How to Treat Tennis Elbow: Physiotherapy Exercises That Work
Tennis elbow is a common cause of pain around the outside of the elbow. Despite its name, you don't have to play tennis to develop it. Activities involving repetitive gripping, lifting, typing, racquet sports, manual work, or other repeated wrist movements can place stress on the tendons around the elbow.
The good news is that tennis elbow can often be successfully managed with physiotherapy and an appropriate exercise program.
At Physical Edge Physiotherapy in Oakville, Ontario, physiotherapists can assess your elbow pain, identify contributing factors, and develop a rehabilitation program to help you return to your normal activities.
What Is Tennis Elbow?
Tennis elbow, medically known as lateral epicondylalgia, involves pain and sensitivity in the tendons on the outside of the elbow.
These tendons help control movements of your wrist and hand. When they are repeatedly loaded without enough time to adapt, they can become painful and sensitive.
Common symptoms include:
Pain on the outside of the elbow
Pain when gripping or carrying objects
Discomfort when shaking hands
Pain when lifting your wrist or hand
Reduced grip strength
Pain during activities such as tennis, golf, weightlifting, or manual work
You may also notice that certain activities that used to be easy—such as opening a jar or carrying a bag—become uncomfortable.
Does Tennis Elbow Need Rest?
Rest can sometimes help reduce symptoms initially, but complete rest is usually not the long-term solution.
Your tendons need to gradually adapt to the loads placed on them. Once symptoms are under control, progressively strengthening the muscles and tendons around the elbow can help improve your ability to tolerate everyday and sporting activities.
This is one of the reasons physiotherapy exercises for tennis elbow are an important part of treatment.
Physiotherapy Exercises for Tennis Elbow
The best exercises depend on your symptoms and how irritable your elbow is. Your physiotherapist can help determine which exercises are appropriate and how much resistance you should use.
1. Isometric Wrist Extension
Isometric exercises involve contracting a muscle without moving the joint.
For this exercise:
Rest your forearm on a table with your palm facing down.
Use your other hand to provide resistance as you try to lift your wrist upward.
Hold the contraction without allowing your wrist to move.
Relax and repeat.
Isometric exercises can be a useful starting point when movement-based exercises are still uncomfortable.
2. Wrist Extension Strengthening
As your symptoms improve, you can progress to strengthening exercises using a light dumbbell or resistance band.
Rest your forearm on a table with your palm facing down.
Allow your wrist to hang over the edge.
Slowly lift your hand upward.
Lower it back down in a controlled manner.
Repeat for several repetitions.
The goal is to gradually increase the capacity of the muscles and tendons around your elbow.
3. Eccentric Wrist Exercises
Eccentric exercises focus on the lowering portion of a movement.
For example, you can use your opposite hand to help lift your wrist upward and then slowly lower the weight back down using the affected arm.
Slow, controlled loading can be incorporated into a progressive rehabilitation program for tennis elbow.
4. Grip Strengthening
Because tennis elbow can make gripping painful, strengthening your grip may eventually become an important part of rehabilitation.
Exercises might include squeezing a soft ball or using a grip-strengthening device.
However, more isn't always better. If gripping exercises significantly increase your elbow pain, your physiotherapist may modify the resistance, repetitions, or exercise selection.
5. Shoulder and Upper-Body Strengthening
Your elbow doesn't work in isolation.
The shoulder, upper back, and wrist all contribute to how forces are transferred through your arm. Depending on your assessment, your physiotherapist may include exercises targeting your:
Shoulder
Rotator cuff
Upper back
Forearm
Wrist
Improving strength throughout the upper limb can help you better tolerate the activities that are contributing to your symptoms.
How Can Physiotherapy Help Tennis Elbow?
Exercises are only one part of physiotherapy treatment.
Your physiotherapist can help determine why your elbow is hurting in the first place and identify activities that may be contributing to your symptoms.
Treatment may include:
Strengthening exercises
Mobility exercises
Manual therapy
Activity modification
Education about tendon loading
Gradual return to sport or work
Ergonomic recommendations
Sport-specific rehabilitation
For athletes, treatment can also focus on technique and gradually rebuilding the capacity needed for activities such as tennis, golf, weightlifting, or other racquet sports.
How Long Does Tennis Elbow Take to Heal?
Recovery time varies considerably between individuals.
Some people improve relatively quickly, while others experience symptoms for several months. Factors such as how long you've had symptoms, the amount of stress placed on the elbow, your strength, and how consistently you complete your rehabilitation can all influence recovery.
Rather than completely avoiding activity, your physiotherapist can help you determine how much activity your elbow can tolerate and how to gradually increase that amount.
Should You Push Through the Pain?
Not necessarily.
Some mild discomfort during rehabilitation may be acceptable, but significant or worsening pain isn't something you should simply push through.
A physiotherapist can help you determine an appropriate level of loading and modify your exercises based on how your symptoms respond.
The goal is to progressively challenge the tendon without repeatedly aggravating it.
When Should You See a Physiotherapist?
Consider getting your elbow assessed if:
Your pain has lasted for several weeks
Your symptoms are interfering with work or sport
You have difficulty gripping or lifting
Your elbow pain keeps returning
You aren't sure what is causing your symptoms
Exercises you've tried haven't helped
An assessment can help determine whether your symptoms are consistent with tennis elbow or whether another condition may be contributing to your pain.
Get Back to the Activities You Enjoy
Tennis elbow doesn't have to mean giving up the activities you enjoy. With the right combination of education, activity modification, and progressive strengthening, physiotherapy can help you build your elbow's ability to tolerate the demands of everyday life, work, and sport.
At Physical Edge Physiotherapy in Oakville, Ontario, our physiotherapists can assess your elbow and create an individualized treatment plan based on your symptoms and goals.
If elbow pain is keeping you from doing what you enjoy, book a physiotherapy assessment to find out how we can help.
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