Tennis elbow is a chronic strain and/or inflammation where the extensor muscles of the wrist attach on the outside of the elbow joint. The condition is usually caused by overuse of weak, or inflexible wrist muscles, repetitive stress, improper technique, and/or poor warm-up. The condition most often occurs in beginner players who have poor technique. However, more advanced players who hit a topspin backhand stroke are also susceptible. Also known as “lateral epicondylitis,” tennis elbow affects the lateral side of the elbow while “pitcher’s elbow” or “golfers elbow” affects the medial side of the elbow (or medial epicondylitis).

Signs and Symptoms

• Initial symptoms include dull ache at rest, which may turn into sharp pain during activity.
• Gradual pain during active wrist flexion or extension, although seldom elicited during passive movement.
• Graduatl pain typically with backhand strokes in racquet sports (pain may radiate down arm).
• Inability to lift objects with injured arm.
• Occasionally a direct blow to the lateral elbow may start inflammation of the soft tissues.
• Possible swelling over the outside of the elbow.
• Point tenderness on the outside of the elbow.

On-Site Management

P.R.I.C.E. PROTECT the area from further injury (i.e. elbow strap). ICE massage after activity is useful for reducing inflammation and pain. COMPRESS the area to move inflammation away. ELEVATE the area to increase circulation towards the heart.

Referral. A Physician should be seen to confirm the injury and to prescribe anti-inflammatory medication as needed.

Active Rehabilitation. A physiotherapist will also be extremely helpful. In addition to various modalities to help reduce inflammation, therapists will often include hand-gripping and wrist extension exercises. The health care practitioner will also counsel you on changing activities to decrease the chances of it happening again.

Return to Activity. Commercially available braces/straps often successfully relieve the pressure at the lateral epicondyle (outside of the elbow).

Prevention. It is important to use a good racquet. Additionally, you should ensure the correct grip size (see picture) and string tension, which should be softer to lessen the impact of repeatedly hitting the ball forcefully.

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