How to Prevent and Treat Tennis Elbow: A Complete Guide

Tennis players of all ages and skill levels might find themselves dealing with the infamous “tennis elbow”. Did you know you can even get tennis elbow through other activities completely unrelated to tennis? This type of injury can induce persistent pain for a few weeks, making daily tasks more difficult to accomplish. It can even require surgery followed by a long recovery. Due to the discomfort caused by tennis elbow, it is something you really want to take care to avoid. There are plenty of steps you can take to not only make the recovery process as smooth as possible, but also to prevent this injury altogether.

What Is Tennis Elbow?

“Lateral Epicondylitis” is the medical term for tennis elbow. The injury occurs in the outer forearm area sustained through overuse – the repetitive movements of playing tennis (or other repetitive movements that mimic those of playing tennis, like painting or using certain tools). The repetitive motions in the wrist and elbow can lead to the tendons and muscles in the forearm becoming inflamed. In more serious cases, the tendons can endure microtearing. Don’t confuse tennis elbow with golfer’s elbow, though. Golfer’s elbow affects the tendons and muscles in the inner (or medial) part of the elbow and forearm area, whereas tennis elbow affects those in your outer (or lateral) elbow and forearm area.

Causes of Tennis Elbow

• Playing tennis or other racket sports 
• Using an improper backhand stroke
• Using the wrong racket
• Painting
• Chopping food
• Using certain plumbing or power tools
• Using a computer mouse

As this is an overuse injury, you will most likely not feel any pain if you are only partaking in these activities infrequently. It’s the repetitive motions and strain that lead to inflammation, tenderness, or microtears. Those who go through these arm motions more often (e.g. those who play tennis frequently or who are professional house painters) may require more repetition to sustain tennis elbow since their muscles may be stronger. If you are new to playing a racket sport or partaking in any of the aforementioned activities, you can be more likely to sustain this injury.

Symptoms of Tennis Elbow

• Pain/weakness in the outer forearm, elbow, and/or wrist
• Pain/weakness when extending the forearm
• Pain/weakness when twisting the arm or wrist
• Pain/weakness when gripping objects with the hand
• Swelling
• Redness
• In severe cases, visual bruising and deformity

When you have tennis elbow, you will experience some degree of pain or weakness in or between your elbow and wrist, on the outer side of your forearm. Unfortunately, so many day-to-day activities and general bodily movements can exacerbate that pain. Simple tasks like twisting a doorknob, shaking hands with someone, using a steering wheel, gripping a cup, etc. can flare your tennis elbow pain.

In most cases of tennis elbow, the symptoms of the injury will only be felt, not seen. Although some swelling or redness is not uncommon. However in severe cases, when the tendons have been notably torn, that can lead to skin bruising or visual deformities of the forearm, elbow, or wrist. In such cases, it may hurt to touch the injured area.

What Does Tennis Elbow Feel Like?

• Muscle aches or soreness
• Burning sensation
• Acute, sharp muscle pains

It goes without saying, the severity of the injury will affect the level of pain. In most cases, tennis elbow will feel like a step above the expected muscle soreness you might endure after an intense workout. It just passes over the threshold of normal soreness and into a more painful sensation. This feeling is often coupled with a burning sensation in the area, which is an indicator that it is in fact an injury you’ve sustained, not just general muscle soreness. 

Treatment for Tennis Elbow

• Resting the arm and avoiding movements that aggravate the pain
• Icing to reduce inflammation
• Wrapping the elbow for compression
• Taking anti-inflammatory medications
• Physical therapy
• Corticosteroid injections
• Extracorporeal shock wave therapy
• Surgery

The best way to treat tennis elbow is always to start by eliminating the activities that caused it until you are fully healed. Like any other injury, you want to rest the injury and try to manage the inflammation. Ice is good for tennis elbow because it directly tackles the inflammation your muscles and tendons are enduring, so that can be an incredibly helpful treatment step. Just make sure that you are only icing for 10-20 minutes at a time, and wait a few hours between icing sessions, otherwise it can have adverse effects on your healing. Too much icing can halt the blood flow to the injury, and proper blood flow is necessary for healing. 

Wrapping the elbow can also be a helpful way to encourage healing and alleviate pain. Similar to icing, make sure you aren’t wrapping it too tightly because that can also decrease necessary blood flow. Over-the-counter anti-inflammatory medications such as ibuprofen, aspirin, and naproxen can also be taken when dealing with tennis elbow, as they can help reduce inflammation and pain.

When is it time to see a doctor?

If pain persists even after taking these recovery steps, you should visit your healthcare provider. They may recommend a more serious treatment plan depending on how serious your injury is. A physical exam and run-through of your medical history will likely be performed first to diagnose tennis elbow. They may, however, decide that you need further testing via imaging (X-rays and/or sonograms). Physical therapy with a focus on range of motion may be recommended if they determine that the injury isn’t severe enough to warrant more serious treatments.

Beyond that, it may be recommended for you to get corticosteroid injections at the elbow on a scheduled basis to reduce inflammation and pain, or extracorporeal shock wave therapy may be recommended to promote healing. In severe cases, surgery may be necessary to repair the torn tendons.

Recovering From Tennis Elbow

As previously mentioned, the best thing you can do for your tennis elbow during recovery is to avoid participating in any activities or physical movements that may aggravate it. It is best to keep the arm slightly bent for recovery, so if you are wrapping or icing the arm, keep that in mind. You will want to straighten your arm throughout recovery slowly to avoid aggravating it. The severity of your tennis elbow will inform how long the recovery process will need to be before you are ready to hit the courts again. In minor cases, it may only take a few weeks, but if you had to undergo surgery, the recovery time can be upwards of 6 months. Always listen to your healthcare provider’s advice about how long to wait before playing again.

When you do pick up your racket for the first time again, make a conscious effort to not overdo it. Don’t play for too long, don’t play too hard, use the right racket for you, and pay attention to how your arm is feeling. Stop if the pain resurfaces. You may also want to wrap your elbow ahead of time to better protect your muscles while playing, and it can also be wise to ice your arm afterward, regardless of whether or not you felt any pain.

How to Avoid Tennis Elbow

In General

• Avoid repetitive tasks that cause pain in the outer forearm area
• Work on strengthening your muscles
• Go to physical therapy if necessary
• Rest your arm after performing repetitive tasks that may cause tennis elbow

For Sports

• Use proper technique and choose the right racket 
• Stretch before and after playing
• Ease into playing to allow your muscles to warm up
• Take breaks while playing
• Stop playing if you begin to notice pain

At Work

• Do hand/arm exercises and stretch before doing any tasks that require repetitive motions
• Try to minimize how often you have to do such tasks or find alternative ways to get them done
• Wrap your arm or use a brace to complete your tasks
• Pay attention to how you are feeling and stop when necessary