What is a ‘Tennis Elbow’ (common extensor tendinopathy)?

A tennis elbow is the name given to pain experienced in the outer aspect of the elbow, usually as a result of overuse.

Although racket sports players can develop a tennis elbow, the vast majority of individuals who develop symptoms do so as a result of prolonged, repetitive activities including warehouse or desk-based work.

Tennis elbow

Common Symptoms

Localised pain is felt directly over the outer elbow which sometimes radiates down the forearm muscle bulk.

Symptoms can be aggravated by any activity which requires repeated use of the wrist or elbow. Common examples may include working at a computer, gripping, lifting or carrying tasks.

How is a Tennis Elbow diagnosed?

Tennis elbow can be reliably diagnosed by your doctor or physiotherapist by taking a history of your condition. In some circumstances it may be necessary to conduct a physical examination but this is usually not necessary.

The main features are tenderness directly over the tendon on the outside part of the elbow. There is also pain directly over the tendon when contracting the forearm muscles against resistance, for example, when gripping.

Scans are not routinely required.

How is a Tennis Elbow treated?

Tennis Elbow can be managed effectively by adhering to the following advice and exercise routine.

Modifying aggravating activities. If there are some particularly stressful tasks such as DIY or racket sports which seem to be aggravating your symptoms, then the common extensor tendon may need 4-6 weeks of relative rest.

Ergonomic adjustments. If the condition has been triggered by repetitive computer work, changes to your overall sitting position to ensure a neutral elbow and wrist position as well as some specialist keyboard and mouse equipment can significantly reduce the stresses placed on the tendon:

Appropriate DSE set up

Exercises. Regular exercises to strengthen the wrist extensor muscles and tendon in the forearm and stretch the flexor muscles:

3×15 repetitions 3-4x per week

5×30 second holds, 2x per day

These are suggested exercises only. If you are at all concerned about whether these exercises are suitable for you or if you experience any pain while doing them, please seek appropriate clinical advice from your GP or Physiotherapist.

Corticosteroid injection therapy. Evidence suggests that if possible, corticosteroid injections are best avoided as the steroid may weaken the tendon in the longer term. However, injections may be discussed with individuals who continue to suffer disabling pain (preventing work and leisure activities) and have failed physiotherapy management. You can read more about local corticosteroid injections here.