Tennis Elbow

Tennis Elbow

Oh no……that dreaded elbow niggle again. It’s there when you grip your racket, when you open a jar, when you shake someone’s hand…..and it won’t go away. Is this tennis elbow? And you have a singles game tonight…..should you just play and hope for the best?

Tennis elbow is a degenerative tendon injury, on the outside of the elbow. This tendon has a poor blood supply and is prone to the effects of excessive use which leads to tiny tears and scarring. These tiny tears will become larger, more painful tears if you ignore the symptoms and try to keep playing. The type of tissue that forms the scar has lots of nerve endings in it, which explains why tennis elbow is so painful.

Tennis elbow can come on in two ways:
1. Acutely when playing tennis; you hit a hard backhand when you haven’t positioned yourself right and your forearms take the brunt of the shot. Immediate pain, impossible to ignore.
2. Gradual onset is more common; Usually you start to notice it over a few weeks and it gets more painful even when you try to cut back on playing. Now that you think about it, you did spend a whole weekend putting up shelves with that old heavy screwdriver and you cut the hedges all around the garden (classic mechanism of injury)…

So what should you do?
Elbow pain will not go away on its own. Come and see us as soon as you can. The longer you try to keep playing, the more tiny (and by now larger) tears and subsequent scarring will develop. Your elbow will get more and more painful and you will notice your arm weakening doing normal daily tasks.

Why Physio?
We will assess your neck, general posture and the range of motion of your shoulder, elbow and wrist. There will be strength testing and stretching of the nerves in your arm to confirm exactly why you have developed this pain. There are some classic tests to confirm if you have tennis elbow (it could be something else too, see below) so you will have a diagnosis during your first session. We will design a treatment and rehab plan with you.

These are the risk factors for developing tennis elbow:

  • Aged over 30 years old, usually in 40s-50s
  • Repetitive wrist extension against resistance, such as occurs playing tennis, squash and badminton
  • Unaccustomed activity involving repeated wrist extension such as carpentry, hedge cutting, using a screwdriver and even knitting
  • Wrong grip size leads to over gripping of the racket
  • More than 2 hours per day playing tennis
  • Tight strings
  • Incorrect backhand technique including snapping wrist
  • Hitting wet tennis balls and hitting into a strong wind


What else could this elbow pain be?

  • A trapped nerve in the muscles around the elbow
  • Injury in the elbow joint itself, such as a ligament sprain
  • Nerve root injury from your neck, referring pain into the elbow
  • The result of muscle imbalance or postural problems around the neck or in the shoulder with the elbow compensating


Verdict on tennis elbow:
You must see a Chartered Physiotherapist if you have elbow pain. It will not go away on its own. Please call us on 01 213 7000 or email if you think you have tennis elbow and we can discuss the best options for you.