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Ways to help tennis elbow: Tennis Elbow Treatments & Remedies: Ice, Rest, and More


Tennis Elbow Treatments & Remedies: Ice, Rest, and More

Tennis elbow is an injury you can have even if you never pick up a racquet. It happens when the tendons that connect your forearm muscles to the bones in your elbow become inflamed.

A tennis backhand stroke is just one of many repetitive movements that can strain your muscles and tendons. Others include painting, carpentry, playing a musical instrument, or using heavy tools.

When you’re having an ongoing problem with your elbow, be sure to see your doctor so you can be diagnosed and get on the road to recovery. If you do have tennis elbow, they can come up with a treatment plan that’s best for you — from pain relief to surgery.

Here are self-care tips to manage your pain, heal more quickly, and try to avoid the problem again.

Rest Your Elbow

This condition comes from repetition and overuse. As much as you can, rest your elbow.

If your injury actually came from tennis or another racquet sport, try a different kind of sport that’s not as tough on your elbow until you get better.


Work can be trickier, naturally, because you can’t always just walk away from the job like you can a hobby. Ask your boss for other tasks you can do while your elbow heals.

But as you rest, remember this mantra: “Absolute rest is rust.” Your tendons need some tension and motion. A couple of tips as you use — but not overuse — your arm:

  • Learn to use your shoulder and upper arm muscles to take the strain off your elbow.
  • Stick to the middle of your range of motion — try not to bend or straighten your arm all the way.

Pain Management

Tennis elbow can be painful. Some ways to ease the pain include:

Over-the-counter pain relievers:Ibuprofen (Advil, Motrin) and naproxen (Aleve) can ease mild to moderate pain. These are called NSAIDs — nonsteroidal anti-inflammatory drugs — and they reduce inflammation, too. Talk to your doctor about taking these, especially if you need them for weeks.

Ice: If you don’t like the idea of taking pills or want to take fewer, cold packs can also reduce swelling and pain. Put one on for about 15 minutes at a time several times a day.

Braces, Splints, Gear, and Tools

Some of the following might help with your recovery:

Braces: Wearing a supportive brace on your forearm may also help take some pressure off the tendons in your elbow. Talk with your doctor or physical therapist about whether you should use one and the right kind of forearm brace for you.

Splints: You might ask your doctor about using a wrist splint at night. This can rest your muscles and tendons.

Sports gear: If tennis really is at the root of your tennis elbow, a stiffer racquet with looser strings may help once you’re up for some light playing again. A few other tips:

  • Work with a tennis pro to improve your swing so you don’t overwork the elbow again. The same idea can apply to other racquet sports.
  • Make sure you have fresh, dry tennis balls. Wet or “dead” tennis balls can aggravate your elbow.
  • Finally, be sure you warm up and stretch your arms gently before playing racquet sports (or any sport, really).

Work tools: If on-the-job equipment is playing a role, you may need to try different tools or techniques. Ask your physical therapist for advice. A few other tool tips:

  • Hold tools with a looser grip; take some of the tension out of your hand, if you can.
  • Use hammers with padding to help absorb shock.
  • Get some training in different methods of doing your job.
  • Use power tools instead of hand tools if possible.

After Physical Therapy

One of the best ways to treat stubborn tennis elbow is with physical therapy. It can improve blood flow to the tendons, which will speed healing, too. A therapist may also teach you ways to change your tennis stroke or other activities that caused your elbow troubles.

Keep the momentum going even if your therapy program is finished. Once your elbow is pain-free and your backhand is better than ever, you should keep your muscles strong and flexible.

That’s because everyday activities don’t keep your muscles as strong and flexible as they should be to avoid sports injuries.

Ask about how to do some of the exercises yourself at home.

Tennis elbow – Diagnosis and treatment


During the physical exam, your doctor may apply pressure to the affected area or ask you to move your elbow, wrist and fingers in various ways.

In many cases, your medical history and the physical exam provide enough information for your doctor to make a diagnosis of tennis elbow. But if your doctor suspects that something else may be causing your symptoms, he or she may suggest X-rays or other types of imaging tests.

More Information

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Tennis elbow often gets better on its own. But if over-the-counter pain medications and other self-care measures aren’t helping, your doctor may suggest physical therapy. Severe cases of tennis elbow may require surgery.


If your symptoms are related to tennis, your doctor may suggest that experts evaluate your tennis technique or the movements involved with your job tasks to determine the best steps to reduce stress on your injured tissue.

A physical therapist can teach you exercises to gradually stretch and strengthen your muscles, especially the muscles of your forearm. Eccentric exercises, which involve lowering your wrist very slowly after raising it, are particularly helpful. A forearm strap or brace may reduce stress on the injured tissue.

Surgical or other procedures

  • Injections. Your doctor might suggest injecting platelet-rich plasma, Botox or some form of irritant (prolotherapy) into the painful tendon. Dry needling — in which a needle pierces the damaged tendon in many places — can also be helpful.
  • Ultrasonic tenotomy (TENEX procedure). In this procedure, under ultrasound guidance, a doctor inserts a special needle through your skin and into the damaged portion of the tendon. Ultrasonic energy vibrates the needle so swiftly that the damaged tissue liquefies and can be suctioned out.
  • Surgery. If your symptoms haven’t improved after six to 12 months of extensive non-operative treatment, you may be a candidate for surgery to remove damaged tissue. These types of procedures can be performed through a large incision or through several small incisions. Rehabilitation exercises are crucial to recovery.

Lifestyle and home remedies

Your doctor may recommend the following self-care measures:

  • Rest. Avoid activities that aggravate your elbow pain.
  • Pain relievers. Try over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB) or naproxen (Aleve).
  • Ice. Apply ice or a cold pack for 15 minutes three to four times a day.
  • Technique. Make sure that you are using proper technique for your activities and avoiding repetitive wrist motions.

Preparing for your appointment

You’re likely to first bring your problem to the attention of your family doctor. He or she may refer you to a sports medicine specialist or an orthopedic surgeon.

What you can do

Before your appointment, you may want to write a list that answers the following questions:

  • When did your symptoms begin?
  • Does any motion or activity make the pain better or worse?
  • Have you recently injured your elbow?
  • What medications or supplements do you take?

What to expect from your doctor

Your doctor may ask some of the following questions:

  • Do you have rheumatoid arthritis or a nerve disease?
  • Does your job involve repetitive motions of your wrist or arm?
  • Do you play sports? If so, what types of sports do you play and has your technique ever been evaluated?

Tennis elbow care at Mayo Clinic

Feb. 14, 2019

Show references

  1. DeLee JC, et al. Elbow tendinopathies and bursitis. In: DeLee & Drez’s Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed April 4, 2016.
  2. AskMayoExpert. Lateral elbow tendinopathy. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
  3. Tennis elbow (Lateral epicondylitis). American Academy of Orthopedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00068. Accessed April 4, 2016.
  4. Jayanthi N. Epicondylitis (tennis and golf elbow). http://www.uptodate.com/home. Accessed April 4, 2016.
  5. Ferri FF. Epicondylitis. In: Ferri’s Clinical Advisor 2016. Philadelphia, Pa.: Mosby Elsevier; 2016. https://www.clinicalkey.com. Accessed April 14, 2016.
  6. Barnes DE. Percutaneous ultrasonic tenotomy for chronic elbow tendinosis: A prospective study. Journal of Shoulder and Elbow Surgery. 2015;24:67.
  7. Laskowski ER (expert opinion). Mayo Clinic, Rochester, Minn. May 13, 2016.
  8. Coombes BK, et al. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: A randomized controlled trial. JAMA. 2013;309:461.
  9. Gosens T, et al. Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: A double-blind randomized controlled trial with 2-year follow-up. American Journal of Sports Medicine. 2011;39:1200.
  10. Brown AY. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Dec. 9, 2015.


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Tennis elbow – Treatment – NHS

Tennis elbow will get better without treatment (known as a self-limiting condition).

Tennis elbow usually lasts between 6 months and 2 years, with most people (90%) making a full recovery within a year.

The most important thing to do is to rest your injured arm and stop doing the activity that caused the problem.

There are also simple treatments to help with the pain, like holding a cold compress, such as a bag of frozen peas wrapped in a towel, against your elbow for a few minutes several times a day.

Avoiding or changing activities

If you have tennis elbow, you should stop doing activities that strain the affected muscles and tendons.

If you use your arms at work to carry out manual tasks, such as lifting, you may need to avoid these activities until the pain in your arm improves.

Alternatively, you may be able to change the way you do these types of movements so they do not place strain on your arm.

Talk to your employer about avoiding or changing activities that could aggravate your arm and make the pain worse.

Painkillers and non-steroidal anti-inflammatory drugs (NSAIDs)

Taking painkillers, such as paracetamol, and NSAIDs, such as ibuprofen, may help ease mild pain and inflammation caused by tennis elbow.

NSAIDs are available as tablets or creams and gels (topical NSAIDs), which are applied directly to the area of your body where there is pain.

Topical NSAIDs are often recommended for musculoskeletal conditions, such as tennis elbow, rather than anti-inflammatory tablets. This is because they can reduce inflammation and pain without causing side effects, such as feeling sick (nausea) and diarrhoea.

Some NSAIDs are only available with a prescription. A GP or pharmacist will be able to recommend a suitable NSAID.

Read more about non-prescription and prescription-only medicines

Physiotherapy for tennis elbow

The GP may refer you to a physiotherapist if your tennis elbow is causing more severe or persistent pain. Physiotherapists are healthcare professionals who use a variety of methods to restore movement to injured areas of the body.

The physiotherapist may use manual therapy techniques, such as massage and manipulation, to relieve pain and stiffness, and encourage blood flow to your arm. They can also show you exercises you can do to keep your arm mobile and strengthen your forearm muscles. 

The use of a brace, strapping, support bandage or splint (called an orthosis) may also be recommended in the short term.

Read more about physiotherapy

Steroid injections for tennis elbow

Steroids, medicines that contains synthetic versions of the hormone cortisol, are sometimes used to treat tennis elbow.

Some people with tennis elbow are offered steroid injections when other treatments have not worked.

The injection will be given directly into the painful area around the elbow. A local anaesthetic may be given first to numb the area and reduce the pain.

Steroid injections are only likely to give short-term relief and their long-term effectiveness is poor. If they’re helping, you may be offered up to 3 injections in the same area, with at least a 3- to 6-month gap between them.

Shockwave therapy for tennis elbow

Shockwave therapy is a non-invasive treatment, where high-energy shockwaves are passed through the skin to help relieve pain and promote movement in the affected area.

The number of sessions you will need depends on the severity of your pain. You may have a local anaesthetic to reduce any pain or discomfort during the procedure.

Shockwave therapy, while safe, can cause minor side effects including bruising and reddening of the skin in the area being treated.

Research shows that shockwave therapy can help improve the pain of tennis elbow in some cases. However, it may not work in all cases, and further research is needed.

PRP injections for tennis elbow

Platelet rich plasma (PRP) is a treatment that may be offered by a surgeon in hospital to treat tennis elbow.

PRP is blood plasma containing concentrated platelets that your body uses to repair damaged tissue. Injections of PRP have been shown to speed up the healing process in some people, but their long-term effectiveness is not yet known.

The surgeon will take a blood sample from you and place it in a machine. This separates the healing platelets so they can be taken from the blood sample and injected into the affected joints. The procedure usually takes about 30 minutes.

Surgery for tennis elbow

Surgery may be recommended in cases where tennis elbow is causing severe and persistent pain. The damaged part of the tendon will be removed to relieve the painful symptoms.

Page last reviewed: 10 November 2020
Next review due: 10 November 2023

Tennis Elbow (And How to Treat It)

Tennis elbow (lateral epicondylitis) is the most common injury of patients seeking medical attention for elbow pain. It is a painful condition involving inflammation of the tendons that attach the forearm muscles to the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions over and over again. Tennis elbow can occur at any age but is most common in people between the ages of 30 and 50.

In this article, we’ll discuss the following:

  • Causes of tennis elbow
  • Symptoms
  • Diagnosis
  • Potential Treatments
  • How Michigan Surgery Specialists can help

Causes of tennis elbow

Repetitive motions, like gripping a racquet during a swing, can strain the muscles and put too much stress on the tendons. This can eventually cause microscopic tears in the tissue.

