Tennis Elbow: Symptoms, Exercises and When to See a Physiotherapist

Meta summary: Tennis elbow commonly causes pain around the outside of the elbow, especially with gripping, lifting and repeated wrist movements. Learn what can help, which exercises are commonly used and when to see a physiotherapist.

Pain on the outside of the elbow can make everyday tasks such as lifting a kettle, carrying shopping, using a mouse or gripping gym equipment surprisingly uncomfortable. One common cause is tennis elbow, also known as lateral elbow tendinopathy.

Despite the name, you do not need to play tennis to develop it. It is often associated with repeated or increased loading of the muscles and tendons that help control the wrist and grip.

What does tennis elbow feel like?

Typical symptoms can include pain or tenderness around the outside of the elbow, discomfort extending into the forearm, pain when gripping or lifting, and symptoms during repeated wrist or hand movements. The exact presentation varies, so persistent elbow pain should not automatically be assumed to be tennis elbow.

What causes tennis elbow?

Symptoms often appear when the demands placed on the forearm have increased faster than the tissues have adapted. This can happen with racket sports, gym training, manual work, DIY, gardening or repetitive computer and hand tasks.

What can help tennis elbow?

1. Modify aggravating activities rather than stopping everything

Temporarily reducing the volume or intensity of movements that strongly aggravate the elbow can help settle symptoms. Complete avoidance of arm use is rarely a practical long-term solution.

2. Build forearm strength progressively

Progressive resistance exercise can be used to rebuild the capacity of the wrist extensor muscles and tendon. The appropriate load depends on symptom irritability, strength and the activities you need to return to.

3. Review gripping and training load

If symptoms started after increasing gym work, racket sport or manual activity, consider whether there was a sudden jump in frequency, duration or resistance. A more gradual progression may be better tolerated.

4. Keep the shoulder and upper limb moving

Rehabilitation does not need to focus only on the painful point. Depending on the assessment, exercises may also address the wrist, forearm, shoulder and overall upper-limb capacity.

Should tennis elbow exercises hurt?

Exercise does not always have to be completely pain-free, but symptoms should remain manageable. A large or sustained increase in pain can indicate that the exercise load needs adjusting. This is one reason an individual programme can be more useful than simply copying a generic routine.

How long does tennis elbow take to improve?

Recovery varies considerably. Tendon-related symptoms can take time to settle, particularly when they have been present for months or when the aggravating activity cannot easily be reduced. Consistent progressive rehabilitation is generally more realistic than expecting a single treatment to provide an immediate cure.

When should you seek medical advice?

Arrange an assessment if elbow pain is persistent, worsening or significantly affecting work, sleep or normal activity. Seek more urgent medical advice after significant trauma, if there is obvious deformity or marked swelling, if you cannot move the elbow normally, or if you develop new substantial weakness, persistent numbness, a hot swollen joint or systemic illness.

Can online physiotherapy help with tennis elbow?

Many elements of an elbow assessment can be performed by video consultation. A physiotherapist can discuss how your symptoms began, observe elbow and wrist movement, guide appropriate strength and functional tests, review aggravating tasks and build a personalised rehabilitation programme.

If your symptoms are associated with returning to strength training, you may also find our guide on preventing shoulder pain when restarting strength training useful.

This article provides general information and is not a substitute for an individual medical assessment.