Do you experience sharp or aching pain on the outer part of your elbow, especially when gripping, lifting, or performing repetitive wrist movements? Does your elbow feel weak when shaking hands or holding objects? If so, you may be dealing with Tennis Elbow, or Lateral Epicondylitis—a common condition not just among tennis players but also manual workers, office employees, and anyone performing repetitive hand and wrist activities.
At Adaptive Physiotherapy & Massage in Booragoon, we specialize in evidence-based rehabilitation to ensure pain relief, tendon healing, and long-term resilience. This guide will take you through everything you need to know about Tennis Elbow, its treatment, and how to prevent recurrence.
What is Tennis Elbow?
Tennis Elbow is an overuse injury affecting the tendons of the forearm extensors, particularly the Extensor Carpi Radialis Brevis (ECRB) tendon, which is responsible for wrist extension and stability during gripping tasks. Over time, repetitive microtrauma leads to degeneration of the tendon fibers, resulting in pain, weakness, and reduced function.
Common Causes of Tennis Elbow
🔹 Repetitive wrist and forearm use (e.g., tennis, golf, weightlifting, typing, carpentry).
🔹 Poor grip mechanics and excessive strain on the ECRB tendon.
🔹 Inadequate forearm strength and flexibility, making tendons more prone to overload.
🔹 Age-related tendon degeneration, particularly in individuals aged 35-55.
Symptoms of Tennis Elbow
✅ Pain and tenderness on the outer elbow, aggravated by gripping or wrist extension movements.
✅ Weakness in hand grip, making it difficult to hold objects or shake hands.
✅ Pain that worsens with repetitive activities, such as typing, racket sports, or manual labor.
✅ Stiffness and reduced range of motion in the elbow and forearm.
At Adaptive Physiotherapy & Massage in Booragoon, we assess movement mechanics, strength deficits, and tendon health to create an individualized rehabilitation plan that restores function and prevents recurrence.
A Carpenter’s Struggle with Tennis Elbow
Michael, a 42-year-old carpenter, began experiencing persistent elbow pain after years of using power tools and repetitive hammering. Initially, he ignored the discomfort, assuming it would resolve on its own. However, over time, his grip weakened, and even simple tasks like holding a coffee cup or shaking hands became painful.
Frustrated with the ongoing pain, Michael visited Adaptive Physiotherapy & Massage. After a detailed assessment, we identified overuse of the forearm extensors as the primary cause of his Tennis Elbow. His rehab plan included:
✔ Manual therapy & soft tissue release to reduce muscle tightness.
✔ Isometric loading exercises to relieve pain and promote tendon healing.
✔ Progressive strengthening program focusing on grip endurance.
✔ Modifications to his tool-handling techniques to reduce excessive strain.
Within six weeks, Michael noticed significant pain reduction. By twelve weeks, he had regained full grip strength and was pain-free at work, proving that structured rehabilitation is the key to recovery.
Tennis Elbow Self-Test: Do You Have It?
Try this quick self-test to see if you may have Tennis Elbow:
1️⃣ Extend your affected arm in front of you, palm facing down.
2️⃣ Use your opposite hand to press down on the back of your affected hand.
3️⃣ Resist the downward pressure and try to lift your wrist up.
✅ If this causes sharp pain on the outer elbow, you likely have Tennis Elbow.
📌 If symptoms persist, seek a professional physiotherapy assessment for accurate diagnosis.
Evidence-Based Treatment for Tennis Elbow
Management of tennis elbow focuses on reducing pain, restoring tendon function, and preventing re-injury.
1. Initial Pain Management & Load Modification
In the early stages, treatment aims to minimize pain and modify aggravating activities.
- Activity Modification:
- Reduce repetitive gripping, wrist extension, and forceful lifting.
- Modify sports or work-related tasks to minimize tendon strain.
- Pain Reduction Strategies:
- Ice therapy (acute phase) to control inflammation and pain.
- Soft tissue release for forearm muscles to reduce tension on the ECRB tendon.
- Taping or bracing (counterforce brace) to offload the tendon and provide relief.
2. Manual Therapy: Reducing Forearm Tension & Improving Mobility
Manual therapy plays an important role in reducing muscle tightness, improving joint mobility, and facilitating tendon healing.
