Tennis Elbow: What is it and what can be done?

Tennis elbow: what is it?

The technical name for tennis elbow is lateral epicondylitis. It presents as pain on the outside of the elbow and commonly occurs as a result of an overuse or a repetitive motion involving the muscles that extend the wrist joint, mainly the extensor carpi radialis brevis muscle. This muscle attaches onto the boney prominence on the outside of the elbow and could be a result of carrying heavy shopping bags, various manual jobs, including plumbing, or even repetitive movements while playing sports (1, 2).

Tiny micro-tears form at the origin of the extensor carpi radialis brevis muscle and this causes fibrosis and granulation tissue to form. In the early stages of this injury, inflammation can occur around this site, which can lead to the skin over the elbow region. This area can then become hot but this can reduce if the duration of the injury increases (1, 2).

Exercises to help tennis elbow

Tennis elbow injuries respond to a combination of both eccentric and static exercises (3).

Eccentric exercises involve lengthening the shortened muscles; these exercises stimulate the mechanoreceptors to strengthen the tenocytes (or tendon cells) and the collagen cells (4, 5, 6, 7).

Static stretching exercises involve passively stretching a muscle/tendon to its maximum stretched position and holding it there (3, 4, 8).

Any exercises given will be specifically tailored to an individual’s needs, depending on their presentation of tennis elbow.

Osteopaths may also suggest a combination of hot and cold hydrotherapy over the elbow to help reduce tissue inflammation. This will also temporarily increase the local blood supply to the area. This is helpful while assessing the mechanics of the elbow and its surrounding joints, and using deep tissue techniques to restore normal functioning of the surrounding tissues.


  1. Finestone, HM. and Rabinovitch, DL.(2008) Tennis elbow no more: Practical eccentric and concentric exercises to heal the pain, Canadian Family Physician, Le Médecin de famille canadie, vol. 54.
  2. Stasinopoulos, D., Stasinopoulou, K. and Johnson, MI. (2005) An exercise programme for the management of lateral elbow tendinopathy, Br J Sports Med,. 39:944–947.


  1. Taylor, C., Dalton, D., Seaber, V., et al. (1990) Viscoelastic properties of muscle-tendon units: the biomechanical effects of stretching, Am J Sports Med., 18:300–9.


  1. Khan, K., Cook, J., Taunton, J., et al. (2000) Overuse tendinosis, not tendinitis: a new paradigm for a difficult clinical problem, Phys SportsMed., 28:38–48.


  1. Khan, KM., Cook, JL., Kannus, P., et al. (2002) Time to abandon the ‘tendonitis’ myth, BMJ, 324:626–7.


  1. Ohberg, L., Lorentzon, R., Alfredson, H. (2004) Eccentric training in patients with Achilles tendinosis: normalized tendon structure and decreased thickness at follow up, Br J Sports Med., 38:8–11.


  1. Selvier, T., Wilson, J. (2000) Methods utilized in treating lateral epicondylitis, Phys Ther Rev., 5:117–24.


  1. Hawary, R., Stanish, W., Curwin, S. (1997) Rehabilitation of tendon injuries in sport, Sports Med., 24:347–58.


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