Despite its name, tennis elbow doesn’t just occur in athletes who engage in racquet sports. It can affect anyone who uses repetitive motions of the wrist and arm, or gripping, such as people who engage in:

  • Construction work
  • Plumbing
  • Gardening
  • Knitting
  • Assembly line work
  • Painting
  • Cooking
  • Weight lifting

. . . and others.

Symptoms of tennis elbow

Tennis elbow is not a sudden injury, it’s something that develops over time. In most cases, it starts as a mild pain and worsens over weeks and months. Unlike other injuries, there is usually no specific instance associated with the start of symptoms.

The most common symptom of tennis elbow is a recurring pain on the outside of the upper forearm, just below the bend of the elbow. Sometimes this is felt further down the arm toward the wrist.

Tennis elbow pain may also happen when you:

  • Lift something
  • Bend your arm
  • Raise your hand or straighten your wrist
  • Perform basic actions, such as writing
  • Make a fist or grip an object, such as a tennis racquet or even a coffee cup
  • Twist your forearm, like when turning a door handle


In many cases, a physical exam is enough for your doctor to determine whether or not you have tennis elbow. During the exam, the doctor may apply pressure to the affected area and ask you to move your elbow, wrist, and fingers in different ways.

But if your doctor suspects there may be other causes of your problem, they may order additional tests.

  • X-rays.These provide clear images of dense structures like bone, and may be ordered to rule out arthritis in your elbow.
  • Magnetic resonance imaging (MRI) scan. An MRI may be in order if your doctor thinks your symptoms could be related to a neck problem. MRIs show details of soft tissue, and would be able to show whether you have a possible herniated disk or even arthritis in your neck. Both of these conditions also produce arm pain.
  • Electromyography (EMG). An EMG would be able to tell your doctor if you’ve got nerve compression. Many nerves travel around the elbow, and compressed nerves in that area have similar symptoms to tennis elbow.

Treatment for tennis elbow

For many patients, tennis elbow goes away on its own. For others, both surgical and non-surgical treatments are available. Between 80% and 95% of all patients have success with nonsurgical treatment, which is always the first approach.

Nonsurgical tennis elbow treatment

Nonsurgical treatment methods like resting the arm, taking non-steroidal anti-inflammatory medication (such as ibuprofen or naproxen) to reduce pain and swelling, and wearing a brace are good first steps to recovering from tennis elbow.

Physical therapy is often recommended, as there are specific exercises that are helpful for strengthening the muscles of the forearm. A physical therapist may also perform an ultrasound, ice massage, or muscle-stimulating techniques to help muscle healing.

Steroid injections. Steroids like cortisone are very effective anti-inflammatory medicines. If your symptoms are very painful and making movement difficult, your doctor may recommend a steroid injection. 

Surgical tennis elbow treatment

In most cases, the nonsurgical treatment methods for tennis elbow listed above are enough. But if symptoms are still occurring after 6 to12 months, your orthopedist may recommend surgery.

Open surgery for tennis elbow

Open surgery is the most common surgery for tennis elbow repair. It involves making an incision over the elbow. It is usually performed as outpatient, and rarely requires an overnight hospital stay.

Arthroscopic tennis elbow surgery

Another method of tennis elbow surgery is arthroscopic surgery. It uses miniature instruments and very small incisions. Like open surgery, this is a same-day or outpatient procedure.

How can Michigan Surgery Specialists help?  

If you suspect you have tennis elbow, make an appointment with Michigan Surgery Specialists to learn more and discuss your treatment options. As we mentioned, most cases of tennis elbow do not require surgery, but Michigan Surgery Specialists will discuss the right approach for your situation. Our team of experts has helped many people suffering from tennis elbow, and we can help you get back to the activities that you love. Contact us today.


6 ways to manage tennis elbow and golfer’s elbow – Canadian Chiropractic Association (CCA) – Association chiropratique canadienne

Now that it’s summer, many people are deep into their favourite sports and recreational activities. A common result of recreational sports is repetitive strain or injury due to overuse. Two of the most popular injuries that occur are tennis elbow and golfer’s elbow. Even if you don’t play tennis or golf, these injuries can easily happen to you over time.

Tennis elbow and golfer’s elbow are different types of injuries that both involve forearm muscles, but impact where the muscles connect to the joint on opposite sides of the elbow. They both relate to inflammation and damage in the elbow and involve the wearing down of different tendons and the slowing of their ability to repair themselves.

What are the differences between the two?

Tennis Elbow

Tennis elbow involves the muscles and tendons of your forearm that extend to your wrist and fingers. Symptoms may develop gradually, with mild pain that slowly worsens over time. Tennis elbow usually doesn’t come from an injury, but rather from overuse of the tendons in your forearm.

Symptoms include weak grip strength and a pain or burning sensation on the outer part of the elbow. Usually, they get worse when you use your forearm in activities like holding a racquet (hence “tennis” elbow), turning a wrench, or shaking hands.

Golfer’s Elbow

Golfer’s Elbow also involves the forearm muscles. In this case, we’re talking about the muscles that attach from the wrist and go to the “funny bone” area of the elbow near the inner bump. These muscles are responsible for wrist flexion (or the twisting motion of the wrist), which explains its connection to golf.

Symptoms include pain or tenderness near the funny bone, or inner bump of the elbow, as well as reduced strength in your grip. This type of injury can happen outside of sports activities: workers that regularly complete tasks that involve repetitive wrist flexion or “twisting” or forearm pronation (turning the palm downwards) commonly suffer from golfer’s elbow.

Luckily, there are some exercises and stretches applicable to both conditions that you can do to help manage your symptoms. Here are some options that can help with both tennis elbow and golfer’s elbow injuries:

Wrist Stretches

For tennis elbow: Hold your arm out in front of you, palm facing down, and pull your hand and fingers back towards you using your other hand. Do so gently so as not to cause pain. This shouldn’t be painful, so if it hurts, pull more gently for a slight stretch. This should stretch your forearm. Hold for 30 seconds, relax, and repeat three times.

For golfer’s elbow: This exercise is similar to the one for tennis elbow, but the hand is inverted to the other direction. Hold your arm out in front of you, palm facing up, and gently pull your hand and fingers back towards your body using your other hand. Hold for 30 seconds, then relax. Repeat three times. You can do these stretches throughout your day.

Common Exercises

Wrist Extension: One of the common range of motion exercises for tennis elbow is wrist extension. Begin with your elbow at a 90-degree angle, palm facing down, resting on a table’s surface. Gently extend your wrist to lift it off the table (this should not be painful). Repeat ten times. As you progress you can add weight, like holding a water bottle, to add resistance and incorporate strengthening into the exercise.

Wrist Flexion: This exercise is similar to the wrist exercise above, but the palm is in the other direction. For the wrist flexion exercise, begin with your elbow at a 90-degree angle, palm facing up, resting on a table’s surface. Gently extend your wrist to lift it off the table towards the ceiling (this should not be painful). Repeat ten times. You can also add weight resistance to add strength training to the exercise.

Grip Strengthening: For this exercise, all you need is a squishy ball or “stress ball.” Hold the ball in your hand and gently squeeze. Hold for five seconds, relax, and repeat ten times. This exercise is helpful for both tennis elbow and golfer’s elbow.

Strength Exercise: One of the common strengthening exercises you can do is informally called the “hammer exercise.” You will need a hammer as your weight resistance. Hold the handle of the hammer, and keep your elbow at 90 degrees, rested flat on a table’s surface. Slowly rotate the hammer towards the centre of your body, turning the direction of your palm downwards. Then slowly reverse the motion, rotating the hammer outwards—your palm begins facing up with the heavy side of the hammer pulling on your arm. Rest briefly. Repeat ten times.

You can also manage your pain by modifying the activities causing the pain, such as reducing the repetition or the duration of the problematic activities. You can also seek chiropractic care, which would include the stretches and exercises listed above. You might also be able to obtain compression or stability braces for your elbow (available from your chiropractor or you can purchase over the counter tension sleeves from your local pharmacy). You could also explore other treatments such as laser or shockwave therapy.

For questions, concerns, or consultations about what sort of treatment is right for you, you can contact your family chiropractor.

How to Get Rid of Tennis Elbow in 30 Days

Week 1  
Step 1:
 Treat Your Symptoms
Step 2: Reintroduce Daily Activity

Week 2
Step 3: Decrease Inflammation
Step 4: Stretch and Strengthen Your Elbow

Week 3
Step 5: Week 3, Incorporate Holistic Treatment for Inflammation
Step 6: Week 3, Use Resistance to Build Elbow Strength

Week 4
Step 7: Week 4, Seek Professional Treatment
Step 8: Week 4, Build Endurance with Integrated Exercises

Don’t procrastinate – get rid of your tennis elbow pain in just 30 days. If you want to regain your top physical performance, it is crucial to become proactive in the treatment of your tennis elbow. You can find pain relief and increase your handgrip by following this succinct self-help guide.

According to OrthoInfo, tennis elbow affects a wide variety of athletes and workers performing repetitive arm, elbow and wrist work.

  • Tennis players
  • Golfers
  • Baseball players
  • Garden and lawn workers
  • Carpenters and mechanics
  • Assembly line workers

One of America’s all-time great professional tennis players, Venus Ebony Starr Williams, knows the importance of prompt and effective tennis elbow treatment.

“The thing about tennis is if you stay off for two weeks, or just for three days, you can lose your rhythm quickly. So it’s just a question of constant diligence and vigilance.” Venus Williams

Day-By-Day 30 Day Tennis Elbow Treatment Plan

Regardless of the sport or occupation that has caused an overuse injury to your elbow, you can find relief from your pain through both basic and advanced exercises. Add in a simple stretching regimen along with self-administered therapies to begin implementing your tennis elbow treatment plan today.

The treatment modalities and tools described below will get you on the fast track to recovery from tennis elbow pain. This article has been specifically designed to help you regain your forearm and elbow strength. Most importantly, to help speed up your rehabilitation and prevent recurrent injury.

Week 1

Step 1: Treat Your Symptoms

Forearm weakness and pain due to tennis elbow can be self-treated through common sense home remedies – P R I C E. Remember, your pain is probably being caused by overuse from a repeated arm movement and could settle over time with a little tender, loving care.

Decrease Inflammation – P R I C E

Begin with a regimen of at home therapies known as P R I C E to naturally relieve the inflammation in your elbow.

  1. P – Protection. Improving your warm up routine and enhancing your form used during your sporting activity is imperative. Consulting with a sports medicine doctor is recommended to make sure your form is sound. If your tennis elbow is due to an occupational activity, rethink your ergonomic setup by evaluating how your workstation may be adjusted to alleviate overuse of your forearm and elbow.

  2. R- Rest. Resting your fingers, wrist and forearm will allow the tendons and muscles surrounding your elbow to heal. Give your elbow time to heal by foregoing activities you know are causing your tennis elbow pain and inflammation.

  3. I – Ice Application. When tennis elbow pain arises, immediately begin to apply ice for 10 to 15 minutes several times per day. Use a thin cloth between the ice pack and your skin. Continue to apply ice as long as it relieves your pain.

  4. C – Compression. Ease pain to your elbow by wearing a counterforce brace during activities requiring grasping or twisting arm movements, worn around your forearm and just below your elbow. These braces spread pressure throughout the arm and away from the muscle and tendon surrounding the elbow joint. Purchase one online, at a medical supply store, or your local drug store in the pharmacy aisle.

  5. E – Elevate. It will help to ease pain and reduce swelling if you elevate your elbow several times a day, preferable when you are applying ice.

Step 2: Reintroduce Daily Activity

When your pain has reduced, begin to build strength in your forearm and elbow by performing these two basic exercises on alternating days throughout Week One. You can stay on top of your daily strengthening exercises by downloading our printable 30-Day Calendar with easy to follow diagrams.

(click here to download our Printable 30-Day Calendar)


Eccentric Exercise

You must perform an exercise specifically targeting your damaged extensor tendon to begin the healing process quickly.

