Tennis Elbow (Lateral Epicondylitis)

Tennis elbow affects the tendons that connect muscles in the forearm to the lateral epicondyle, or the bony knob on the outer side of the elbow. It is named for and commonly caused by the  force of the tennis racket hitting balls in the backhand position.

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To schedule an appointment, please call the UC Health Sports Medicine & Concussion team at 513-475-8690.


Understanding Tennis Elbow (Lateral Epicondylitis)

Tendons are strong bands of tissue that connect muscles to bones. Lateral epicondylitis affects the tendons that connect muscles in the forearm to the lateral epicondyle. This is the bony knob on the outer side of the elbow. The condition occurs if the extensor tendons of the wrist become painful and swollen (irritated). This can cause pain in the elbow, forearm, and wrist. Because the condition is sometimes caused by playing tennis, it's also known as “tennis elbow.”

What causes tennis elbow?

Tennis elbow (Lateral Epicondylitis), as the name implies, is often caused by the force of the tennis racket hitting balls in the backhand position. Your forearm muscles, which attach to the outside of your elbow, may become sore from excessive strain. When making a backhand stroke in tennis, the tendons that roll over the end of our elbow can become damaged. Tennis elbow may be caused by:

  • Improper backhand stroke.

  • Weak shoulder and wrist muscles.

  • Using a tennis racket that is too tightly strung or too short.

  • Other racquet sports, like racquetball or squash.

  • Hitting the ball off center on the racket, or hitting heavy, wet balls.

However, many people who suffer from tennis elbow do not play tennis. The problem can also be caused by overuse or any repetitive movement. This can be from any activity that repeatedly puts stress on the forearm extensor muscles or tendons and wrist. Wear and tear of the tendons from aging or an injury to the tendons can also cause the condition. Other causes of tennis elbow include:

  • Lifting weights.

  • Typing.

  • Painting with a brush or roller.

  • Working a chainsaw.

  • Frequent use of other hand tools on a regular basis.

  • Using repeated hand motions in various types of work, such as butchers, musicians, dentists, and carpenters.

What are the symptoms of tennis elbow?

The following are the most common symptoms of tennis elbow. However, you may experience symptoms differently.

At first, you may have pain, burning, or an ache along the outside of your forearm and elbow. With time, the pain gets worse. If you continue the activity that caused your condition, the pain may spread down to your wrist, even at rest. Pain may also persist when you place your arm and hand palm-down on a table, and then try to raise your hand against resistance. You may also feel pain when you try to lift and grip small objects, such as a coffee cup. A weak grip is another symptom of tennis elbow.

The symptoms of tennis elbow may look like other medical problems or conditions. Always see your healthcare provider for a diagnosis.

How is tennis elbow diagnosed?

Your healthcare provider can usually diagnosis your tennis elbow with a physical exam. In some cases, you may have certain tests, such as:

  • An X-ray to look at the bones of your elbow to see if you have arthritis in your elbow.

  • MRI can show your tendons and the amount of damage. An MRI of your neck can show if arthritis is in your neck, or disk problems in your spine are causing your arm pain.

  • Electromyography (EMG) of your elbow may show if you have any nerve problems that may be causing your pain.

Treatment for Tennis Elbow

Treatments may include:

  • Resting the elbow, forearm, and wrist. You’ll need to avoid movements that can make your symptoms worse. You also may need to avoid certain sports and types of work for a time. This helps relieve symptoms and prevent further damage to the tendons.

  • Changing the action that caused the problem. For instance, if the tendons were damaged from playing tennis, it may help to change your playing technique or use different equipment. This helps prevent further damage to the tendons.

  • Using cold packs. Putting an ice pack on the injured area can help reduce pain and swelling.

  • Taking pain medicines. Taking prescription or over-the-counter pain medicines may help reduce pain and swelling.  

  • Wearing a brace. This helps reduce strain on the muscles and tendons in the forearm, which may relieve symptoms. It's very important to wear the brace properly.

  • Doing exercises and physical therapy. These help improve strength and range of motion in the elbow, forearm, and wrist.

  • Getting shots of medicine into the injured area. These may help relieve symptoms for a time.

  • Having surgery. This may be an option if other treatments fail to relieve symptoms. In many cases, the surgeon removes the damaged tissue.

What can I do to prevent tennis elbow?

  • Keep your arms flexible and strong.

  • Stay away from repetitive movements.

  • Warm up before exercising or using your arms for sports or other repetitive movements.

  • If you play a racquet sport, make sure your equipment is right for you

If the tendons involved don’t heal properly, symptoms may return or get worse. To help prevent this, follow your treatment plan provided from your physician.

When should I call my healthcare provider?

Call your healthcare provider if you have any of the following:

  • Pain or trouble moving affects your daily activities.

  • Pain doesn’t get better or it gets worse with treatment.

  • You see a bulge or lump on your arm.

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