Tennis elbow: symptoms, exercises and relief

What is tennis elbow?

Tennis elbow is lateral epicondylalgia, also known as lateral epicondylitis. The painful area is near the epicondyle, the bony prominence on the outside of the elbow, where several tendons of the wrist and finger extensor muscles attach.

Tennis accounts for only some cases. DIY, gardening, manual work, prolonged use of a mouse or repeatedly carrying loads can overload these tendons. Gripping the racket too tightly, an unsuitable handle or an increase in playing time can also trigger symptoms.

What are the symptoms of tennis elbow?

Pain on the outside of the elbow is the main sign. It can spread down the forearm and be accompanied by reduced grip strength. Turning a handle, pouring from a bottle, shaking hands or carrying a bag with the elbow straight can sometimes become difficult.

The pain is often reproduced when raising the wrist against resistance. Pressing on the epicondyle is tender. In a long-standing form, discomfort may appear at rest or during the night.

Pain on the inner side is more suggestive of medial epicondylitis, sometimes called golfer’s elbow. Tingling in the hand, loss of sensation, a locked elbow or neck pain radiating down the arm require a different assessment.

Why does the pain sometimes persist?

Tendons adapt slowly to load. The movements responsible are often part of work or daily tasks, which makes complete rest difficult. At the other extreme, immobilising the arm for a long time reduces its capacity and can make the return to activity more sensitive.

The strategy is to temporarily reduce the most irritating movements, then gradually restore strength. Change the way you carry objects, use both hands and keep the load close to your body. At the office, bring the mouse closer and avoid keeping your wrist raised for long periods.

Which exercises can help lateral epicondylitis?

These exercises are suitable for pain already identified as tennis elbow. Start with a light load. Discomfort should remain moderate and return to its usual level after the session. Stop if you feel sharp pain, tingling or a sudden loss of strength.

Isometric wrist extension

Rest your forearm on a table, palm facing down. Place your other hand on the back of the painful hand. Try to raise your wrist while blocking the movement with your other hand. Hold for 5 to 10 seconds. Repeat three to five times.

Eccentric wrist extension

Hold a small bottle or a light dumbbell, with your forearm resting on a surface and your hand over the edge. Use your other hand to help the painful hand move up. Lower it slowly over three to five seconds using the painful side. Start with two sets of eight to ten repetitions.

Forearm rotation

Hold a light, elongated object, such as a small hammer, with your elbow bent at 90 degrees. Slowly rotate your palm up and then down within a comfortable range. Perform two sets of ten controlled movements.

Gentle extensor stretch

Extend your arm in front of you, palm facing the floor. Gently bend your wrist with your other hand until you feel tension along the top of the forearm. Hold for 20 seconds and repeat twice. Sharp pain in the elbow indicates that the tension is too strong.

A physiotherapist can adjust the repetitions, load and frequency. Regular strengthening matters more than a single very intense session.

How can you relieve your elbow day to day?

Cold wrapped in a cloth can provide temporary comfort after an irritating activity. An elbow support or a strap below the elbow helps some people during manual tasks, but it does not replace retraining the tendon.

Also review your sports or work equipment. A suitable racket grip, corrected technique and a lighter tool reduce the demand on the forearm. For medication, ask a pharmacist or doctor for advice.

To better understand programmes for the upper limb, see the Bluetens guide to arm electrostimulation and the guide to electrode placement.

What role can electrostimulation play?

TENS can complement pain relief measures by temporarily modulating the perception of pain. EMS targets muscle contraction and can be used in certain rehabilitation programmes. The choice depends on the stage of the tendinopathy and how well the elbow tolerates it.

Bluetens devices give access to TENS and EMS programmes with placement guidance in the app. This use accompanies exercises, the adaptation of movements and professional follow-up. It does not replace the diagnosis of persistent pain.

When to see a professional?

See a professional if the pain does not improve after two weeks of relative rest and simple care, or if it seriously affects work and sleep. A professional can confirm lateral epicondylitis and look for nerve irritation or joint involvement.

Prompt medical attention is needed after a fall or impact, or in case of deformity, significant swelling, a locked elbow, sudden weakness or loss of sensation in the hand.

FAQ

Frequently asked questions

How long does tennis elbow last?

Improvement may begin after a few weeks, but some tendinopathies last several months. How long the pain has been present, daily load and regular exercise all influence the time frame.

Should you stop sport completely?

Temporarily reducing painful movements is often helpful. Comfortable activities can be continued. Returning to tennis is done gradually, paying attention to volume, technique and equipment.

Should the exercises hurt?

Mild, controlled discomfort may be acceptable. The pain should not intensify over the repetitions or remain clearly stronger the next day. If it does, reduce the load or range of motion.

Is an injection always necessary?

No. Treatment generally begins with adapting activities and rehabilitation. The doctor will discuss other options depending on the duration, severity and response to conservative treatment.

Medical sources

• NHS: tennis elbow, symptoms and treatment

• APTA: clinical practice guideline on lateral elbow pain