  1. Use a light weight – 1 or 2 lb. dumbbell

  2. Sit in a chair having a sturdy armrest

  3. Rest your forearm on the armrest and grasp the weight with your palm facing down

  4. Simply let your wrist fall downward slowly

  5. Then, lift and extend your wrist upward even with the armrest

  6. Perform 3 sets of 10 repetitions of this exercise every other day

Forearm Extensor Stretch

Although this is a stretch – not technically an exercise – it is very crucial to your healing process. Overcoming a repetitive strain in your arm requires an increase in blood flow throughout the affected area to speed up recovery.

  1. Raise your arm at a 90 degree angle directly in front of your chest

  2. Your arm should be parallel to the floor

  3. Rotate your hand and point your thumb toward the floor as if to drop something

  4. Bend your wrist outward and grab your fingers with your other hand

  5. Now you simply pull your fingers and stretch your forearm, holding for 30 seconds

  6. Do this stretch three times for 30 seconds every other day, alternating days with the eccentric exercise.

Week 2

Step 3: Decrease Inflammation

Beginning with Week Two, you will begin applying hot compresses to your forearm and elbow to encourage blood flow.

A regimen of anti-inflammatory drugs and dietary changes will help to decrease inflammation and increase nutrition to your elbow. These will help to accelerate the healing process.

Your objective during Week Two is to continue to improve strength and increase circulation in your forearm and elbow joint.

Accelerate your elbow’s healing process by implementing these treatment tips.

  1. Deep Tissue 

  2. Hot compress application

  3. Deep tissue massage

  4. Stress ball exercises

  5. Dietary improvements 

Deep Tissue Massage

Either simply press on the trigger point area of your pain with your fingertips and thumb and hold for 10 to 60 seconds, or apply small kneading strokes circular and back and forth. For more detail, see the link below for a guide to Self Massage by Body Mind Conspiracy. 

[Video: Self Massage for Tennis Elbow]

OTC Anti-Inflammatory Medication

Decrease inflammation by taking over-the-counter (OTC) anti-inflammatory medications known as NSAIDs (nonsteroidal anti-inflammatory drugs). These NSAIDs are available at your local drugstore.

  1. Ibuprofen – Advil or Aleve

  2. Naproxen

  3. Aspirin – Tylenol

Hot Compress Application

Apply a hot compress to your forearm and elbow for 10 to 15 minutes 2 or 3 times per day.

Dietary Improvements

Healing will speed up if you improve your daily nutritional intake through simple dietary changes.

  1. High Potassium Foods

  2. Magnesium Rich Foods

  3. Low Sodium Diet

Step 4: Stretch and Strengthen Your Elbow

Increase the strength in your forearm and elbow by adding the following basics into the alternating regimen of your 30 Day Exercise/Stretch Calendar.

Forearm Flexor Strengthening Exercise

This simple exercise works the forearm flexor muscle quickly and effectively.

  1. Using a light weight barbell – 1 or 2 lbs. – sit on solid chair having an armrest

  2. Or, use your thigh to rest your arm

  3. Lay your arm on the armrest holding the barbell palm up

  4. Keeping your arm flat on the armrest, curl your wrist up toward the ceiling

  5. Perform 3 sets of 10 reps every other day


Tricep Stretch

This is another stretching tool, but it is one that can be very important to the speed of your recovery. This tricep stretch will help to decrease stiffness in your arm and increase its mobility. It is imperative to improve your arm’s range of motion on a steady basis when recovering from tennis elbow.

  1. Bend your arm behind your back as if someone were putting you in an arm lock move

  2. Pull your other arm around your back to grab your arm lock elbow

  3. Now place gentle pressure by pulling on your elbow and feel the stretch in your tricep

  4. Hold this position for a count of 30 – repeating 3 times every other day

Stress or Tennis Ball Squeeze

A stress ball is like a tennis ball in that it has some give. Using the ball squeeze will work the flexors and smaller muscles in your forearm and hand. This technique is designed to strengthen your hand grip and reduce pain. Find a stress ball at any drugstore or online.

  1. While in a sitting position, grip the ball in your hand

  2. Squeeze the ball and hold the position for a count of three and then release

  3. Each time you squeeze and hold the ball, try to up your count

  4. Squeeze the ball and hold the position at least 3 seconds 10 times in 2 sets

  5. Perform the ball squeeze twice daily

Week 3
Step 5: Incorporate Holistic Treatment for Inflammation 

Continue to accelerate your elbow’s healing process by implementing these treatment tips during Week Three. Make sure to take care not to harm your liver health by taking anti-inflammatory medications for too long. Here are some methods for reducing inflammation to your elbow without the aid of over-the-counter non-steroidal anti-inflammatory drugs (NSAIDS).

Decrease Inflammation – Natural Remedies

Prescription topical anti-inflammatory creams have been shown to be effective since 1998 according to the Clinical Journal of Sports Medicine.

However, you can incorporate natural anti-inflammatories without a prescription.

  1. Topical treatments available over-the-counter

  2. Essential oils available at your local health food store or nutrition store

  3. Natural supplements such as tart cherry juice available at your grocery

Step 6: Use Resistance to Build Elbow Strength

Continue to build strength in your forearm and elbow joint by using light weights and implementing light stretching and resistance tools. Remember, you are continuing to build on your strength improvement from Week One and Week Two. In addition to the daily alternating exercises you have implemented in Week One and Week Two, increase the strength in your forearm and elbow by adding the following basics into the alternating regimen of your 30 Day Exercise/Stretch Calendar.

Alternating every other day, perform two highly recommended advanced exercises – Drawing the Sword  and Forearm Pronation and Supination.

Drawing the Sword

Using a resistance band that can be purchased online for about $10, simply pretend you are drawing a sword from its sheath.

  1. Hold the resistance band in both hands near your waste where you pretend sword is located in its sheath

  2. Your thumb will be directed downward as your hand pretends to grab the sword from its sheath

  3. As you draw the sword, your thumb will end facing upward

  4. Lift your arm outward and upward to the ceiling

  5. Perform 10 repetitions 3 times every other day

Forearm Pronation and Supination

This exercise is performed with a light weight dumbbell – 1 to 2 lbs. – depending on your comfort level with the movement.

  1. Standing feet shoulder length apart

  2. Bring your arm up, out in front of you, and parallel to the floor while holding the weight

  3. Holding the weight, your thumb should be pointing up

  4. Now, rotate your hand and point your thumb down

  5. Perform 10 repetitions 3 times every other day

Improve Circulation

Your elbow will need special attention in improving circulation with the implementation of the more advanced exercises included in your routine during Week Three.

Don’t skimp on your attention to improving circulation or you may slow down the healing process and lose ground on the hard work you have done in Week One and Week Two.

  1. Apply hot compress treatment to the injured area indirectly protect your skin. 

  2. Implement Deep transverse friction therapy – This is pressure applied to the connective tissues around your elbow. Pressure applied should be clear, strong and satisfying and have a relieving, welcoming quality. This is good pain. For more tips, and to watch how a friction massage is performed, follow the link below to a guided practice by Max King.

[Video: Elbow Treatment/Cyriax Friction]

Week 4

Step 7: Seek Professional Treatment

When your elbow pain persists after applying the recommended exercises/stretches in Week One, Two and Three, you should seek professional physical therapy treatment. Effective tennis elbow treatment begins with an accurate diagnosis.

An experienced tennis elbow treatment doctor will be able to recommended cutting edge treatment modalities for your persistent tennis elbow inflammation and pain.

Hands-On (Manual) Physical Therapy

The doctor can help you to build additional strength through hands-on (manual) physical therapy range of motion exercises such as:

  1. Myofascial release techniques

  2. Stretching of restricted structures

  3. Specific strengthening of weak muscles

  4. Soft tissue and joint mobilization/manipulation

  5. Muscle energy

  6. Mulligan techniques

Pain Management Therapies

Most importantly, your doctor can help manage your pain through state of the art tennis elbow treatment modalities.

  1. Cryotherapy

  2. Ultrasound

  3. Phonophoresis

  4. Iontophoresis

  5. Medical Massage

  6. Compression Braces 

(Links: Copper Wear $10, Copper Compression Recovery Elbow Sleeve $19, 
McDavid Elastic Elbow Sleeve $37, Band-It Elbow Brace $23, Futuro Adjust to Fit Support Brace $17)


Step 8: Build Endurance with Integrated Exercises 

Continue to build strength in your forearm and elbow joint by using light weights and implementing light resistance tools. In addition to the daily alternating exercises you have implemented in Week One, Two, and Three, incorporate the following daily advanced exercises every other day in your 30 Day Exercise/Stretch Calendar.

Some advanced exercises recommended for persistent elbow pain treatment include bicep curls and hammer curls to be performed on an alternating daily basis. A rhomboid and back strengthening exercise is also highly recommended for alleviating elbow tennis.

Bicep Curls

To strengthen your forearm and bicep, this exercise focuses primarily on the two muscle groups on either side of your elbow. These muscle groups need to be kept in prime condition to avoid recurrent injury.

  1. Use a light weight dumbbell – 1 to 2 lbs.

  2. Get into a sitting position on a firm chair or bench with your legs open

  3. Grasping the weight, let your arm fall between your legs

  4. Rest your elbow on the inside of your thigh

  5. Your forearm is facing your opposite leg

  6. Bend and flex your arm upward to strike a bicep pose

  7. Your forearm should be parallel to the floor

  8. Perform 10 repetitions 3 times every other day


Hammer Curls

This exercise helps to thicken and strengthen your arm. Hammer curls focus on strengthening muscles, flexors, extensors, and tendons. Hammer curls are a simple, yet advanced exercise.

  1. Use a light weight dumbbell – 1 to 2 lbs.

  2. Stand with your feet shoulder length apart

  3. Hold the weight in your hand straight down, keeping your arm close to the body

  4. Your hand should be over the weight in a hammer grip

  5. Bend your elbow upward to a 90 degree angle

  6. Perform 10 sets, 3 times every other day

(click here to download our Printable 30-Day Calendar)


Rhomboid and Back Strengthening Exercise

Yes, this integrated back, neck, and shoulder strengthening exercise will help to alleviate your symptoms of tennis elbow.

The Hosford Muscle Table – Shoulder Muscle Girdle Musculature – details how the rhomboid major muscle connects your upper body extremity to the vertebral column. The rhomboid muscles work together with the levator scapulae muscles situated at the back and side of the neck. A winged scapula is a skeletal condition in which the shoulder blade protrudes from the back in an abnormal position. This leads to functional difficulties extending to the arms, including tennis elbow.

Physical therapy – consisting of stretching and endurance exercises of the shoulder – will help to heal from tennis elbow.

  1. Lie on your stomach

  2. Your arms are by your side palms upward

  3. Squeeze your shoulder blades together

  4. Raid both arms, hands, palms upward

  5. Hold for a 20 second count

  6. Perform 3 reps 3 times every other day

Final Thoughts On Staying In The Game

When you’re back into the game, always listen to your body and watch out for when it is telling you that something is not right. A tennis elbow injury can go from slight to severe within days. The sooner you seek medical attention for a professional recommendation for tennis elbow treatment, the quicker you will recover.

Be proactive and discover more about how to prevent tennis elbow!  For more information, book an appointment.


Tennis Elbow | Michigan Medicine

Topic Overview

What is tennis elbow?

Tennis elbow is soreness or pain on the outer part of the elbow. It happens when you damage the tendons that connect the muscles of your forearm to your elbow. The pain may spread down your arm to your wrist. If you don’t treat the injury, it may hurt to do simple things like turn a key or open a door.

Your doctor may call this condition lateral epicondylitis.

What causes tennis elbow?

Most of the time tennis elbow is caused by overuse. You probably got it from doing activities where you twist your arm over and over. This can stress the tendon, causing tiny tears that in time lead to pain. A direct blow to the outer elbow can also cause tendon damage.

Tennis elbow is common in tennis players, but most people get it from other activities that work the same muscles, such as gardening, painting, or using a screwdriver. It is often the result of using equipment that is the wrong size or using it the wrong way.

Anyone can get tennis elbow, but it usually occurs in people in their 40s.

How is tennis elbow diagnosed?

To diagnose tennis elbow, a doctor will examine your elbow and ask questions about the elbow problem, your daily activities, and past injuries. You probably won’t need to have an X-ray, but you might have one to help rule out other things that could be causing the pain.

If your symptoms don’t get better with treatment, you might have an imaging test, such as an MRI. This can tell your doctor whether a bone problem or tissue damage is causing your symptoms.

