What is Tennis Elbow Injury, Causes, and Treatment?

Tennis elbow is a condition characterized by pain on the lateral/outer side of the elbow which radiates downwards to the muscles of forearm due to inflammation of the muscles or their tendons around the elbow joint. Also known as Lateral epicondylitis in medical terms. Unlike the name suggests a lot of sports players other than those who play tennis also suffer from tennis elbow, Sachin Tendulkar being the best example. But in India women especial those y involved in household chores are largely affected. This is generally due a repetitive movement at the elbow joint subjecting the surrounding structures to stress.

The most commonly affected muscle is EXTENSOR CARPI RADIALIS BREVIS (ECRB). The extensor carpi radialis brevis (ECRB) muscle helps stabilize the wrist when the elbow is straight.

What causes Tennis elbow ?

  1. Overuse of the muscles. This occurs in activities like:
  2. winning-of-cloths winning-of-cloths winning-of-cloths
  3. Trauma: Direct hit on the lateral side of the elbow joint by any object.


  1. Pain at the outer side of elbow (sharp shooting)
  2. Pain during movements which include:
    • - Extension of forearm
    • - squeezing of an object
    • - gripping onto something
    • - weightlifting
    • - Typing
  3. Radiation of pain may be to the upper or lower arm
  4. Tenderness over the lateral aspect

Associated factors

  1. Age does not play a vital role when it comes to affection by this condition.
  2. Gender: It is equally found in both male and females.
  3. Sports player associated with activities majorly involving hand movements/ strokes (tennis, badminton, and cricket) are more prone to acquire this than those which do not involve much hand movements (football, swimming)

Goals of treatment:

  1. Relieving the pain
  2. Reducing inflammation
  3. Improving the strength of the muscles
  4. Improving stability of the elbow along with adjacent joints (shoulder wrist).
  5. Make patient aware of the ergonomic changes as and when required.

Physiotherapeutic treatment approach:

  1. Icing:
    • – Thrice a day by placing the pack on the elbow for at least 5-10 mins
    • - massage the ice in circular motion over the painful area for 3-5 mins.
  2. Stretching – Forearm extensor stretch
  3. winning-of-cloths
  4. Thermotherapy:
  5. Ultrasound given over the affected area for at least for 5-8 mins help facilitate the healing process by improving the blood flow in that area.

  6. Exercises –once pain has been reduced strengthening and gaining eccentric control is the part of rehab.
  7. The exercises included in rehab are:

    • - Eccentric wrist extensor strengthening
    • - Isometric wrist extensor strengthening
    Fig: Eccentric exercises using flexible rubber bar
  8. PNF facilitation techniques are then used to improve the functional activities of the individual.
  9. Myofacial release: releasing the muscles or tigger points of the arm or forearm also help relieve pain.
    • - IASTM- use of an instrument to release the muscles combined with movements is a technique that gives better result and relief.
  10. Chiropractic treatment: Spinal manipulation along with other joints help keep the overall alignment of the body healthy and gives patients an relaxing effect which further facilitates the treatment process at the OsteoRehab clinic.