What Is Tennis Elbow? Causes, Symptoms, and Treatment

Most people who get tennis elbow have never held a racket. Painters, plumbers, carpenters, and anyone who spends the day gripping tools or typing can end up with the same tendon damage as a club player with a shaky backhand. The name stuck because the injury was first described in tennis players, not because the sport causes most cases.

What Is the Lateral Epicondyle?

It’s the bony bump on the outer side of the elbow. Several forearm muscles that extend the wrist and fingers share a tendon that attaches there. Overwork those muscles through repeated gripping or wrist extension, and the tendon gets irritated, develops small tears, and you’re left with tennis elbow.

Common Causes

Cause Category	Examples
Racket sports	Tennis (especially backhand technique), squash, badminton, padel
Occupational	Painting, plumbing, carpentry, butchery, typing
Everyday activities	Repeated lifting, using a screwdriver, prolonged mouse use

In tennis, the usual culprit is backhand technique: a bent wrist or too much forearm in the swing loads the lateral tendons more than they can handle. String tension, grip size, and frame stiffness can make it worse too.

Symptoms

• Pain and tenderness on the outside of the elbow
• Weakness in the wrist and forearm
• Pain that worsens when gripping, lifting, or twisting the forearm, like turning a door handle
• Discomfort that radiates down the forearm toward the wrist
• Stiffness when straightening the arm fully

It usually builds gradually. Most people can’t point to a single moment it started.

Diagnosis

A doctor or physiotherapist typically diagnoses it with a physical exam, checking how much pain shows up when the wrist is extended against resistance. Ultrasound or MRI gets used occasionally, mostly to confirm tendon damage or rule out something else.

Treatment Options

Conservative treatment works for most people:

1. Rest and activity modification. Cut back on whatever movement triggers the pain.
2. Ice. Short applications to the outer elbow help with acute inflammation.
3. Physiotherapy. Eccentric strengthening exercises for the forearm extensors do most of the heavy lifting in recovery.
4. Counterforce brace. A strap below the elbow reduces load on the tendon during activity.
5. Anti-inflammatory medication. NSAIDs like ibuprofen help with short-term pain.
6. Corticosteroid injections. Useful for temporary relief, though they don’t necessarily improve long-term outcomes.
7. PRP therapy. Platelet-rich plasma injections show up in persistent cases to help the tendon heal.
8. Surgery. A last resort, considered only after months of conservative treatment haven’t worked.

Prevention in Tennis Players

• Hit the backhand with a stable wrist, not a flicked forearm.
• Use a grip size that fits your hand; too small forces the forearm muscles to work harder.
• Try lower string tension to cut down on shock transmission.
• Build forearm strength gradually, and don’t skip the warm-up.
• Ramp up playing volume slowly instead of jumping straight into heavy hitting.

Tennis Elbow vs. Golfer’s Elbow

The two get confused often enough that it’s worth laying out side by side:

Condition	Affected Side	Tendons Involved
Tennis elbow (lateral epicondylitis)	Outside of elbow	Wrist extensor tendons
Golfer’s elbow (medial epicondylitis)	Inside of elbow	Wrist flexor tendons

Both come from overusing tendons, just on opposite sides of the elbow and involving different muscle groups.