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Tennis elbow – more than just tennis

Colloquially known as Tennis Elbow – and also referred to as Lateral Epicondylitis, Lateral Epicondylalgia or just plain Lateral Elbow Pain – this condition is not just for tennis players.

For the purpose of this page, we will refer to this condition as Lateral Epicondylalgia.

Lateral Epicondylalgia refers to pain experienced on the outside of the elbow, which can also travel down the forearm towards the wrist.

The muscles which extend the wrist all originate from the bony prominence on the outside of the elbow called the Lateral Epicondyle.

Often Lateral Epicondylalgia is experienced as a result of overloading these muscles and their tendon.

Common activities which overload the forearm include repetitive gripping, lifting, using power tools, sub-optimal keyboard and mouse set up, painting and of course, tennis (particularly backhanded shots).


  • Pain on the outside of your elbow
  • Weakness in your wrist and when gripping
  • Tightness along top/outside of forearm


Activity modification

  • Reducing the activities and movements which will put extra strain on the muscles/tendons

Pain relief

  • Over the counter medication such as Paracetamol
  • Non-Steroidal Anti-Inflammatory Medication (NSAIDs) such as Nurofen, Voltaren etc.
  • Ice

Manual Therapy

  • Massage
  • Mobilisation
  • Dry Needling


  • Taping or bracing


  • Strength
    – Strengthening exercises, in particular Isometric strengthening can be helpful in relieving pain in the elbow
    – Strengthening the muscles of the forearm is an important way to increase the capacity of the elbow
  • Flexibility
    – Stretching exercises can be helpful in reducing pain


  • There is promising evidence that shockwave therapy can reduce pain and improve function in patients with Lateral Epicondylalgia
  • It is safe and low risk


Lateral Epicondylalgia can be notoriously stubborn and unpredictable with regard to prognosis.

Some cases will settle quickly with de-loading and activity modification.

Some cases may be more stubborn, especially if they have been present for a period before seeking treatment.

Initial management should focus on activity modification and symptom relief.

If you are experiencing lateral elbow pain and symptoms persist for more than a few weeks, physiotherapy should be commenced.

A study by Bowen, Dorey and Shapiro (2001) found that 90% of Lateral Epicondylalgia cases resolved within one year.


Bowen, R. E., Dorey, F. J., & Shapiro, M. S. (2001). Efficacy of nonoperative treatment for lateral epicondylitis. American journal of orthopedics (Belle Mead, N.J.)30(8), 642–646.

Vicenzino B. (2003). Lateral epicondylalgia: a musculoskeletal physiotherapy perspective. Manual therapy8(2), 66–79. https://doi.org/10.1016/s1356-689x(02)00157-1