Tennis Elbow (Lateral Epicondylitis)

Typical Symptoms

Hallmark signs

• Localized pain/tenderness on the outer elbow, sometimes traveling down the forearm

• Pain with resisted wrist extension or middle-finger extension

• Reduced grip strength (opening jars, lifting a pan, shaking hands)

• Morning stiffness; “warms up then flares later” after overuse

Diagnosis

What a clinician looks for

• History of aggravating tasks and load spikes

• Targeted tests (resisted wrist or finger extension)

• Point tenderness at the lateral epicondyle

When imaging is used

Imaging is rarely necessary unless symptoms are atypical or not improving with good conservative care.

What Actually Helps

The most reliable plan combines load management (short term) with progressive exercise (medium to long term), supported by selected adjuncts.

Load Management (Short Term)

• Temporarily modify aggravating tasks (heavy palm-down lifts, long mousing sessions, sustained gripping)

• Take 30–60-second micro-breaks every 30–45 minutes

• Favor neutral-grip carries and keep the wrist aligned with the forearm

• Use heat or ice for comfort—whichever feels better

• Consider a counterforce strap during high-load activities

Progressive Exercise (Medium to Long Term)

Early phase

• Pain-tolerant isometric wrist-extension holds (e.g., 5×30–45 seconds once or twice daily)Middle phase

• Slow eccentric and then concentric-eccentric wrist-extension drills with a light dumbbell

• Grip-strength work to restore functional capacitySupportive strength

• Shoulder external rotation, rows, scapular control so the elbow doesn’t overworkLater phase

• Heavy, slow resistance within tolerance

• Task/sport-specific progressions (work simulations, swing drills, technique cues)

24-hour rule: mild soreness that settles by the next day is acceptable; sharp or lingering pain means adjust the dose.

Treatment of Tennis Elbow (Internal Links Ready)

A multi-faceted approach helps most people. Link each item to your service pages.

Physiotherapy

A structured plan uses graded loading to restore tendon capacity, complemented by manual techniques and movement coaching. Expect education on pacing, ergonomic fixes, and a phased, personalized exercise program.
See: Physiotherapy
Osteopathy

Focuses on restoring musculoskeletal balance and improving mobility of related joints and soft tissues to reduce local overload at the tendon.
See: Osteopathy

Acupuncture

May provide short-term analgesia and reduce muscle guarding around the elbow and forearm, helping participation in progressive exercise.
See: Acupuncture

Shockwave Therapy (ESWT)

For persistent cases, extracorporeal shockwave therapy can stimulate tissue-healing responses and reduce pain when paired with a solid rehab plan. Often considered after 6–12 weeks if progress plateaus.
See: Shockwave Therapy

Bracing & Orthotics

A counterforce strap (worn just below the painful area) can lower tendon stress during gripping and lifting. Wrist supports may be used selectively and short term.
See: Bracing & Orthotics

Ergonomics & Workplace Setup

Optimizing workstation height, mouse placement, keyboard position, and grip strategy reduces repeated spikes in tendon load.
See: Ergonomics Assessment

Sample Home Exercise Progression

Education only—adjust sets/reps to tolerance; if pain lingers >24 hours, reduce the load.

1) Isometric Wrist Extension

• Forearm supported, palm down

• Hold the wrist gently into extension against immovable resistance for 30–45 seconds

• 4–5 holds

2) Eccentric Wrist Extension

• Help the wrist up with the other hand, then slowly lower for 3–4 seconds with the affected side

• 3×10–12 reps

3) Grip–Release Sets

• Moderate squeezes on putty or a soft ball: 3 seconds on, 3 seconds off

• 2–3 sets of 10–15

4) Proximal Support Work

• Rows and shoulder external rotation 2–3 sessions/week, steadily progressing load and tempo

Ergonomics & Technique Tips

Workstation pointers

• Keep the mouse close to your body; elbow near 90°, wrist neutral, and grip relaxed

• Use a light touch; avoid resting on the wrist edge for long periods

Lifting & sport

• Hinge at the hips/knees, keep the load close, avoid cranking the wrist into extension

• For racquet sports, ensure correct grip size and appropriate string tension; progress court time gradually

Recovery Timeline & Expectations

What to expect week by week

• Many improve within 8–12 weeks of consistent, well-dosed rehab

• Long-standing cases may take longer; expect occasional flare-ups

The real goal

Not just “less pain,” but more capacity—a tendon that comfortably tolerates your work, sport, and daily life.