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Tennis Elbow - So Much More than Tennis

Tennis elbow refers to a repetitive use disorder causing recurring pain on the outside of the elbow. Without treatment beyond anti-inflammatory approaches, recurrence is high

While this condition is all too familiar to experienced tennis players, the majority of cases actually seem to be work related.1 This painful and sometimes debilitating elbow condition has been connected with many activities:

  • Using a screwdriver
  • Excessive hand shaking
  • Increased use of garden shears
  • Painting
  • Repetitive lifting
  • Brick laying
  • Hammering
  • Typing
  • Golf
  • Swimming
  • Pitching
  • Tennis
  • Other racquet sports
  • And other similar activities


The technical name for this condition is lateral epicondylalgia (which literally means pain over the bony spot on the outside of your elbow). The medical term for this condition was formerly lateral epicondylitis, but that term is technically wrong. Lateral epicondylitis means inflammation over the bony spot on the outside of your elbow. However, we now know this condition is not an inflammatory condition. A more accurate description of the condition would be to say that the body’s natural process of healing and rebuilding is not keeping up with the demands of the given activity.2

It was also previously thought that tennis elbow would be benign and self-limiting. In fact, one-year recurrence rates reached 72% in care groups receiving older treatment plans.3 

This current understanding of lateral epicondylalgia guides modern treatment standards. Tennis elbow  is not a simple inflammation that can be chased away with anti-inflammatories such as aspirin.4 Masking the pain can be asking for trouble. The pain of tennis elbow is telling the worker, athlete, and gardener that the tendons in the area are not keeping up, and a problem is growing.

While individualised treatment at Advanced Physiotherapy will be determined by numerous variables, it is generally true that we will develop a healthy and safe plan to improve the conditioning of the involved structures so that you can safely and effectively return to work and play. Treatment may include:

  • Stretching, strengthening, and conditioning of the upper extremities
  • Splinting / strapping
  • Pain relief and spasm reduction modalities
  • Manual therapy
  • Consultation regarding equipment modification
  • Consultation regarding athletic & work technique improvements



  1. Haahr JP, Andersen JH. Physical and psychosocial risk factors for lateral epicondylitis: a population based case-referent study. Occupational and Environmental Medicine. 2003 May 1;60(5):322-9.
  2. Khan K, Cook J, Kannus P, et al. Time to abandon the ‘tendinitis’ myth. BMJ. 2002; 324: 626-7.
  3. Coombes B, Bisset L, Brooks P, et al. Effect of corticosteroid injections, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia. JAMA. 2013; 309 (5): 461-469.
  4. Coombes B, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Lancet 2010; 376: 1751-67.






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