Introduction to Tennis Elbow

Tennis elbow, medically known as lateral epicondylitis, is a condition characterised by pain on the outer part of the elbow, which typically arises from overuse of the forearm muscles and tendons. Despite its name, the condition is not limited to tennis players and can affect anyone who engages in activities that put repetitive stress on the elbow joint.

Understanding the Causes of Tennis Elbow

Tennis elbow develops due to the overuse of the muscles and tendons in the forearm that extend to the wrist and fingers. This repetitive motion can lead to small tears in the tendon attached to the lateral epicondyle that causes pain and tenderness. The main factors contributing to the development of tennis elbow include:

  • Occupational and Recreational Activities: Certain professions and hobbies that involve repetitive arm, elbow, and wrist movements increase the risk of developing tennis elbow.
  • Age: While tennis elbow can occur at any age, it is most prevalent among adults between 30 and 50 years old. The ageing process may contribute to the tendon’s decreased ability to tolerate stress.
  • Lack of Muscle Conditioning: Insufficient strength and flexibility in the forearm muscles can strain the tendons, making them more susceptible to injury.
  • Equipment and Technique: Improper sports equipment, like a tennis racquet that is too heavy or has a grip that is too large, can lead to increased stress on the forearm muscles. Similarly, incorrect technique in sports or activities can contribute to the risk of tennis elbow.

Key Signs and Symptoms of Tennis Elbow

The symptoms of tennis elbow may develop gradually, with mild discomfort worsening over weeks or months. Recognising the signs early can lead to more effective management. Key symptoms include:

Pain and Tenderness

The most common symptom is pain that radiates from the outside of the elbow into the forearm and wrist. Tenderness may be felt over the outer elbow area.


A feeling of stiffness in the elbow, especially in the morning, or when making a fist, is often reported.


Grip strength may decrease, making it difficult to hold onto objects, turn a doorknob, or shake hands.

Numbness or Tingling

Some people may experience a sensation of numbness or tingling that extends into the fingers, usually the ring and little fingers.

Pain with Activities

Pain typically worsens with activities that involve gripping or lifting objects, even something as light as a coffee cup, or when performing repetitive wrist movements.

Diagnosing Tennis Elbow

The diagnosis of tennis elbow primarily involves a medical history review and a physical examination. Advanced imaging tests are not routinely required but may be used to rule out other conditions if the diagnosis is unclear.

Medical History and Physical Examination

Inquiries about the onset of symptoms, any activities that exacerbate the pain, and previous injuries to the arm or elbow may be asked. During the physical exam, pressure may be applied to the affected area, or the arm may be moved in certain ways to assess pain and stiffness.

Imaging Tests

Imaging tests are employed to exclude other causes of elbow pain or to investigate further when the diagnosis is uncertain:

  • X-rays: Can help rule out bone fractures or signs of arthritis.
  • MRI Scans: Offer detailed images of soft tissues, including tendons and muscles, and are helpful if the diagnosis is unclear or treatment hasn’t improved.
  • Ultrasonography: Useful for visualising soft tissue structures; it can show changes in the tendon’s appearance associated with tennis elbow.

When to Seek Medical Advice

Seek medical advice if the pain interferes with daily activities, such as turning a doorknob or gripping objects, or if there is a noticeable decrease in grip strength. Additionally, experiencing severe elbow pain, swelling, or a visible deformity warrants immediate medical attention.

Early intervention can prevent the condition from worsening and facilitate a quicker recovery. Identifying and addressing the issue promptly ensures the best possible outcomes and helps maintain overall arm health.


Tennis elbow is a common condition that results from the overuse of the forearm muscles and tendons, leading to pain and discomfort. While it can significantly impact daily activities, recognising the symptoms early and seeking appropriate medical advice can lead to effective management and recovery.