How is it treated?

You can start treating tennis elbow at home right away.

  • Rest your arm, and avoid any activity that makes the pain worse.
  • As soon as you notice pain, use ice or cold packs for 10 to 15 minutes at a time, several times a day. Always put a thin cloth between the ice and your skin. Keep using ice as long as it relieves pain. Or use a warm, moist cloth or take hot baths if they feel good. Do what works for you.
  • Take over-the-counter pain relievers such as ibuprofen or naproxen (NSAIDs) or acetaminophen if you need them. Or try an NSAID cream that you rub over the sore area. Be safe with medicines. Read and follow all instructions on the label.
  • Wear a counterforce brace when you need to grasp or twist something. This is a strap around your forearm worn around your forearm just below the elbow. It may ease the pressure on the tendon and spread force throughout your arm.

After the pain eases, your doctor or physical therapist can teach you rehabilitation (rehab) exercises to stretch and strengthen your tendon. Doing these exercises at home can help your tendon heal and can prevent further injury.

When you feel better, you can return to your activity, but take it easy for a while. Don’t start at the same level as before your injury. Build back to your previous level slowly, and stop if it hurts. To avoid damaging your tendon again:

  • Take lessons or ask a trainer or pro to check the way you are doing your activity. If the way you use a tool is the problem, try switching hands or changing your grip. Make sure you are using the right equipment for your size and strength.
  • Always take time to warm up before and stretch after you exercise.
  • After the activity, apply ice to prevent pain and swelling.

Be patient, and stay with your treatment. You will probably feel better in a few weeks, but it may take 6 to 12 months for the tendon to heal. In some cases, the pain lasts for 2 years or longer.

If your symptoms don’t improve after 6 to 8 weeks of home treatment, your doctor may suggest a shot of corticosteroid. This could give you some short-term relief so you can start rehab exercises. But in the long term, having the corticosteroid shot may not help any more than not having it. Surgery is seldom needed for tennis elbow.


Overuse of the forearm muscles using a repeated twisting motion is the most common cause of tennis elbow. These movements are common to various jobs, such as carpentry or plumbing, and to many daily activities, such as yard work and lifting objects. Racquet sports, swimming, and throwing sports (such as baseball) can also lead to tennis elbow.

Tennis elbow injuries can result from:

  • Overuse. Repeated movements that involve twisting of the elbow cause small tears in the tendon, weakening it. Overuse depends on how hard or how long you do something.
  • Technique, or the way you do an activity. This includes holding equipment or a tool in a awkward position while you use it.
  • Equipment. This can happen, for example, if you use a tool or sports equipment that is too heavy for you or that has a grip that is the wrong size for your hand.
  • A single accident, such as a direct hit to the side of the elbow (lateral epicondyle), or falling on an outstretched arm.


Tennis elbow symptoms usually begin gradually. The main symptom is pain, which may begin with a dull aching or soreness on the outer part of the elbow that goes away within 24 hours after an activity. As time goes on, it may take longer for the pain to go away. The condition may further progress to pain with any movement, even during everyday activities, such as lifting a jug of milk. Pain may spread to the hand, wrist, other parts of the arm, shoulder, or neck.

Tennis elbow pain:

  • Usually occurs in the dominant arm (your right arm if you are right-handed, or left arm if you are left-handed).
  • Affects the outside of the elbow (the side away from your body). Pain increases when that area is pressed or when you are grasping or twisting objects.
  • May increase in the evening and make sleep difficult. The elbow might be stiff in the morning.
  • Over time may occur with mild activity, such as picking up a coffee cup, turning a jar lid or doorknob or key, or shaking hands. Simply starting your car could hurt. You may even have pain when you aren’t using your elbow.

Other parts of the arm, shoulder, and neck may also become sore or painful as the body tries to make up for the loss of elbow movement and strength.

Swelling rarely occurs with tennis elbow. If your elbow is swollen, you may have another type of condition, such as arthritis.

Radial tunnel syndrome is an unusual type of nerve entrapment that is sometimes confused with or can develop at the same time as tennis elbow.

What Happens

Tennis elbow pain is a symptom of tendon injury.

Overuse or stress can cause microtears in the tendon. This usually occurs because of repetitive motions of the arm or wrist. The longer you use an injured tendon, the more damaged it becomes.

The most common symptom of tennis elbow is pain on the outside of the elbow. Given enough rest, the tendon can mend on its own. But if you continue the activity, the weakened tendon may become more vulnerable to tear or rupture from a sudden accidental blow, fall, or forceful movement.

With early rest and treatment, an injured tendon is likely to heal with minimal scar tissue and maximum strength. While a recent, mild tendon injury might need a few weeks of rest to heal, a severely damaged tendon can take months to mend.

  • Mild soreness in the elbow that comes and goes may improve in 6 to 8 weeks.
  • Prolonged elbow pain and soreness may improve in 6 to 12 months. In some cases, the pain lasts for 2 years or longer.
  • Severe elbow pain or tennis elbow that doesn’t improve with 6 to 12 months of tendon rest and rehab may benefit from surgery.

What Increases Your Risk

Risk factors for tennis elbow include:

  • Activities that involve repeated movements of the forearm, wrist, and fingers. This includes grasping and twisting arm movements done in jobs (such as carpentry, plumbing, or working on an assembly line), daily activities (such as lifting objects or gardening), and sports (such as racquet sports, throwing sports, or swimming).
  • Improper techniques while doing certain movements, such as gripping a handle or twisting an object.
  • Improper equipment for work, daily activities, and sports, such as using a hammer or a tennis racquet with a grip that is the wrong size for your hand.
  • Age. Tennis elbow is most common in people who are in their 40s.
  • History of tendon injuries. Some people seem susceptible to tendon injury, based on a history of various tendon injuries such as rotator cuff disorders.

If you think that your workplace activity is causing elbow pain or soreness, talk to your human resources department for information on other ways of doing your job, equipment changes, or other job assignments. For more information, see the topic Office Ergonomics.

When should you call your doctor?

Call your doctor immediately if you had an injury to your elbow and:

  • You have severe elbow pain.
  • You cannot move your elbow normally.
  • Your elbow looks deformed.
  • Your elbow begins to swell within 30 minutes of the injury.
  • You have signs of damage to the nerves or blood vessels. These include:
    • Numbness, tingling, or a “pins-and-needles” sensation below the injury.
    • Pale or bluish skin.
    • The injured arm feeling colder to the touch than the uninjured one.

Call your doctor if you have:

  • Pain when grasping, twisting, or lifting objects.
  • Work-related problems caused by your elbow pain.
  • Elbow pain after 2 weeks of home treatment or if treatment is making your elbow pain worse.

Watchful waiting

Watchful waiting is when you and your doctor watch your symptoms to see if your health improves on its own. If it does, no treatment is needed. If your symptoms don’t get better or they get worse, then it’s time to take the next treatment step.

Home treatment often helps mild tennis elbow pain. You may want to try resting the elbow and applying ice or heat several times a day for 1 to 2 weeks before you call your doctor.

Who to see

For evaluation, diagnosis, or treatment of tennis elbow, you may see:

You may be referred to a:

  • Physical therapist (for stretching and strengthening exercises).
  • Tennis or other sports instructor (for training in sports).
  • Specialist in job-related safety or ergonomics (for work-related activities).

Exams and Tests

Your doctor can usually determine if you have tennis elbow by talking to you about the history of your symptoms, daily activities, and past injuries. You’ll have a physical exam too.

X-rays aren’t usually needed for diagnosis of tennis elbow but can sometimes rule out other causes of elbow pain, such as arthritis, signs of another type of injury, or a buildup of calcium crystals in a tendon or ligament. X-rays can show unusual bone structure that might cause soft-tissue damage (such as to tendons or muscles), but they don’t show soft tissues very clearly. If your elbow pain isn’t severe and can’t be linked to a specific injury, your doctor may recommend starting treatment without doing X-rays to see whether the problem clears up in a few weeks.

If nonsurgical treatment (such as rest, the use of ice and anti-inflammatory drugs, rehabilitation exercises, and changing or stopping certain activities) hasn’t helped relieve elbow pain, or if the diagnosis is unclear, other tests may be helpful.

  • MRI can show problems in soft tissues such as tendons and muscles.
  • Arthroscopy allows the doctor to see inside the elbow and get information that can be used with what he or she knows from your X-rays or physical exam. (Doctors can surgically treat tennis elbow with arthroscopy.)
  • Bone scans are done in rare cases. They can show stress fractures in the bone or certain disease conditions, such as a tumor or infection.

If your doctor thinks you have nerve damage, electromyogram and nerve conduction tests can check how well your nerves are working.

Treatment Overview

Tennis elbow treatment is most often successful. The most important part of treatment is tendon rest. A long rest from aggravating activity allows the small tears in the tendon to heal. Depending on how severe your condition is, you may need to rest your tendon for weeks to months. Surgery is a last resort if other treatment isn’t helpful.

Initial home treatment

Treatment for tennis elbow works best when it starts as soon as symptoms appear. If your condition is just starting, rest may be all you need. But in most cases, more treatment is needed to protect and heal the tendon.

You can treat your tennis elbow by:

  • Reducing pain.
    • As soon as you notice pain, use ice or cold packs for 10 to 15 minutes at a time, several times a day. Always put a thin cloth between the ice and your skin. Keep using ice as long as it relieves pain. Or use a warm, moist cloth or take hot baths if they feel good. Do what works for you.
    • You can also take nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin (such as Bayer), ibuprofen (such as Advil), or naproxen (such as Aleve). Be safe with medicines. Read and follow all instructions on the label. Do not give aspirin to anyone younger than 20 because of the risk of Reye syndrome, a serious illness. Or try an NSAID cream that you rub over the sore area. Acetaminophen (such as Tylenol) can also help with pain.
  • Stopping or changing activities that may irritate the tendon. Learn new techniques for certain movements, and use different equipment that may reduce the stress on your forearm muscles.

Wrist and elbow splints can be used in the treatment of tennis elbow. Splints are sometimes helpful for other bone, joint, and tendon problems. But splints have not been shown to help with pain or recovery for tennis elbow injuries.

Ongoing treatment

Over the first months of recovery from tennis elbow, continue your initial treatment and begin:

  • Rehabilitation (rehab). This can include exercise and other physical therapy treatments to decrease pain and increase range-of motion.
  • Wearing a special counterforce brace. This strap, worn around your forearm just below the elbow, may spread pressure throughout the arm instead of putting it all on the tendon. With a counterforce brace, you may do some grasping and twisting activities. It won’t help, though, if you continue using a poor technique or the wrong equipment that originally caused your tennis elbow. You don’t need a doctor’s advice before trying a counterforce brace. You can find these braces in most drugstores or sporting goods stores.
  • Working with an expert to see whether you need to change how you do an activity or what equipment you use. A sports trainer can help with sports activities and equipment. An ergonomic specialist, occupational therapist, or physical therapist can help with your workplace, including what tools you use, how your workspace is set up, and how you do your job.

Treatment if the condition gets worse or does not improve

The longer you continue activity that harms the tendon after tennis elbow symptoms begin, the longer rehab will take. This ongoing activity can cause severe tendon damage and may someday require surgery. If your symptoms don’t go away, your doctor may suggest:

  • Corticosteroid injection. An injection is sometimes used when you still have pain after 6 to 8 weeks of rest and rehab. It may help relieve pain for a short time. But over the long term, having the corticosteroid injection may not help any more than not having it.footnote 1 Corticosteroids may be harmful to the tendon. But this is usually only a problem after having many injections in the same year.
  • Ultrasound therapy. Ultrasound may help your tendon heal and stop pain.
  • Surgery, which is seldom used to treat tennis elbow (less than 5 out of 100 cases).footnote 2 Surgery may be a treatment option if persistent elbow pain doesn’t improve after 6 to 12 months of tendon rest and rehab. Surgery usually involves cutting (releasing) the tendon, removing damaged tissue from the tendon, or both. In some cases, tendon tears can be repaired.

What to think about

Your treatment choices will depend in part on whether elbow pain affects your job or daily life. It also depends on whether you are willing or able to change habits or activities that are causing your elbow pain.

