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Tennis Elbow

The problem

  • Also known as lateral epicondylosis
  • This is a break down of the wrist extensor tendon where it attaches to the outside of the elbow.
  • It generally results from repetitive stress, which causes micro tears of the tendon at its attachment to the elbow.
  • No special tests are needed for diagnosis of the problem, a thorough history and physical examination should be adequate.

Interesting facts

  • Tennis elbow is not always caused by playing tennis.
  • Any activity, which involves repetitive use of the muscles on the top of the forearm, can result in tennis elbow symptoms.
  • The term tendonitis has now been replaced with tendonosis as there are no inflammatory cells present.
  • Nerve root irritation in the neck can often contribute to the pain presentation in the forearm.

What you can expect/look out for

  • Pain is increased with activities that require contraction of the forearm muscles.
  • These activities include, shaking hands, turning a doorknob, picking up objects with the palm facing down and a backhand in tennis.
  • When there is involvement of the nerves running from the neck into the arm, pain may be felt radiating down into the forearm.

Suggestions for management

  • Avoiding aggravating activities is the first step in allowing tissue to settle.
  • Use of a counterforce brace can help in taking the load off the injured area.
  • The next phase of intervention involves strengthening the damaged tissue.
  • Physiotherapy and prescription of eccentric loading exercises has been shown to be effective in building strength in the damaged tendon.

More information

  • Activity modification to eliminate the cause of the breakdown is important to prevent re-occurrence.
  • Return to activity should be done gradually to ensure that the tissue that is still healing is not overloaded.

At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries.



Contact us today – 9252 5770


This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.

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