Understanding Tennis Elbow

You’ve probably heard the words “tennis elbow,” the common phrase for that pesky pain on the outside of the elbow commonly found in – you guessed it – tennis players. However, tennis elbow isn’t exclusive to athletes; it can affect anyone who engages in repetitive arm movements. So, what exactly causes this condition, and how can you manage it effectively?


Let’s get nerdy for a moment. Your elbow joint is made up of a number of anatomical structures. There are the bones – humerus (upper arm), radius (thumb side of forearm), and ulna (pinky side of forearm). There are numerous muscles, but the ones that are related to tennis elbow include the wrist extensor muscles (the top of your forearm) and specifically one called extensor carpi radialis brevis. We know- it’s a lot. The final important structure is the bony landmark called the lateral epicondyle. The lateral epicondyle is that bumpy protrusion on the outside of your elbow. 

In medical terms, “tennis elbow” is referred to as lateral epicondylitis, which means inflammation in the lateral epicondyle. This condition typically arises from overuse, often due to repetitive actions involving the wrist extensor muscles.

Picture this: when you extend your arm straight in front of you with your palm facing up, the wrist extensors facilitate the movement of your hand towards the floor. Even though this motion may not seem common in everyday activities, the wrist extensors also resist movements in the opposite direction. For instance, if you were to hold a heavy bag with your arm extended and your palm facing down, your wrist extensors would be engaged in maintaining the position of your wrist.

These wrist extensor muscles are attached to the lateral epicondyle via tendons. Consequently, any strain placed on these muscles translates into stress on the elbow and its associated tendons. In tennis elbow, this excessive stress leads to collagen breakdown in the tendon, resulting in pain and inflammation at the attachment site, namely the lateral epicondyle.


Common symptoms of tennis elbow include:

  • Pain and tenderness on the outer side of the elbow, near the lateral epicondyle
  • Discomfort when gripping objects or performing activities that involve wrist movement
  • Weakness in grip strength
  • Stiffness and limited range of motion in the affected arm

While the name suggests a prevalence among tennis players and other racket sports enthusiasts, individuals in various professions involving repetitive hand and wrist movements are also at risk. These may include electricians, painters, musicians, chefs, massage therapists, and even those who spend prolonged hours working on computers.


Tennis elbow can often be diagnosed through simple hands-on orthopedic assessments and palpation. Signs that may indicate tennis elbow include:

  • Tenderness at the site where the wrist extensor tendons attach to the lateral epicondyle
  • Pain experienced during resisted wrist extension
  • The Tennis Elbow Test, which combines these assessments

In cases where the diagnosis is less straightforward, medical imaging may be recommended to rule out other potential causes of elbow pain, such as arthritis or nerve compression. Manual therapists may also explore alternative causes, including trigger points, nerve compression, and ligament damage.

At Life Moves MT, our practitioners are trained in the orthopedic assessments used to identify tennis elbow. Please remember that while Licensed Massage Therapists (LMTs) may use these results to inform their treatment plan and recommendations, or to communicate findings to the Chiropractor, LMTs cannot legally provide a diagnosis to you, the client.


Managing tennis elbow often involves a multifaceted approach aimed at reducing pain and inflammation while promoting healing. Some effective treatment strategies include:

  • Rest: Giving the affected arm adequate rest to allow the injured tendons to heal. Remember, once the joint and surrounding tissues are “angry” (inflamed), they will respond more sensitively to all activity. Think of this as a “cooling off” period.
  • Ice and Heat Therapy: Applying ice packs to reduce inflammation followed by heat therapy to improve blood flow and promote healing.
  • Orthotic Devices: Using splints or braces to provide support and alignment to the elbow during activities.
  • Massage Therapy: Clinical massage can help to ease discomfort and increase circulation (good for healing) as well as address other imbalances developing due to compensations from discomfort.
  • Chiropractic Adjustment: Healthy joint alignment is key in supporting proper body mechanics during and after healing. 
  • Stretching and Strengthening Exercises: Incorporating gentle stretching and strengthening exercises to improve flexibility and muscle endurance while avoiding exacerbating symptoms.
  • Anti-inflammatory Medications: Over-the-counter or prescription medications may be recommended to alleviate pain and inflammation.
  • Frequency-Specific Microcurrent: Microcurrent can help alleviate inflammation in the affected tissues and promote increased ATP production to help speed up recovery. 
  • Physical Therapy: Working with a physical therapist to develop a customized rehabilitation program focusing on strengthening the muscles around the elbow joint and improving range of motion can support near term relief and long term prevention.
  • Kinesiology Taping (K-Taping): K-tape applications can provide additional support and help support healthier neuromuscular engagement.
  • Ergonomic Modifications: Making adjustments to workstations or equipment to minimize repetitive stress on the elbow joint.

In cases where conservative treatments fail to provide relief, or if there are underlying structural issues contributing to tennis elbow, more advanced interventions such as corticosteroid injections, PRP injections, or surgical procedures may be considered.

Research indicates that ignoring or delaying treatment for inflammatory conditions like tennis elbow can accelerate joint degeneration. Hence, it’s crucial to address these issues promptly.


In the long term, preventing overuse injuries like tennis elbow involves proactive measures. Remember, overuse injuries are often indicative of underpreparedness, so investing time in conditioning your body for specific movements is essential for maintaining optimal musculoskeletal health. Some preventive measures include:

  • Using proper technique and equipment during sports and activities to minimize stress on the elbow joint. Even though proper technique can be problematic when repeated over and over again, improper technique or body mechanics will become much more problematic with far fewer reps. Re-evaluate and check in with a professional to see if you’re doing everything you can to support your body. 
  • Incorporating regular strength and flexibility exercises to maintain optimal muscle balance and joint stability. Whether your repetitive activity comes from a favorite hobby or your job (or both!), at LMMT we like to say “train for your life.” Cross training outside of your work activities or favorite hobby plays a vital role in maintaining balance in a healthy (and prepared) joint.
  • Taking frequent breaks during repetitive tasks to prevent overuse injuries. “Sleep is for the weak” is something people who get injured say. “Pushing through” is not how you get stronger or better. Instead, proper recovery allows your body to grow and strengthen from all your training efforts. Taking breaks and getting adequate rest (especially on training days) is a sign of respect for your body and joints, and leads to improved abilities in the long-run.

Gradually increasing the intensity and duration of physical activities to allow the body to adapt and avoid sudden spikes in stress on the tendons. Ignore that little voice saying how quickly you “should” be increasing your training. That’s your ego talking. Chances are, you need to cut whatever it says in half. History of being an overachiever? Cut it in half again. Increasing activity levels faster than we ought to will only lead to a quick retirement.

Understanding the intricacies of tennis elbow empowers individuals to recognize the symptoms, seek appropriate treatment, and adopt preventive measures to safeguard against recurring injuries. By prioritizing joint health and implementing proactive strategies, you can continue to enjoy your favorite activities with reduced risk of debilitating conditions like tennis elbow. Stay informed, stay active, and prioritize your well-being for a healthier, pain-free lifestyle!