Nonsurgical treatment is usually started if the injury is:

  • A result of overuse.
  • A sudden (acute) injury that doesn’t have large tears in the tendon or other severe damage in the elbow.

Most cases of tennis elbow respond to rest, ice, rehab exercises, pain medicine, and counterforce braces. This injury does take from 6 months to 12 months to heal. Patience helps.

Surgery is considered as a last resort when all other nonsurgical treatments have failed. You may be referred for surgery if:

  • The injury is from a sudden (acute) injury that left large tears in the tendon or other severe damage in the elbow.
  • The injury is from chronic overuse and more than 6 to 12 months of tendon rest and rehab haven’t relieved elbow pain. (If the tendon is very weak, surgery may not improve your situation much.)
  • Pain continues despite other treatment.
  • You have had a corticosteroid shot and it hasn’t helped.

In as many as 9 out of 10 people who have tennis elbow, symptoms go away and the people can return to their normal activities whether they have had surgery or not.footnote 3


The best way to prevent tennis elbow is to stretch and strengthen your arm muscles so that they are flexible and strong enough for your activities.

Other ways to prevent tennis elbow include:

  • Staying in good overall physical shape.
  • Using the correct techniques and movements during activities.
  • Using equipment appropriate for your ability, body size, and body strength.
  • Not overusing your arm with repeated movements that can injure your tendon. For example, alternate hands during activities, if possible.
  • Strengthening the muscles of your arm, shoulder, and upper back to help take stress off of your elbow.
  • Wearing a counterforce brace during activities that require grasping or twisting arm movements. A counterforce brace is a strap worn around your forearm just below your elbow. This brace may distribute pressure from muscle use throughout the arm, easing pressure on the tendon. The brace is not usually used for prevention. But it may be recommended for someone who is at very high risk for tennis elbow. Talk to your doctor if you are thinking of using one of these braces for prevention. A counterforce brace is not a substitute for rehab exercises or an excuse to continue overuse activities.

If you feel that certain activities at your job are causing elbow pain or soreness, talk to your human resources department for information on other ways of doing your job. They can help with changes to equipment or other job assignments.

Consider taking lessons to learn the proper technique for sports, such as tennis and golf, that require grasping and twisting motions in the arm. Have a sports trainer or a person who is familiar with sports equipment check yours to make sure it suits your level of ability, body size, and body strength.

In daily routines or hobbies, look for activities that use repeated arm movements that strain your fingers, wrist, or forearm, such as in gardening, cooking, or playing musical instruments. Train yourself to use techniques that won’t stress your elbow. For example, when you lift objects, lift with the palm of your hand facing upwards.

Home Treatment

If you have tennis elbow, follow these simple steps to reduce pain and start tendon healing. A rehab program such as this will prevent further injury by making your arm muscles stronger.

  • Rest your fingers, wrist, and forearm muscles to allow your tendon to heal. Stop any activity that you think may be causing your elbow pain and soreness. Depending on the severity of tendon damage, you may have to avoid this activity for weeks to months.
  • As soon as you notice pain, use ice or cold packs for 10 to 15 minutes at a time, several times a day. Always put a thin cloth between the ice and your skin. Keep using ice as long as it relieves pain. Or use a warm, moist cloth or take hot baths if they feel good. Do what works for you.
  • Wear a counterforce brace during activities that require grasping or twisting arm movements. A counterforce brace is a strap worn around your forearm just below your elbow. This brace may spread pressure throughout the arm instead of putting it all on the tendon. These braces are not a substitute for rehab exercises.
  • Try elevating your elbow to help ease pain and reduce swelling in your wrist or forearm.
  • Take nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin (such as Bayer), ibuprofen (such as Advil), or naproxen (such as Aleve) to reduce pain and inflammation. NSAIDs come in pills and in a cream that you rub over the sore area. Be safe with medicines. Read and follow all instructions on the label. Acetaminophen (such as Tylenol) can also help with pain.
  • Do simple warm-up and stretching exercises to keep your tendons from getting stiff. If you have any pain, stop the exercises.
  • When your pain is gone, start doing stretching and strengthening exercises, then gradually increase these exercises. Learn the correct techniques and which equipment is best for your activities.


Along with tendon rest, people often use medicine to treat tennis elbow. Medicine can help with pain and relieve or reduce swelling.

Medicine choices

Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin (such as Bayer), ibuprofen (such as Advil), or naproxen (such as Aleve), are the most commonly used medicines for treating tennis elbow. NSAIDs are available with or without a prescription. NSAIDs come in pills and in a cream that you rub over the sore area. Acetaminophen (such as Tylenol) can also help with pain. Be safe with medicines. Read and follow all instructions on the label.

Your doctor may suggest corticosteroid injections (shots) if you are still in pain after at least 6 to 8 weeks of tendon rest and rehab. Corticosteroids are a class of powerful anti-inflammatory medicine. Even though inflammation isn’t usually present in long-term (chronic) tennis elbow, corticosteroid shots may ease elbow pain for a short time. But in the long term, having the steroid shot may not help any more than not having it.

What to think about

Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroid shots don’t cure tennis elbow. But they can reduce pain and give you enough relief to start rehab.


Most cases of tennis elbow are treated without surgery. Less than 5 out of 100 cases require surgery.footnote 4 You and your doctor might consider surgery if several months of tendon rest and rehabilitation (rehab) haven’t stopped the pain or returned the flexibility and strength to your forearm.

Consider surgery if:

  • Your elbow is still sore and painful after more than 6 to 12 months of tendon rest and rehab.
  • Your doctor has ruled out other possible causes of elbow pain, such as nerve problems, arthritis, muscle injury, or injury to another tendon.
  • You can’t do normal daily activities and job tasks because of elbow pain.

Your doctor may suggest that you try a corticosteroid injection before you think about surgery. A steroid shot may help ease elbow pain for a short time. But over the long term, having the steroid shot may not help any more than not having it.

During surgery, a doctor will most likely cut (release) the tendon, remove damaged tissue from the tendon, or both. In some cases, tendon tears can be repaired.

After surgery, rehab is needed to restore flexibility and strength in the forearm.

Surgery choices

Surgery for tennis elbow involves cutting (releasing) the tendon and removing damaged tissue from the tendon. In some cases, tendon tears are repairable (reattached) if the repair can be done without overtightening the tendon. These procedures can be done both arthroscopically and through a larger incision (open surgery) or with a combination of the two techniques.

What to think about

There are different approaches to surgery for tennis elbow, such as where to enter the elbow and what type of reconstruction or repair on the tendon is done. Surgical technique is determined by the type, location, and severity of the injury and by the doctor’s preference and experience.

There is no strong medical research that shows that one type of surgery is better than another or that surgery is better than other treatment.footnote 5

The success of surgery depends in large part on the amount of time and effort you put into a rehab program.

Other Treatment

Other treatment for tennis elbow pain includes physical rehabilitation (rehab), acupuncture, topical nitric oxide, shock wave therapy, and transcutaneous electrical nerve stimulation (TENS).

Physical rehab is combined with tendon rest to restore flexibility and build muscle strength. Rehab is needed after surgery too.

Other treatment choices

A physical rehab program includes:

  • Relieving pain.
  • Maintaining good overall physical fitness.
  • Exercises, including warm-ups, stretching, and strengthening.
  • Learning new techniques for certain movements; using equipment that best suits your ability, body size, and strength; and limiting activities that require grasping or twisting arm movements.
  • Retraining and ergonomic changes at your work site. For more information, see the topic Office Ergonomics.

Other treatments include:

  • Acupuncture. Small studies report tennis elbow relief after acupuncture treatment. But there is not enough strong evidence to support or refute this treatment.footnote 6
  • Extracorporeal shock wave therapy. A review of shock wave therapy for tennis elbow had conflicting findings. Some studies reported that shock wave therapy improved tennis elbow recovery. But others found that it offered no therapeutic benefit when compared to placebo treatment.footnote 7
  • Topical nitric oxide. In a patch form, nitric oxide is applied to the elbow to speed recovery. This medicine has been used as a treatment for tennis elbow for a short time. One study showed positive results.footnote 8
  • Transcutaneous electrical nerve stimulation (TENS). TENS is sometimes used to treat tennis elbow, usually in a physical therapy setting.

What to think about

A physical rehab program not only helps heal injured tendons and muscles but also helps prevent further injury.

Physical rehab combined with tendon rest is the main tennis elbow treatment. Corticosteroid shots are only considered if several weeks of rest and rehab have not reduced symptoms. Surgery may be considered after 6 to 12 months of nonsurgical treatment.

If the type of work you do is causing your injury, an occupational therapist may help you change how you are working or the kind of work that you do.



  1. Coombes BK, et al. (2010). Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: A systematic review of randomised controlled trials. Lancet, 376(9754): 1751–1767.
  2. American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Medial and lateral epicondylitis. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 370–374. Rosemont, IL: American Academy of Orthopaedic Surgeons.
  3. Rasouli A, Gupta R (2007). Elbow, wrist, and hand injuries. In PJ McMahon, ed., Current Diagnosis and Treatment in Sports Medicine, pp. 146–159. New York: McGraw-Hill.
  4. American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Medial and lateral epicondylitis. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 370–374. Rosemont, IL: American Academy of Orthopaedic Surgeons.
  5. Buchbinder R, et al. (2011). Surgery for lateral elbow pain. Cochrane Database of Systematic Reviews (3).
  6. Bissett L, et al. (2011). Tennis elbow, search date June 2009. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
  7. Buchbinder R, et al. (2005). Shock wave therapy for lateral elbow pain. Cochrane Database of Systematic Reviews (4). Oxford: Update Software.
  8. Paoloni J, et al. (2003). Topical nitric oxide application in the treatment of chronic extensor tendinosis at the elbow. American Journal of Sports Medicine, 31(6): 915–920.


Current as of:
November 16, 2020

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP – Emergency Medicine
Kathleen Romito MD – Family Medicine
Adam Husney MD – Family Medicine

Coombes BK, et al. (2010). Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: A systematic review of randomised controlled trials. Lancet, 376(9754): 1751-1767.

American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Medial and lateral epicondylitis. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 370-374. Rosemont, IL: American Academy of Orthopaedic Surgeons.

Rasouli A, Gupta R (2007). Elbow, wrist, and hand injuries. In PJ McMahon, ed., Current Diagnosis and Treatment in Sports Medicine, pp. 146-159. New York: McGraw-Hill.

American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Medial and lateral epicondylitis. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 370-374. Rosemont, IL: American Academy of Orthopaedic Surgeons.

Buchbinder R, et al. (2011). Surgery for lateral elbow pain. Cochrane Database of Systematic Reviews (3).

Bissett L, et al. (2011). Tennis elbow, search date June 2009. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.

Buchbinder R, et al. (2005). Shock wave therapy for lateral elbow pain. Cochrane Database of Systematic Reviews (4). Oxford: Update Software.

Paoloni J, et al. (2003). Topical nitric oxide application in the treatment of chronic extensor tendinosis at the elbow. American Journal of Sports Medicine, 31(6): 915-920.

90,000 What are the best ways to prevent tennis elbow?

Tennis elbow can be difficult to treat, so prevention is usually the best strategy. One of the best ways to prevent tennis elbow is to keep the muscles in your forearm, hand, and wrist strong enough to relieve stress on your elbow. Using the proper equipment is another method of preventing elbow tendinitis, as using the wrong size or weight can cause injury.Of course, form plays a big role in preventing any kind of sports injury, so lessons in proper hitting technique may be necessary.

There are various exercises that can help reduce stress on the elbow as they strengthen the muscles in the forearm, arms and wrist. Light weights can be used in this endeavor, as wrist lengthening and curls are often good ways to start strengthening your wrist. Putting a rubber band around your fingers and then stretching them can also help prevent tennis elbow, like putting a tennis ball in your palm and squeezing it repeatedly.General stretching exercises before playing tennis can also help prevent tennis elbow as this ensures that the muscles are properly warmed up.

Using a racket that is too heavy, light, large or small can have a big impact on who gets the tennis elbow. Players should check with their coach to ensure that the racket they choose is appropriate for their size and weight. You should also check your grip, as too small or large can strain your forearms.Even checking the tension on the strings in the racquet can make a big difference, as too tight strings can contribute to the tennis knee. On the other hand, while looser strings can help prevent tennis elbow, they can also reduce ball control, so it is important to consult a professional about your equipment.

