressing both the symptoms and the underlying causes, physiotherapy helps runners not just heal but also return stronger and more resilient than before.
Effective Physiotherapy Treatments for Tennis Elbow
The choice of physiotherapy treatments for tennis elbow largely depends on the chronicity of the issue — meaning how long the condition has been present and how severe the symptoms are. There are a variety of things that we could do, each chosen carefully based on the stage of healing and the specific needs of the individual.
Common physiotherapy treatments for tennis elbow include:
- Manual Therapy Techniques: Hands-on approaches such as soft tissue release, joint mobilizations, and myofascial techniques help improve movement, reduce muscle tension, and support tendon healing.
- Progressive Loading Exercises: Specific exercises designed to gradually load the extensor tendons, rebuild strength, and improve tolerance to the forces encountered during daily activities and sport.
- Blood Flow Restriction (BFR) Training: BFR allows for the strengthening of muscles and tendons using lighter loads, making it a valuable tool when tendons are too irritated for traditional strength training. It can safely accelerate strength gains without overloading the healing tissues.
- Acupuncture: Used to help reduce pain, relax tight muscles, and stimulate circulation to the affected area. Acupuncture can be particularly useful in the early stages to modulate pain and calm down local inflammation.
- Shockwave Therapy: This non-invasive treatment uses acoustic sound waves to stimulate blood flow, promote tissue regeneration, and break down scar tissue in chronic cases. Shockwave therapy can be particularly effective when tennis elbow symptoms have persisted for several months without improvement.
- Custom Orthotics (When Needed): In some cases, improper biomechanics at the wrist, elbow, or even shoulder can contribute to excess strain on the tendons. Custom orthotics or wrist supports can help offload stress, improve joint alignment, and reduce aggravation during recovery.
By selecting treatments based on the individual’s specific presentation, physiotherapy not only addresses the immediate pain but also targets the underlying causes of the condition to ensure a more complete and lasting recovery.
How Long Does It Take to Recover From Tennis Elbow With Physiotherapy?
The timeline for recovering from tennis elbow varies greatly depending on the person and the severity of the injury. This is all very dependent on the person and the severity of the injury. In the worst cases, there have been actual tears and injuries to the muscle, which naturally make the recovery longer and more complex.
Mild cases may resolve within a few weeks with proper treatment, while more advanced or chronic conditions might take several months of consistent rehabilitation. Early intervention and adherence to a customized physiotherapy program often lead to faster, more complete recoveries.
Patience, consistency, and proper guidance are critical for ensuring full tendon healing and reducing the risk of recurrence.
Exercises Recommended for Tennis Elbow Recovery
Exercises are a cornerstone of effective tennis elbow rehabilitation. The goal is to improve the capacity and tolerance of the extensor tendons so that they can better withstand the demands of daily activities and sports.
Exercises that physiotherapists often recommend for tennis elbow recovery include:
- Wrist Extension Strengthening: Targeted exercises to improve the strength of the wrist extensor muscles, such as resisted wrist extensions using light weights or resistance bands.
- Eccentric Loading Exercises: Controlled eccentric (lengthening) exercises for the wrist extensors help stimulate tendon remodelling and improve tissue resilience.
- Grip Strengthening: Gentle grip exercises help build strength in the supporting muscles of the forearm, which can offload stress from the affected tendons.
- Stretching Exercises: Gentle wrist and forearm stretches maintain flexibility and reduce excessive tension along the extensor tendons.
At its core, tennis elbow occurs when a tendon is repeatedly stressed beyond what it can tolerate. The underlying issue isn’t just the amount of load, but the tendon’s inability to withstand it effectively. So to put it simply, we want to improve the capacity and tolerance of these tendons — especially if we continue to load them in the same manner in work, sport, or daily activities.
Strengthening these tissues gradually and carefully is essential for both recovery and prevention.
Can Physiotherapy Prevent Tennis Elbow From Recurring in the Future?
Absolutely. Prevention is a major focus of physiotherapy and often a crucial part of long-term success. We always like to say that prevention is far cheaper than management.
One of the most beneficial aspects of seeing a physiotherapist is the educational component. This allows you to understand what caused your injury and how to prevent it from coming back. Learning proper movement techniques, incorporating tendon-specific strengthening exercises, managing workload appropriately, and recognizing early warning signs can dramatically reduce the chances of developing tennis elbow again.
Through a combination of education, targeted strengthening, and individualized movement strategies, physiotherapy empowers people to stay pain-free and active long after treatment ends.
Enhanced Mobility and Pain Relief Start Here
If you’re struggling with persistent elbow pain, professional guidance can make all the difference. At Ottawa Health: Performance and Rehabilitation, our physiotherapists are committed to helping you not only recover but also build lasting resilience against future injuries.
Through personalized treatment plans and hands-on education, we’ll help you regain strength, confidence, and pain-free movement. Contact us today to start your recovery journey — because life’s too short to be held back by pain.
