The term Tennis Elbow is about as contentious as discussing the cause of Tennis Elbow, within the physio field. Perhaps originally, the term was coined because no one else labelled it, and it was quite common in the days of heavy wooden tennis racquets. Nowadays, the condition occurs more in people who have never picked up a racquet, than those who have, and we technically call it Lateral Epicondylitis.

In my own opinion, Tennis Elbow occurs because of some dysfunction in the forearm and shoulder, and possibly some troubles occurring in the neck. That is a pretty broad description of the cause, but that’s because what we know now, is that the cause is pretty broad, and pinning down a specific reason is most likely inaccurate and lazy on the part of the treating professional.

The arm is a very mobile limb, and with that mobility comes the need for really good stability and control, which will allow you to use the arm in all sorts of manner, efficiently and successfully. Sadly, a lot of humans don’t have enough control over the shoulder for the things they want to do, which means they recruit more support from areas that don’t encourage efficiency. Like anything, if it’s not efficient, there’s a good chance it will break down, and Tennis Elbow is just one way the chain can break down.

The muscles that bend your wrist backwards run from your fingers and wrist, along the back of the forearm to the outside of your elbow. These are the ones that get upset when you have Tennis Elbow. They are often expected to do more than they can – go back to what was said above, something in the shoulder or the neck isn’t not functioning properly, so these muscles are compensating. When they are overused, they pull hard on their connection to the elbow and this creates irritation, leading to pain (in basic terms).

So our job as Physiotherapists is

  1. Reduce your pain.
  2. Work out where in the chain the problem is beginning.
  3. Work out where in the chain is being affected by the problem.
  4. Solve the problem.

This will mean for you

  1. You should see a professional. This professional should probably be a Physio, a Sports Doctor, or an Osteopath.
  2. You’ll need a thorough assessment of the movement and strength in your elbow, wrist and hand.
  3. We’ll also be looking at your shoulder movement and strength, particularly in the actions where you feel pain, as well as looking at your neck and its function. NB - If your chosen professional does not look at your neck and shoulder movement, as well as your grip and elbow movement, see another professional (until you find one that does).
  4. Then we’ll be educating you about the problem, how we think it started, and how we plan to get rid of this together.


Treatment could involve a whole host of things because you need to be addressing several areas that all function differently. Be ready for any of the following:

  1. Wrist and grip strength – at home.
  2. Wrist and finger stretching – at home.
  3. Shoulder strengthening and control in lots of different positions – at home
  4. Neck stretches – at home.
  5. Neck and shoulder strengthening together- at home.
  6. Manual therapy to your elbow, shoulder and/or neck to help improve movement, modulate pain, and give reassurance.
  7. Advice on cold therapy.
  8. Maybe a few needles.
  9. Maybe even trialling some tape or a brace.

At the end of the day, what we used to think was simple Tennis Elbow which only needed rest and a rub, is now understood much better and managed much better. The one guarantee I’ll give you is – You will have to work at this to get it better and keep it away, so put the effort in!

Are you suffering from tennis elbow? Please feel free to contact us to make a booking here.