Some people show poor shape when playing tennis, which makes tennis elbow likely. Even someone with the best equipment can develop this medical problem if their punches are not in the correct shape, as weak punches can strain the elbow.For example, you should swing the whole arm during each stroke, not just the wrist. In addition, the muscles in the arms should be used instead of the muscles in the forearm when twisting or lifting the racquet. Lessons in proper hitting technique can not only prevent tennis elbow, but also improve the overall tennis player’s gameplay.


90,000 4 Ways To Cure Tennis Elbow

Tennis elbow is a commonly used term for tendon pain in the back of the elbow and is often caused by repetitive strain.Although the condition can be painful, it is usually not too serious and can be easily treated. Fortunately, tennis elbow can heal on its own if you don’t do anything to make the injury worse. Taking pain relievers and massaging your elbow also helps. Always check with your doctor when you first feel pain to check if you have a sprain or tendon rupture that requires surgery.


Method one of 4: Rest with your injured elbow

  1. one Stop doing what caused your tennis elbow. Although tennis elbow can be caused by playing tennis, the full spectrum of potential causes is much broader. Any physical activity you do that includes repetitive elbow movements can cause tennis elbow. It is important to stop doing this in order for the elbow to heal. Non-tennis activities that can trigger tennis elbow include:

    • Lifting or carrying heavy loads
    • Daily computer and keyboard use
    • Sports such as basketball or hockey
    • Plumbing, gardening, or painting

  2. 2 Change the repetitive steps if you can’t stop doing them. Tennis elbow often occurs due to repetitive movements associated with the rotation of the wrist and shoulder. In some cases, your tennis elbow may have been triggered by an activity that is part of your job or daily life. If so, look for ways to change your exercises and reduce the strain on your elbow.

    • For example, if you work in construction, your job may depend on your ability to carry heavy bags of cement. Try changing your activity by asking someone to help you carry your bags or using a wheelbarrow to lug around.
  3. 3 Rest your elbow for at least 1 week. It is very important to allow damaged tendons time to heal and heal. Do this while avoiding any activity that strains your elbow. Try not to lift heavy objects with your injured hand. Minimize computer and keyboard usage whenever possible. Also try to find a way to give your arm physical rest during the day so that you don’t over-strain the tendons in your elbow.

    • For example, if you are sitting on a couch or chair, keep your elbow raised on the arm of the chair. Or, if uncomfortable, try supporting your elbow with two pillows while sitting in a chair.


Method 2 of 4: Reduce Tennis Elbow Pain

  1. One Wear a forearm brace to relieve elbow pain. Putting a tight brace around the center of your forearm will help relieve pressure from the tendons of your sore elbow and the muscles that move your arm.This, in turn, will reduce the amount of pain you feel from damaged tendons. When you put the brace on your arm, tighten it about 5.1 cm below your elbow.

    • Buy a forearm or elbow brace from any large pharmacy or drugstore. They are usually inexpensive and should cost less than $ 10.
    • Ask your physical therapist or partner to help you put on the brace to make sure it is the right size.
  2. 2 Use the other hand to massage the painful points on the elbow. Find the softest or most painful spot on your elbow. Using 3-4 fingers of the other hand, massage the tender area with long firm strokes. Apply moderate pressure, but not enough to make the pain worse. Massage from bottom to top and over the area. Do this 1-2 times a day.

    • You will find that the pain extends to the areas surrounding the elbow, so massage any areas where pain occurs.
    • Use a small amount of natural massage oil to relieve pain.
  3. 3 Freeze your elbow for 15 minutes. Apply frozen girl or any other ice pack directly to painful elbow for 15 minutes. Do this 3-4 times a day and set aside ice packs for at least 4-5 hours. The ice will help reduce inflammation in the tendons (and muscles) as well as relieve the pain you feel. Low temperatures can also reduce inflammation in damaged tissues.

    • You can buy an ice pack filled with gel at any pharmacy or supermarket.
    • If you don’t have an ice pack on hand, try bringing a bag of frozen peas or frozen corn to your elbow.
  4. 4 Take NSAIDs to relieve pain and reduce swelling in your elbows. NSAIDs – non-steroidal anti-inflammatory drugs – include ibuprofen, naproxen (found in drugs like Aleve), and diclofenac (found in Cambia and Cataflam). These medications will have two effects: they stop (or reduce) elbow pain and reduce swelling in damaged tendons.

    • Always follow the directions printed on the side of the NSAID package. Do not exceed the recommended daily dosage.
  5. 5 Apply NSAID cream to elbow for more specific treatment. Not all NSAIDs are taken by mouth. Pharmaceutical companies also make topical creams that can be purchased over the counter at your local pharmacy. Apply topical cream directly to the elbow where the tennis elbow is located.The cream will reduce pain and swelling, just like oral NSAIDs.

    • Carefully follow the directions on the tube of NSAID cream. Do not use more cream than indicated, and only apply cream as often as indicated on the package.


Method 3 of 4: Promoting Healing with Therapy and Stretching

  1. one Practice physical therapy to strengthen and heal your injured elbow. Physical therapy aimed at strengthening the muscles of the affected elbow may help reduce symptoms associated with tennis elbow.So, ask your therapist if they can refer you to a therapist for help with tennis elbow. The physical therapist will ask you to do various exercises that involve eccentric contractions of the injured elbow.

    • You need to train your tendons to heal properly because your body will not know how to heal itself unless you instruct it on how to place the new fibers of your tendon through exercise.
    • Eccentric contractions occur when you strain your elbow by lengthening it (for example, when you straighten your arm).
  2. 2 Perform a simple exercise with 2 to 5 lb (0.91 to 2.27 kg) dumbbells. Place your hand on the table to support yourself, extend your arm fully so that your palm is facing the ground. Then take your weight and lift your wrist. If you feel pain in the elbow area, you are training the correct tendon.
    • Perform wrist movements for 20 sets: 3 sets in the morning and 3 in the evening.
    • As it gets easier, increase the number of reps, not the weight.This teaches the tendon to heal.
  3. 3 Stretch your wrist to maintain flexibility. Gently rotate the hand that is on the arm with the painful elbow. Pull your arm back and forth to stretch the tendons that connect to the elbow. Also try rotating your wrist in a circular motion 5–6 times. Stretching the wrist also increases blood flow to the area, which should encourage painful tendons to heal.

    • If you feel more pain at any time while stretching, stop immediately.
    • Try a forearm stretch as well. Extend your arms so that your fingertips are facing away from you, then bend your wrists 90 °. Then turn your palms so that your fingertips are pointing back towards your knees and do the same.
  4. 4 Use the rowing machine after you have recovered, stretch and strengthen your elbow. Rowing machines allow you to move your body weight back and forth with both hands.This stretches and strengthens the elbow muscles. Stimulating these muscles can help prevent further damage to your tendons and build strength. Rowing machines are available in most gyms.

    • Consult a doctor or physiotherapist before using the rowing machine. Ask them to show you how to use the correct rowing technique. If you use the wrong shape, you can damage your elbow even more.


Method 4 of 4: Get Medical Treatment

  1. One See your doctor if your elbow still hurts after trying other methods. For severe tennis elbows, simple elbow rest and pain relief with over-the-counter medications may not be enough to stimulate the healing of injured tendons. If your tennis elbow persists for more than 1–2 days, make an appointment with your doctor.

    • Also see your doctor if elbow pain becomes severe or stops responding to ice and NSAIDs.
  2. 2 If recommended, inject steroids around damaged tendons. If you have tried several methods for reducing elbow pain and have failed, ask your doctor about steroid injections. Doctors usually inject corticosteroids into painful tendons or muscles that need tissue repair. If the initial treatment works, your doctor may recommend follow-up injections over a period of several weeks.

    • The doctor giving the steroid injection will first inject a local anesthetic to prevent you from feeling multiple injections into the painful tendon.
  3. 3 Ask your doctor about PRP injections into the injured tendon. Treatment of tennis elbow with PRP – Platelet Rich Plasma – is relatively new, but highly effective. You will need to visit a doctor or surgeon and have a blood test to start the procedure. The surgeon uses a machine to remove platelets from a blood sample, and then re-injects those platelets back into the injured elbow tendon.

    • Platelets can heal damaged tissue and should significantly speed up the healing process of damaged tendons.
    • The whole procedure will only take about 15 minutes. You may feel mild discomfort during the injection.
    • Check with your insurance company if this type of procedure is covered for you.
  4. 4 Try shockwave therapy as a non-invasive option. If you or your doctor would prefer not to use injections to treat tennis elbow, ask them about shockwave therapy.When you receive shock wave therapy, your doctor will use an electrical device to transmit high energy shock waves to your injured elbow. This will stop the pain you feel and it will also help the damaged tendons heal.

    • Because shock wave therapy can be a little uncomfortable, your doctor may prescribe a local anesthetic for you first.
    • If you have severe pain or severe damage to your tendons, you may need to return for several shockwave therapy sessions.
  5. 5 Consider surgery if other treatments are not improving your tennis elbow. Surgery is considered the last treatment option for tennis elbow, but may be advisable if the condition does not improve for several months. To reduce the pain you feel from damaged or torn tendons, your doctor will shorten or repair the tendons. It will take several months.

    • Your GP will most likely refer you to a surgeon for this procedure.


Community Q&A

Search Add New Question

  • Question: How to quickly heal tennis elbow? Jonathan Frank, M.D.
    Sports Orthopedic Surgeon and Joint Preservation Specialist Dr. Jonathan Frank is an orthopedic surgeon based in Beverly Hills, California, specializing in sports medicine and joint preservation. Dr. Frank’s practice focuses on minimally invasive arthroscopic surgery of the knee, shoulder, hip and elbow.Dr. Frank holds a M.D. from the University of California, Los Angeles School of Medicine. He completed an Orthopedic Residency at Rush University Medical Center in Chicago and an Internship in Orthopedic Sports Medicine and Hip Conservation at the Steadman Clinic in Vail, Colorado. He is the staff physician for the US ski and snowboard team. Dr. Frank is currently a scientific reviewer for leading scientific journals and his research has been presented at regional, national and international orthopedic conferences, receiving several awards, including the prestigious Mark Coventry and William A. Gran awards.Jonathan Frank MD Sports Orthopedic Surgeon and Joint Preservation Specialist Expert Answer Tennis elbow is easy to treat, but it takes time to get better. Be religious about working with a damaged tendon regularly but appropriately so that it receives information from the environment on how to heal it.
  • Question: What is the best treatment for tennis elbow? Joshua Gralman, PT, DPT, FAFS
    Physiotherapist and Entrepreneur Dr. Joshua Gralman, PT, DPT, FAFS, is the founder and chief sports mechanic of Clutch PT + Performance, a private physical therapy clinic specializing in sports and orthopedics in New York City.With over a decade of experience, Dr. Gralman specializes in the treatment of acute and chronic pain and injury, optimization of athletic performance and post-operative rehabilitation. Dr. Gralman received his Doctor of Physical Therapy (DPT) from Columbia University College of Physicians and Surgeons. He is one of the few general practitioners in New York to receive Applied Functional Science Fellowship at the Gray Institute for Functional Transformation (GIFT). He is certified in Active Relaxation Technique and Back Manipulation and is also a TRX Suspension Training Specialist.Dr. Gralman has treated athletes of all levels throughout his career, from Ironman champions and Olympians to marathon moms. He advises Triathlete, Men’s Health, My Fitness Pal and CBS News. Joshua Grahlman, PT, DPT, FAFS Physiotherapist and Entrepreneur Response Stretch your forearms to improve range of motion. Extend your arms so that your fingertips are pointing away from you, palms down, then bend your wrist so that your fingers are pointing down to the floor. Then flip your arms over and bend your wrists down again.

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  • Avoid sleeping on your tennis elbow. Try sleeping on your back or side (for example, sleeping on your left side if your right arm has a tennis elbow).



  • If you are allergic to medications, check the composition of your medicated creams to make sure you do not have an allergic reaction.
  • Some people have different pain tolerances. Even if you feel a little pain in your elbow, check it to make sure it isn’t torn.


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90,000 Treating Tennis Elbow Syndrome | Clinic ALODERM, Moscow

You will forget about unpleasant, painful sensations

Hand movements will become free and relaxed

Our clinic has the necessary equipment to eliminate pain symptoms.We carry out treatment procedures that give a stable effect.

