Tennis Elbow / Common Extensor Tendinopathy

Tennis elbow or Lateral Epicondylitis is a common chronic condition of the extensor muscles of the forearm. It is characterised by pain in the region where the wrist extensor muscles originate (pulling the knuckles up). The most common cause of this condition is chronic one-sided overload from a high volume of repeated contraction which stresses the tendon.

Most patients seen with tennis elbow have manual jobs such as electricians, plumbers, gardeners and production operatives which involve repeated heavy lifting, tool use, gripping & pulling actions. Although it is commonly referred to as tennis elbow, the prevalence in tennis athletes is <5% and has been reported with other racket sports, swimming and throwing sports. The highest prevalence is those aged 35-50 with no significant differences between sexes.

Predisposing activities and occupations involving repeated wrist extension expose the elbow tendons to excessive strain which the body cannot adapt to, resulting in poor healing and pain. Despite being referred to as epicondylitis and ‘itis’ pertaining to inflammation, the current evidence suggests that this is only present in the very immediate stages of the condition.

• Pain when palpating the lateral elbow soft tissue

• Radiating pain along the upper arm and down the outside of the forearm

• Reduced movement and wrist strength, specifically extension of the wrist and gripping

• Symptom irritation 24-48 hours following overload

• Morning stiffness and pain which improves with gentle movement

• Sudden increase in activity or changes in technique or equipment

At Pure Physiotherapy, your therapist will take a full history of your condition to identify relevant factors which may raise suspicion of lateral epicondylalgia. Your Physio will then perform a full physical examination to rule out conditions which may be linked to your symptoms or to confirm your diagnosis.

Following your assessment and the confirmation of diagnosis, you will be prescribed some personalised strengthening exercises to help address the underlying structural changes coupled with education and guidance on how to effectively manage your symptoms.

Please find the patient resources section of our website where we have created a series of recommended exercise programmes. To access these, please contact us to obtain the password. We advise consulting with your Physiotherapist prior to trying any of these exercises.

In some instances, your Physiotherapist at Pure may implement taping methods or recommend a brace to help ease your discomfort and offload the affected tendon.