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What to do with elbow pain...?

What causes lateral elbow pain and how to fix it ?

By: Sasha Guay, FCAMPT, MClSc, Sports Medicine Fellow, MScPT, BScKin, CIDN

Lateral Epicondylitis aka “Tennis Elbow”

What is “tennis elbow”?

How is it possible to develop tennis elbow without playing tennis (or any racquet sports?)

How do I fix it?

These are some of the very common questions we have in the clinic with people complaining of elbow pain. Physiotherapy can help you figure out the cause and eliminate the pain... here's how...

What is “tennis elbow”?

Tennis elbow is the layman term for lateral epicondylitis, which means inflammation of the boney prominence on the outside of your elbow (your lateral epicondyle). The significance of this boney landmark is that it is the “common extensor origin”, which is where many muscles attach, including those that extend your wrist and fingers.


How did I develop it?

This is a very common injury in racquet players and has therefore claimed the name “tennis elbow”. These types of sports result in continued loading of the muscles that attach to this boney site while controlling the racket. Over time and with over-use, these muscles irritate their boney attachment site and cause inflammation (which has given the name of this injury the suffix “-itis”).


If you don’t play any racquet sports, understandably it seems strange to have developed this type of injury. However, prolonged mouse and keyboard use is also a common activity amongst people that develop this irritation. Improper workplace ergonomics and neck and shoulder tension can lend to increased loading of the neck, shoulder and forearm muscles, and overtime, cause enough irritation to inflame the lateral epicondyle.


How do I fix it?

1.      Review your workplace ergonomic set up.

Proper positioning of your body at your work station is paramount to avoiding injuries such as this one, as well as sore necks and backs, headaches, shoulders and more. If you spend 6+ hours a day using these muscles in a position that overloads them, it makes sense that they will develop an over-use type injury over time. 

Focus specifically on your arm/wrist/hand position. Your upper arm should be in line with your torso, hanging straight at your side, with your elbow comfortably resting on the armrest of your chair. Next, you want to make sure that your forearms are parallel to the floor and your wrist is supported in a neutral position. This wrist support is very important; you don’t want to have to rely on the small muscles in your forearm to statically hold your wrist up all day (which can contribute to this injury!). Lastly, make sure that your mouse and keyboard are in reach of this position. Think of this upper body posture as your “home base”.

2. Visit your physiotherapist!


What would a physiotherapist do for me?

Physiotherapists have a number of assessments/tests we can do to diagnose this injury.

We will first talk about the symptoms you have been experiencing, what you do on a daily basis and get a thorough sense of what could have led to this type of pain.

Next, we will review your posture, movements of your neck, shoulder girdle and entire upper extremity muscle strength. We conduct a series of tests that can rule in or out this diagnosis.


The treatment would include exercises designed to strategically load the muscle, stretching, manual hands-on therapy to reduce tension and improve range of motion. We would also advise if you would benefit from the use of a "tennis elbow" brace.


3. What is the brace people wear for tennis elbow?

You may have seen people using a strap around their forearm for elbow pain. The purpose of this strap is to put pressure on the muscles 2-3 inches below the site of irritation. This helps offset the load put through the lateral epicondyle, which allows for healing.

The position of this strap is important. If worn incorrectly, the brace will not be able to support the lateral epicondyle and will not help with the healing process. If you have this strap, bring it in to your physiotherapist to review how to maximize the benefits of this brace for you.

If you are suffering from elbow pain, give us a call and we can help to diagnose the cause and work with you to find a solution.

phone: 905-844-8425

Online booking with Sasha Guay click:



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