Understanding Tennis Elbow - DesiMD
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Tennis Elbow

Dr.Surya Rao Poodipeddi profile Authored by Dr.Surya Rao Poodipeddi on 19 May 2014 - 14:09.


The elbow joint is formed by three bones, the humerus, radius and ulna. Articulations between the trochlea of the humerus with the ulna and the capitulum of the humerus with the head of the radius comprise the elbow joint. The elbow is an example of a hinge joint or a joint which moves only in one direction. The joint is reinforced with several strong ligaments.

Common causes of pain in the elbow:

One of the commonest causes of pain in the elbow is due to a condition called Tennis elbow.

Tennis Elbow

Though tennis elbow is commonly seen in tennis players it is also seen in those who play cricket. On bending the fore arm at the elbow, you will notice three bumps at the elbow joint. Tennis elbow is associated with the two bumps that lie on each side of the main bump in the elbow.

Overuse of the elbow joint is the main cause for tennis elbow. Continuous load on the muscles of the joint is another trigger leading to tennis elbow. The exact cause for this condition is a tear(s) due to injury to the tendons that anchor muscles to these bumps. Constant use of the elbow like in a game of tennis or cricket or even a game of badminton leads to strain and/or tears which in turn lead to accumulation of the tears to cause pain and reduced movement of the elbow joint. Depending on the number of tears, extent of involvement and the degree of swelling over the joint, a full recovery might take six months.

Symptoms:  The symptoms of tennis elbow include:

  • Pain in the elbow joint especially when attempting to straighten the arm.
  • Dull ache over the elbow even when the joint is resting.
  • Pain when you try to make a fist i.e. closing all the fingers. (Medial epicondylitis) where there is inflammation of the medial epicondyle of the elbow.
  • Pain when trying to open the fingers (lateral epicondylitis) where there is inflammation of the lateral epicondyle of the elbow.
  • The area around the affected elbow joint is painful to touch.
  • The grip while attempting to hold something becomes weak.
  • Any attempt to grasp objects with the outstretched arm will lead to pain.

The bumps which play an important role in the causation of tennis elbow include:

Lateral Epicondyle: The bump which we notice at the outer side of the elbow is known as lateral epicondyle. The muscle on the back of the forearm responsible for curling the wrist backwards is anchored to this bony point. Pain if localized only to this bump is termed as lateral epicondylitis. This part is more prone for tennis elbow because of its poor blood supply.

Medial Epicondyle: The bump on the inner side of the elbow is termed as the medial epicondyle. The muscles on the front of the forearm, responsible for moving the wrist upwards are anchored to this bony point. Any pain localized to this bony point is referred to as medial epicondylitis. More often this area becomes involved from playing a game of golf.

Other conditions and events that may contribute to tennis elbow include:

  • Reduced strength in the muscles of the forearm.
  • Lack of flexibility in the muscles of the forearm.
  • Weak shoulder muscles.
  • Unstable elbow joint.
  • Poor technique while playing certain sports like tennis and golf which puts too much strain on the elbow joint.
  • Use of inappropriate sports equipment like the use of a heavy tennis racquet or a wrong sized grip on the tennis or golf racquets.
  • Repetitive movements of the hands and arms like in the nature of work in assembly line.
  • Continuously making the muscles and joint take heavy loads.
  • Other factors such as painful neck or irritation of nerves supplying the joint.

Immediate First aid:

  • Stop whatever you are doing.
  • Give rest to the elbow for few days.
  • Use of icepacks every two hours 15 minutes each time.
  • Massage the area and stretch the muscles after 48 hours to relieve stress and train to the joint.
  • Must call on your doctor for proper diagnosis of the cause and extent of involvement

If the symptoms don’t subside with initial first aid or if one is prone to recurring bouts of tennis elbow, one should not lose any time and must consult a doctor or a physiotherapist or both .

The treatment options may include:

  • Soft tissue massage.
  • Ice massage
  • Acupuncture
  • Joint mobilization.
  • Flexibility and strengthening exercises as prescribed by the physiotherapist.
  • Tape
  • Anti-inflammatory medications.
  • Electrotherapy
  • Corticosteroid injections.
  • Pain killing drugs.
  • Bracing.
  • Surgical procedures in severe cases.

Flexibility and strengthening exercises: As the names imply, these exercises and procedures help strengthening the muscles of the elbow joint and give more mobility to the joint movements thereby making movements easier and comfortable. The exercises recommended by your doctor or physiotherapist include:

  • Standing in front of a wall with the arms stretched out straight in front of you at shoulder height with the palms facing upwards. Bending your wrists so as to place your palms on the wall until you feel a stretch in your forearm, making sure that there is no pain at all. Holding for 10 seconds, relaxing and repeating the procedure five times.
  • Holding a stick horizontally with both the hands and curl the wrist up and down making sure to maintain the position for 10 seconds.
  • Holding a firm ball, the like of a tennis ball and squeezing and releasing the ball keeping the arm stretched straight in front of you.

Preventive measures: Always try to prevent the occurrence of a tennis elbow. The following tips might help preventing tennis elbow or reducing its intensity:

  • Whenever you play a sport it is advisable to warm up and cool down thoroughly.
  •  Whatever sport you choose to play you should make sure that you use proper equipment and technique. If necessary consult a sports specialist.
  • Use hand weights for strengthening exercises as per advice from a physiotherapist.

Regular stretching of muscles before beginning any strenuous and potentially stressful activity must be done as per the instructions of your physiotherapist:

We find several top ranking tennis players developing tennis elbow requiring rest, being off the field for a protracted length of time.


*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.