Attractive environment for patients

We will offer our patients:

  1. Only innovative technologies;
  2. Comprehensive diagnostics. Precise equipment is used;
  3. Treatment interventions based on an individual approach;
  4. Complete recovery after therapy;
  5. The necessary help in solving any difficulties.

Medical staff will provide an environment of trust with patients.

Tennis Elbow: Define and Establish Reasons

Tennis elbow refers to diseases of the musculoskeletal system. Its nature has not yet been established. It is diagnosed in athletes, patients performing monophonic, repetitive movements while working on machines, knitting machines and other equipment.

Tennis elbow syndrome has the following causes:

  1. Micro-tears arising from increased stress on the tendons in the area of ​​the external articulation;
  2. Formation of new microtraumas as a result of constant exposure to the joint;
  3. Age-related changes in the condition of muscle, cartilaginous tissues and bone structure;
  4. Deterioration of blood circulation;
  5. The presence of concomitant diseases (osteochondrosis, osteoporosis, etc.)p.

People over forty years of age are most affected by the disease. Their physical activity decreases. Movement becomes more constrained, uncertain. There is a rapid increase in body weight. Internal changes are observed in the body. They lead to a deterioration in general well-being and cause complications. As soon as you find such symptoms, come to our clinic. Here you will be provided with the assistance you need. Otherwise, the disease will progress and negatively affect the usual rhythm of life, reduce efficiency, activity.

Tennis elbow: symptoms, treatment

A similar disease is expressed in different symptoms:

  1. Increased pain in the elbow joint with increased physical exertion;
  2. Numbness of muscle tissue;
  3. Characteristic tingling and constant “chills”;
  4. Rapidly developing impotence of the affected arm.

At the beginning, there are sharp, burning pains that penetrate into the hand. Then they become dull, aching.The patient feels pain symptoms when flexing the elbow joint and extending the forearm. At the elbow affected by inflammation, the range of motion gradually decreases.

Answer the question “How to treat tennis elbow?” only an experienced doctor can. Do not treat yourself by researching material on the Internet. Only competent and experienced specialists will help to heal your body and restore your well-being.

Diagnostic methods, medical procedures in “Aloderm”

Our patients will have the opportunity to undergo treatment that includes:

  1. Ultrasound of ligaments, muscle tissues;
  2. Ultrasound of bone and cartilage formations;
  3. Injections of joints based on technological preparations;
  4. Shock wave therapy (SWT).The clinic is equipped with the latest model of the BTL-6000 SWT Topline non-invasive shock wave therapy device;
  5. Laser physiotherapy (LFT). The elbow joint is treated with a non-invasive laser therapy device;
  6. Electromyostimulation / myoneurostimulation / myostimulation (EMS).

You will feel a powerful surge of energy after a complex of medical procedures. You will feel vigorous, full of desire to go in for sports, what you love. Forget about unpleasant, painful sensations.Hand movements will become free and relaxed.

“Tennis elbow”: what it is and how to treat it

Among tennis players there are often complaints of pain in the elbow, someone comes to trainings with bandages, someone takes a timeout and goes to procedures, and someone ends up with an operation. GameSetMatch.ru decided to study the problem and how to treat it, as well as get an expert’s opinion.

The disease, called “tennis elbow” (epicondylitis) and accompanied by pain in the elbow and other parts of the arm, occurs not only in tennis players – it can manifest itself in everyone who has to often repeat the stereotypical movements of flexion-extension of the arm, carry heavy bags or briefcases …But whoever the patients are, in the last 10 years they have been offered basically the same treatment – injections of cortisone (a steroid).

Recent studies in the United States and the United Kingdom have shown that administration of a steroid that rapidly relieves pain and fights inflammation is the preferred treatment for many orthopedic surgeons. However, a growing body of evidence suggests that these injections, while effective in the short term, can often worsen the patient’s condition in the months that follow.This raises an interesting question about the risks of rapidly treating pain.

Eduard Bezuglov, the chief physician of the Russian national football team and at the same time head of his own sports medicine clinic Smart Recovery, commented on the treatment of this tennis ailment.

Eduard Bezuglov / photo: Alexander Mysyakin

I would treat tennis elbow with an injection of platelet-rich plasma in parallel with long-term magnetotherapy (3 hours or more) and X-ray therapy for 6-7 sessions.

For decades, it was believed that the cause of “tennis elbow” – inflammation of the tissues around the elbow joint. However, new research on the disease, including biopsies of damaged tissue, shows that severe inflammation only exists in the early stages of the disease. Instead, it is worth talking about tissue degeneration: if a constant increased load is applied to the joint, then the body does not have time to recover from all microtraumas received during it, and the tendons holding the elbow begin to “wear out” and deform.The pain from this can be severe and last for months.

The appeal of cortisone injections is also that it is a fairly simple treatment that any practitioner can provide. But in the most serious study to date on tennis elbow therapy, cortisone may even be counterproductive.

In this study, published last summer in the BMC Musculoskeletal Disorders, 177 people with newly diagnosed tennis elbow were given either two shots of cortisone over three weeks, or a placebo shot in the same way.

Patients were randomly selected for each of these two groups. All participants in these groups received an elbow massage and also began a six-week home-based course of specific hand exercises.

There was also a third, control group, to whose members no type of treatment was applied.

The pain symptoms and functionality of the elbow of the study participants were regularly assessed for one year after the end of treatment. At the first checkup, six weeks later, men and women who received cortisone injections reported much less pain than participants in the other two groups, who reported only slightly less pain on average than at the start of the study.But over the next six weeks, the intensity of pain in people receiving cortisone shots was equal to everyone else, and after six months it became even much greater.

Why cortisone may cause the disease to worsen remains unclear, says Dr. Morten Olaussen, family doctor, researcher at the University of Oslo in Norway and co-author of the study described above. But there is a possibility that the steroid may interfere with the structural repair of the joint.

The good news is that after a year, all study participants recovered – regardless of the presence, absence, or type of treatment.The cure rate in the control group was the same as in the others – about 80%. These results show that despite our instinctive urge to do something when it hurts, time is the cheapest and most effective remedy for tennis elbow.

“Eliminate traumatic activities, just wait and watch,” says Dr. Olaussen.

Source and Authors: Adapted from the New York Times, Ksenia Denisova, translated by Evgenia Pyatakova

Tennis elbow

A condition in which the outside of the elbow becomes painful and painful.

Tennis elbow , also known as lateral epicondylitis , is a condition in which the outer part of the elbow becomes painful and painful. The pain can extend to the back of the forearm, and the grip strength can be weak. Symptoms usually appear gradually. Golfer’s elbow is a similar condition that affects the inside of the elbow.

This is due to excessive stress on the muscles of the dorsum of the forearm.This usually happens as a result of work or sports, classic rocket sports. The diagnosis is usually based on symptoms with medical imaging used to rule out other potential causes. The pain is more likely to worsen when the subject tries to flex the wrist while the wrist is held in a neutral position. The power screwdriver can cause injury if misused with one hand. It is classified as chronic tendinosis rather than tendinitis.

Treatment includes reducing the activity that causes symptoms, together with physical therapy or other treatment that gradually increases the load. Pain relievers such as NSAIDs or acetaminophen (paracetamol) may be used. A forearm brace may also be helpful. If the condition does not improve, corticosteroid injections or surgery may be recommended, although some experts recommend avoiding cortisone injections due to poor long-term results in high-quality studies.Many people recover within one month or two years.

About 2% of people were injured. Most often, people between the ages of 30 and 50 are affected. The disease was first described in 1873. The name “tennis elbow” first appeared in use for this condition in 1882.

Signs and Symptoms

  • Pain in the outer part of the elbow (lateral epicondyle)
  • Pinpoint tenderness over the lateral epicondyle, the protruding part of the bone on the outside of the elbow.
  • Pain when grasping and moving the wrist, especially when extending the wrist (for example, when turning a screwdriver) and lifting movements

Symptoms associated with tennis elbow include, but are not limited to, pain radiating from the outside of the elbow to the forearm and wrist, pain on extension of the wrist, weakness in the forearm, painful grip when shaking or rotating the doorknob, and inability to hold relatively heavy objects. The pain is similar to the condition known as elbow in golf , but the latter occurs on the medial side of the elbow.


The term “tennis elbow” is widely used (albeit informally), but this condition should be understood not only for tennis players. Historically, the most commonly used medical term for this condition is lateral epicondylitis.

Because the histological findings reveal non-inflammatory tissue, the terms “lateral elbow tendinopathy”, “tendinosis” or “angiofibroblastic tendinosis” have been proposed instead of “lateral epicondylitis”.More recently, in 2019, a group of international experts concluded that the most appropriate terminology is “lateral elbow tendinopathy”.


Tennis elbow location

Tennis elbow is a type of repetitive injury caused by overexertion of a tendon and failure to heal. In addition, the short radial extensor of the wrist plays a key role.

An example of a repetitive motion that can cause tennis elbow

Early experiments showed that tennis elbow is primarily caused by overexertion.However, studies show that injuries such as direct impacts to the epicondyle, sudden strong sprains, or severe sprains account for more than half of these injuries. Repeated incorrect hitting of a tennis ball in the early stages of sports training causes shock in the elbow joint and can worsen the condition.

There are several aspects of tennis that can cause a player to develop tennis elbow. Technically speaking, backhand dribbling with the elbow, over-pronation of the forearm when doing topspin on the front edge, and over-flexing of the wrist when serving can all lead to tennis elbow to a large extent.Other things that can be improved are the type of racket, the size of the handle, the tension on the string, the type of surface of the court, and the weight of the ball.


Histological findings include tissue granulation, microrelief, degenerative changes, no traditional inflammation.

Longitudinal sonogram of the lateral elbow shows thickening and irregularity of the common extensor tendon, consistent with tendinosis, as ultrasonography reveals calcifications, intramaterial ruptures, and marked irregularities in the lateral epicondyle.Although the term “epicondylitis” is often used to describe this disorder, most histopathological findings show no evidence of an acute or chronic inflammatory process. Histological studies have shown that this condition is the result of tendon degeneration in which normal tissue is replaced by disorganized collagen. Therefore, the disorder is more appropriately referred to as tendinosis or tendinopathy rather than tendinitis.

Color Doppler ultrasound reveals structural changes in tendons with the presence of vessels and hypoechoic areas corresponding to areas of pain in the extensor region.

The pathophysiology of lateral epicondylitis is degenerative. Non-inflammatory, chronic degenerative changes in the origin of the muscle of the short radial extensor muscle of the wrist (ECRB) are detected in samples of surgical pathology. It is unclear whether the pathology is affected by prior administration of corticosteroids.

Tennis players generally assume that tennis elbow is caused by the repetitive striking of thousands of tennis balls, resulting in tiny tears at the insertion of the forearm tendon at the elbow.

The little finger extensor also has a small origin site medial to the elbow joint that this condition can affect. Muscle includes little finger extension and some wrist extension to adapt to the “click” or flick of the wrist — usually associated with the swing of the racket.More often than not, the extensor muscles become painful due to tendon rupture due to excessive stretching. Incorrect shape or movement allows the force of the swing to rotate through and around the wrist, creating moment at that joint rather than at the elbow or rotator cuff. At this point, the pressure creates shock forces on the tendon, causing irritation and inflammation.

At least one author doubts that lateral epicondylitis is caused by repetitive trauma / overuse, supporting a theory that is probably exaggerated and not scientifically supported.

Other putative risk factors for lateral epicondylitis include playing tennis at an older age, unusual physical activity, decreased mental timing and speed, and repetitive eccentric muscle contractions (controlled lengthening of the muscle group).


Physical examination

To diagnose tennis elbow, doctors perform a series of tests in which they apply pressure to the affected area, asking the patient to move their elbow, wrist, and fingers.The diagnosis is made on the basis of discrete and characteristic clinical signs and symptoms. For example, when the elbow is fully extended, the patient feels soreness over the affected point of the elbow. Most often, pain occurs at the beginning of the short extensor of the radial joint of the wrist from the lateral epicondyle (the beginning of the short extensor of the wrist), 1 cm distal and slightly in front of the lateral epicondyle. Pain is also observed with passive wrist flexion and resistive wrist extension (Kosen test).