Soft Tissue Release & Myofascial Techniques
- Targeted forearm muscle release (reduces excessive tension in the extensor muscles).
- Cross-fiber friction massage on the ECRB tendon (promotes tendon healing and collagen remodeling).
- Dry needling or trigger point therapy (helps relieve deep-seated muscle tightness and irritation).
Joint Mobilization & Neural Glides
- Radial head mobilization (improves elbow joint mechanics and reduces excessive tendon loading).
- Nerve mobilization techniques (neural glides) (help alleviate nerve irritation contributing to pain).
Grip Strength Re-Education
- Optimizing wrist and hand positioning (reduces strain on the forearm extensors during daily tasks).
At Adaptive Physiotherapy & Massage in Booragoon, we integrate manual therapy with movement-based rehabilitation, ensuring tendon recovery is both effective and long-lasting.
3. Exercise Rehabilitation: Strengthening the Tendon for Long-Term Recovery
Structured exercise therapy is the gold standard for tendon healing, strengthening, and resilience.
Phase 1: Isometric Loading for Pain Relief
✅ Wrist Extensor Isometrics – Holding a light resistance band in wrist extension for 30 seconds.
✅ Grip Strength Isometrics – Squeezing a soft ball or towel without excessive movement.
✅ Radial Deviation Holds – Training forearm stabilizers to offload the ECRB tendon.
Phase 2: Eccentric Loading for Tendon Repair
✅ Slow Eccentric Wrist Extensions – Strengthens the extensor tendons.
✅ Resisted Finger Extensions – Builds fine motor control and tendon endurance.
✅ Tyler Twist Exercise (Flexbar) – Highly effective for reducing lateral epicondylalgia symptoms.
Phase 3: Functional Strength & Load Tolerance
✅ Progressive Grip Strength Training – Using hand grippers to restore forearm endurance.
✅ Kettlebell Carries (Farmer’s Walks) – Improves wrist and elbow stability under load.
✅ Sport-Specific Drills & Plyometric Training – For athletes returning to high-impact sports.
At Adaptive Physiotherapy & Massage in Booragoon, we customize exercise progressions based on individual pain levels, strength deficits, and daily activity demands.
Long-Term Recovery & Prevention Strategies
Once symptoms improve, rehabilitation transitions toward long-term tendon resilience and injury prevention.
Key Strategies for Long-Term Recovery:
✅ Gradual reintroduction of gripping & wrist extension movements.
✅ Forearm & shoulder strengthening to support tendon function.
✅ Regular mobility work to prevent stiffness & strain recurrence.
At Adaptive Physiotherapy & Massage in Booragoon, we ensure rehabilitation strategies are sustainable, allowing you to return to pain-free daily activities, work, and sports.
Conclusion: Take Control of Your Recovery
Tennis Elbow can be frustrating and persistent, but with structured rehabilitation, strength training, and tendon load management, most individuals experience full recovery.
At Adaptive Physiotherapy & Massage, we take a scientific and individualized approach to help you reduce pain, restore function, and prevent recurrence.
If you’re dealing with chronic elbow pain or reduced grip strength, contact us today for a comprehensive rehabilitation plan that gets you back to full function—pain-free. 🚀
References
- Coombes, B. K., et al. (2015). “Efficacy and safety of conservative treatment options for tennis elbow: Systematic review and network meta-analysis.” British Journal of Sports Medicine, 49(5), 297-305.
- Cullinane, F. L., et al. (2014). “Exercise-based therapy for lateral epicondylitis: A systematic review and meta-analysis.” Journal of Orthopaedic & Sports Physical Therapy, 44(11), 768-780.
- Nirschl, R. P., & Ashman, E. S. (2003). “Elbow tendinopathy: Tennis elbow.” Clinical Sports Medicine, 22(4), 813-836.
- Stasinopoulos, D., & Johnson, M. I. (2005). “Effectiveness of eccentric exercise for the management of tendinopathy: A systematic review.” Clinical Rehabilitation, 19(3), 254-272.
- Malliaras, P., et al. (2013). “Tendon adaptation and response to loading: Clinical implications for rehabilitation.” British Journal of Sports Medicine, 47(5), 262-268.
