How to recognise and treat Tennis Elbow

When returning back to gardening after the winter many people start to prune / cut back dead or overgrown plant growth using secateurs. Interestingly enough this is one of the main times in the year we can see an increase in Tennis Elbow injuries caused by pruning activities.


Tennis Elbow injuries can be caused by pruning activities

Tennis Elbow or “lateral epicondylagia” is a tendinopathy at the site where the forearm muscles attach to the elbow. We call this injury tendinopathy as the tendon is in a state of disrepair. Over winter the forearm / wrist muscles haven’t been gripping instruments such as secateurs. Then we perform multiple wrist squeezing and gripping movements while pruning. Our elbow tendon can’t cope with the added strain, leading to the cells in the elbow tendon becoming damaged. Unfortunately normal healing processes do not heal the tendon back to its original state leading to pain on the outside of the elbow when gripping or twisting the hand, i.e. Tennis Elbow.

Extensor Muscles, Tennis Elbow

Overuse of Extensor Muscles


Usually this will be a mild discomfort when you use your arm, but can regress to sharper pain when gripping which refers down the arm. You may also start to experience pain at night.  Simple tasks such as lifting a kettle or a cup can cause pain at the elbow.

In mild cases Tennis Elbow may last a couple of weeks and be helped by rest, ice, medication and some simple stretches.  However, in some cases the symptoms persist and require additional help.

What Can Physio do?

A well trained Physiotherapist can perform a thorough assessment of not only the elbow but the whole upper limb / shoulder girdle and neck to check for areas that can refer pain to the elbow.

Also, the posture and strength of our shoulder girdle muscles have a huge influence on elbow joint position and how well the elbow muscles can work. Poor shoulder girdle posture and / or strength can cause our elbow joint to rotate which stops certain muscles around our elbow from working efficiently. Once identified and corrected, the elbow can be positioned correctly and the elbow muscles can work more efficiently and become stronger.

This is also the case for the wrist, correct position and muscle training has an influence on our elbow strength.

Physiotherapists can also identify movements that may be causing excessive strain on the elbow and help adapt and modify these movements to help manage the load on the elbow.

One example is if you find it painful to lift objects, try to lift with your palms facing upward with the elbow flexed.

Research now has identified performing certain exercises that place a slight strain on the damaged tendon over a set period of time can allow the tendon to adapt and become tolerant of strain and stresses. This tolerance builds up until the tendon can perform stronger muscle contractions with no pain. We are trained to identify what exercises, at what level and for how long can allow this adaptation to occur, thus restoring normal function.

On top of the above descriptions Physiotherapists can also perform acupuncture to the arm for pain relief and to release tight muscles. We also use tape and can recommend certain elbow braces and supports which help take the strain of the muscle pulling on the elbow tendon.

If you have had tennis elbow for 2-3 weeks and have tried the basic treatments highlighted in this article and it hasn’t resolved please call for a Physiotherapist to perform a thorough assessment and identify why your pain is persisting.

Contact our Team on 01727 855 414 or email to arrange an appointment.

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