Medical Imaging

X-rays can confirm and distinguish possible causes of pain other than tennis elbow, such as fracture or arthritis. In rare cases, calcification can be found where the extensor muscles attach to the lateral epicondyle. Medical ultrasound and magnetic resonance imaging (MRI) are other valuable diagnostic tools, but are often avoided due to their high cost. MRI screening can confirm excess fluid and swelling in the affected area of ​​the elbow, for example, at the junction between the forearm bone and the extensor radicular extensor muscle of the wrist.


If tennis elbow injury is due to lateral epicondylitis, experience and ability are another contributor to tennis elbow injury. The proportion of players with a history of tennis elbows increased in the number of playing years. In terms of ability, poor technique increases the chance of injury, just like any sport. Hence, a person must learn the correct technique for all aspects of their sport. The competitive level of an athlete also affects the incidence of tennis elbow.Classes A and B players had a significantly higher incidence of tennis elbows compared to Classes C and beginners. However, there is an opposite, but not statistically significant, trend of recurrence of previous cases, with increasing frequency as the level of ability decreases.

Other ways to prevent tennis elbow:

  • Reduce the amount of playing time if you are already injured or feel pain outside the elbow.
  • Stay in good physical shape overall.
  • Strengthening the muscles of the forearm: (Quadratus pronator, Teres pronator, instep muscle) and radial extensor LONGUS and Brevis – upper arm: (biceps, triceps) nd shoulder (deltoid muscle) and upper back (trapezius). Increased muscle strength increases the stability of joints such as the elbow joint.
  • As with all sports, use equipment that is appropriate for your ability, body size, and muscle strength.
  • Avoid repeated lifting and pulling of heavy objects (especially overhead).

Vibration dampers (also known as gummies) are not considered a reliable preventative measure. Rather, the correct distribution of weight in the racket is considered a more viable option for countering impact.


There was insufficient evidence for the treatment of lateral epicondylitis prior to 2010. There have been clinical trials of many of the proposed treatments, but they were of poor quality.

In some cases, tennis elbow symptoms resolve without treatment within 6-24 months. If left untreated, tennis elbow can lead to chronic pain that impairs the quality of daily life.


There are several recommendations for the prevention, treatment and prevention of relapse that are highly speculative, including stretching and progressive strengthening exercises to prevent re-irritation of the tendons and other exercise measures.

One way to help treat minor tennis elbows is to simply relax the affected arm. The rest allows the tension and tension in the forearm to slowly relax and eventually bring the hand into working condition – after a day or two, depending on the case.

Eccentric rubber bar exercises are very effective in relieving pain and increasing strength. In the exercise, you need to take a rubber rod, twist it, and then slowly unwind it.While this can be considered evidence-based practice, long-term results have yet to be determined.

There are different opinions about whether it is normal for pain to occur during these exercises. Some people think less than 5/10 pain is normal.

There is moderate evidence that joint manipulation to the elbow and wrist and back manipulation to the cervical and thoracic spine lead to clinical changes in pain and function.There is also moderate evidence for the short- to medium-term effectiveness of cervical and thoracic spine manipulation as adjunctive therapy to concentric and eccentric stretching plus wrist and forearm mobilization. Although not yet definitive, the short-term analgesic effect of the manipulation may allow more vigorous stretching and strengthening exercises, leading to a better and faster healing process of the affected tendon in lateral epicondylitis.

Low-level laser therapy, administered at specific doses and wavelengths directly to the lateral attachments of the elbow tendons, can result in short-term pain relief and reduced disability.

Extracorporeal shockwave therapy, while safe, has unclear benefits.

Orthopedic appliances

Counterforce brace reduces lengthening of tendon fibers

A wrist extensor orthosis reduces stress on the affected area.

A brace is a device that is used on the outside of the limb to improve function or reduce pain. Orthopedics may be helpful for tennis elbow, however long-term effects are unknown. To address this problem, two main types of orthoses are prescribed: resistance elbow orthoses and wrist extension orthoses. The Counterforce brace has a circular structure that surrounds the arm. This orthosis usually has a strap that applies a binding force to the origin of the wrist extensors.The force applied by the orthosis reduces the elongation of the tendon fibers. The wrist extensor orthosis supports the wrist in slight extension. This position reduces the overload in the affected area.

Studies have shown that both types of braces improve hand function and reduce pain in people with tennis elbow.


Although anti-inflammatories are commonly prescribed in the treatment of tennis elbow, the evidence for their effect is usually anecdotal, with only limited research showing benefit.A systematic review found that topical nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce pain in the short term (up to 4 weeks), but was unable to draw firm conclusions due to methodological problems. The evidence for oral NSAIDs is mixed.

There is insufficient evidence of long-term improvement from any type of injection, be it corticosteroids, botulinum toxin, prolotherapy or other substances. Corticosteroid injections may be effective in the short term, but they are not beneficial after a year compared to a wait and see approach.A recent randomized control study comparing the effect of corticosteroid injection, physiotherapy, or a combination of corticosteroid injection and physiotherapy, showed that patients receiving corticosteroid injections compared with placebo had a lower overall cure or improvement at 1 year (relative risk 0.86). Patients receiving corticosteroid injections also had a higher relapse rate at 1 year compared with placebo (54% versus 12%, relative risk 0.23).Complications from repeated steroid injections include skin problems such as hypopigmentation and fat atrophy, resulting in skin being depressed around the injection site. Steroid injections are more effective than shock wave therapy. Botulinum toxin type A for forearm extensor paralysis in people with chronic tennis elbow that has not improved with conservative measures may be viable.


In stubborn cases, surgical intervention is possible.Surgical methods include:

Surgical techniques for lateral epicondylitis can be performed by open surgery, percutaneous surgery, or arthroscopic surgery without high quality evidence that any particular type is better or worse than another. Side effects include infection, nerve damage, and inability to straighten the arm. A review of the data related to surgery found that the published studies were of poor quality and did not show that surgery was more effective than other treatments.Subsequent research showed that the surgery was no more effective than sham surgery, in which only a skin incision was made in patients, although the study was limited to a small number of patients.


Response to initial therapy is common, but relapses (25% to 50%) and / or prolonged moderate discomfort (40%) are also possible.

Depending on the severity and number of accumulated multiple tendon injuries, the radial extensor carpus may not be completely cured with conservative treatment.Nirschl defines four stages of lateral epicondylitis, showing that irreversible damage begins in stage 2.

  1. Inflammatory changes that are reversible
  2. Irreversible pathological changes in the origin of the short radial extensor of the wrist
  3. Rupture of muscle origin ECRB
  4. Secondary changes such as fibrosis or calcification.


About 39.7% of tennis players reported current or previous elbow problems.Less than a quarter (24%) of these athletes under 50 reported that tennis elbow symptoms were “severe” and “disabling,” while 42% of athletes over 50 had. More women (36%) than men (24%) considered their symptoms to be serious and disabling. Tennis elbow is more common in people over 40 years old, with men this figure is about four times higher, and women – twice. Tennis elbow affects both sexes equally, and although males have a slightly higher overall prevalence rate than females, this is not constant across every age group and is not a statistically significant difference.

Playing time is an important contributor to tennis elbow, with increased play time increasing for respondents under 40. Individuals over 40 who play for more than two hours double their chances of injury. Those under 40 increased it by 3.5 times compared to those who played less than two hours a day.


The German physician F. Runge is usually credited with the first description of this condition, calling it “writer’s spasm” ( Schreibekrampf ) in 1873.This was later called “washing a woman’s elbow”. British surgeon Henry Morris published in The Lancet an article describing the “tennis hand” in 1883. The popular term “tennis elbow” first appeared in the same year in an HP Major article described as “tennis elbow”.

See also


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☝️ First, it is necessary to change the biomechanics of the elbow joint, as during sports or work, to eliminate the cause of the pain.⠀
👍 In this case, treatment will quickly help relieve pain.

👨‍⚕️Orthopedic traumatologists of our center prescribe the most effective ✅ methods of treatment: shock wave and PRP therapy.

🔹 #shock_wave_therapy is one of the key treatments for epicondylitis.
🔁The procedure stimulates collagen production, improves microcirculation in tissues and softens fibrous compaction. Usually 📌 4-6 procedures are performed with a frequency of 1 time per week.

🔹 # PRP_therapy. The non-surgical technique is carried out with the help of 💉 injections of the patient’s blood plasma.This method not only relieves pain and inflammation, PRP-therapy accelerates the healing of the tendon attachment site, which is constantly injured when the patient performs movements in the 💪 elbow joint.

👌Also effective in treatment will be:

🔺Special orthopedic aids
🔺Cold can help in the treatment of epicondylitis.
🔺 The elbow is being taped.

🏆Professional athletes are advised to change the technique while playing and replace the tennis racket 🎾 with a model with different parameters.⠀
Sign up for a consultation by phone:
📞 +38 (050) 236-60-70
📞 +38 (096) 879-79-47
🏥 st. Jacob …


☝️ First, it is necessary to change the biomechanics of the elbow joint, as during sports or work, to eliminate the cause of the pain.

👍 In this case, treatment will quickly help relieve pain.

👨‍⚕️Orthopedic traumatologists of our center prescribe the most effective ✅ methods of treatment: shock wave and PRP therapy.

🔹 #shock_wave_therapy is one of the key treatments for epicondylitis.🔁The procedure stimulates collagen production, improves microcirculation in tissues and softens fibrous compaction. Usually 📌 4-6 procedures are performed with a frequency of 1 time per week.

🔹 # PRP_therapy. The non-surgical technique is carried out with the help of 💉 injections of the patient’s blood plasma. This method not only relieves pain and inflammation, PRP-therapy accelerates the healing of the tendon attachment site, which is constantly injured when the patient performs movements in the 💪 elbow joint.

👌Also effective in treatment will be:

🔺Special orthopedic aids
🔺Cold can help in the treatment of epicondylitis.🔺Massage.
🔺 The elbow is being taped.

🏆Professional athletes are advised to change the technique while playing and replace the tennis racket 🎾 with a model with different parameters.

Sign up for a consultation by phone:
📞 +38 (050) 236-60-70
📞 +38 (096) 879-79-47
🏥 st. Jacob … – Center for Shock Wave Therapy, Orthopedics and Rehabilitation Arthrolife

Tennis elbow BARNA MEDICAL

It seems to you that something is wrong with your elbow? Painful symptoms in the area of ​​the external or internal joint of the elbow, called “tennis elbow” (or “golf elbow”) make life unpleasant not only for a number of successful athletes.Put your trust in the hands of the professionals. Our doctors will compose a comprehensive therapy for you based on an accurate examination using the most modern methods and technologies.

What are the causes of the complications?

Inflammatory diseases with pain in the inner or outer joint of the elbow occur with intense short-term or vice versa – repeated long-term overload of the tendons. the most common cause is incorrect working position, poor ergonomics while working on the PC, incorrect sports technique, unsuitable equipment or a disease such as, for example.diabetes. Latent infection in the body, such as a tooth, glands, ovary or intestines, latent mycotic infection and elevated uric acid levels are also common and often overlooked causes. And we are able to discover this thanks to communication with the patient and a general integrated approach.

Jak se projevuje tenisový loket?

A typical manifestation of tennis elbow is pain on the outside, which “shoots” in the forearm, fingers, but also in the arm and shoulder. Often accompanied by swelling, redness and fever in the elbow joint.An unpleasant manifestation of the disease responds with lifting weights or shaking hands. If you feel any signs of inflammation, please contact us immediately. Thanks to a timely and reliable diagnosis, we can set up the correct treatment process.

How does a golf elbow manifest itself?

Sharp, gouging, shooting pain accompanies golf (sometimes also spear-throwing elbow) appears on the inner side of the elbow joint when the fingers are bent or the wrist is overturned.Thus, complications can also appear during daily activities, such as opening a door, screwing or turning the steering wheel. Even the smallest symptoms of the disease should not be underestimated. Therefore, we recommend that you make an appointment with our specialists as soon as possible. With the right therapy, you will soon be able to return to maximum results.

How will we cure you?

Traditional methods of treatment are often based on superficial examination, therefore, incorrect treatment occurs.Our clinic has a completely different procedure.