Tennis Elbow (Lateral Epicondylitis): Symptoms, Causes & PT Treatment
Updated July 20261 minute read
Tennis elbow is an overload of the tendons on the outer side of the elbow, causing pain there with gripping, lifting, and wrist movements — and most people who get it never play tennis. It's an irritated, under-conditioned tendon, not damage, and the proven treatment is progressive loading (strengthening), not rest. It can be slow to settle (often a few months), but the large majority improve without surgery.
What is tennis elbow?
Tennis elbow (lateral epicondylalgia/tendinopathy) is an overuse condition of the wrist-extensor tendons where they attach to the outer elbow.
Symptoms
Common features are pain and tenderness on the outer elbow, worse with gripping, lifting (especially palm-down), shaking hands, or wrist extension, sometimes with a weaker, painful grip.
What causes it / risk factors
Repetitive gripping and wrist use (work, sport, DIY), a sudden increase in load, and under-conditioned forearm muscles contribute.
How it's diagnosed
Diagnosis is clinical from the location and aggravating tasks. Imaging is reserved for unclear or non-responding cases.
Physical therapy treatment
What a PT does. Your therapist reduces aggravating load, then progressively loads the tendon to rebuild capacity, plus grip and forearm strengthening. Exercises & progression (overview). Progressive wrist-extensor and grip strengthening, load management, and graded return to activity; a counterforce brace can help some short-term. Recovery timeline. Often a few months; tendons respond slowly but reliably to loading.
Treatment options compared
Progressive loading is first-line. Bracing and activity changes help. Injections may give short-term relief but don't outperform exercise over time; surgery is rare.
Red flags
Seek care for a hot swollen elbow with fever, significant pain/deformity after injury, or numbness/cold fingers.
Frequently asked questions
Sources (4)
- Lucado AM, et al. Lateral Elbow Pain and Muscle Function Impairments: Clinical Practice Guidelines. J Orthop Sports Phys Ther. 2022. — PubMed
- Bisset L, et al. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006. — PubMed
- AAOS OrthoInfo: Tennis Elbow (Lateral Epicondylitis). — AAOS OrthoInfo
- MedlinePlus: Tennis elbow. — NIH/MedlinePlus
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.