Tennis ElbowElbow Rehabilitation & Recovery

Overuse‑related pain on the outside of the elbow—how physiotherapy reduces pain and restores grip and function.

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What is tennis elbow and how does physiotherapy help?

Tennis elbow (lateral epicondylalgia) is irritation of the wrist extensor tendon origin from load spikes or repetitive activity.

Physiotherapy focuses on pain reduction and restoring tolerance via load management, mobility and strengthening.

Tendons respond best to the right amount of load. We reduce painful overload in the short term, then rebuild capacity with structured strengthening and better ergonomics (keyboard/mouse, tools, racquet grip and technique).

You’ll get a clear pacing plan and staged progression from isometrics to heavier resisted work and functional tasks, helping you return to work and sport without recurrent flares.

Typical recovery timeline

  • 2–6 weeks: pain settling with isometrics and ergonomics
  • 6–12 weeks: strength and function gains with progressive loading
  • 12+ weeks: return to sport and heavier tasks as tolerated

Understanding tennis elbow

Risk factors

  • Repetitive wrist extension and gripping tasks
  • Load spikes in sport or manual work
  • Ergonomics and technique issues
  • Proximal weakness at shoulder/scapula

Imaging considerations

Ultrasound/MRI are rarely required initially; findings should be interpreted alongside clinical assessment.

Common contributing factors

Overuse

Repetitive wrist extension and gripping.

Ergonomics

Poor workstation or tool setup.

Grip load

Heavy or prolonged gripping tasks.

Proximal weakness

Shoulder/scapula deficits increasing tendon load.

What are the symptoms?

Primary symptoms

  • Elbow pain: outside of the elbow, worse with gripping
  • Weakness: reduced grip strength
  • Tenderness: at the lateral epicondyle

Functional limitations

  • Lifting kettles, opening jars, racquet sports
  • Manual tasks or prolonged mouse/keyboard use
  • Return to sport or heavier work tasks

Related symptoms: Elbow pain, Muscle weakness, Reduced range of motion

How can physiotherapy help?

Care focuses on education, load management and progressive strengthening to restore grip and function.

Core components

  • Load management and ergonomics
  • Isometrics then eccentric/concentric strengthening
  • Proximal (shoulder/scapula) strengthening
  • Tendon education, flare planning and pacing strategies
  • Technique cues and equipment setup for work/sport
  • Objective progression (grip force, reps, resistance)
  • Graded return to sport and provoking tasks

Effective treatments

Manual therapy

Hands‑on techniques to reduce pain and improve mobility.

Exercise therapy

Isometrics then eccentric/concentric loading to restore tolerance.

Education

Load management, pacing and recurrence prevention.

Lifestyle

Ergonomics, equipment setup and sport technique.

What happens in a physiotherapy session?

Assessment reviews pain location, aggravating tasks, grip tolerance and ergonomics. Strength, range and tendon provocation tests guide loading.

  • Subjective: onset, repetitive tasks, equipment setup
  • Testing: grip strength, resisted wrist extension, palpation
  • Education: load thresholds, pacing, ergonomic changes
  • Plan: staged loading (isometrics → eccentrics → function)

Home exercises support progress across 6–12 weeks with objective progression (reps, resistance, grip).

Can you manage tennis elbow at home?

Many people can self‑manage early symptoms with load management and simple exercises.

Simple stretches

  • Wrist extensor stretch: elbow straight, wrist flexed with gentle pressure
  • Forearm stretch: gentle pronation/supination range

Strengthening

  • Isometrics for pain relief and early loading
  • Eccentric/concentric loading as tolerated

Lifestyle

  • Ergonomics and equipment setup
  • Modify provoking tasks; gradual re‑exposure

Weekly progression example

  • Week 1–2: isometrics 5 x 45–60s, 1–2/day; light ergonomics changes
  • Week 3–4: add eccentrics/concentrics 3 x 8–12; monitor symptoms
  • Week 5+: graded return to gripping tasks/sport‑specific drills

When should you seek help?

Urgent assessment

  • Severe trauma with inability to use the arm
  • Neurological symptoms (numbness/weakness not improving)

Consult a physiotherapist if

  • Symptoms persist beyond 6–8 weeks
  • Difficulties with work, sport or daily tasks
  • Recurrent flares impacting function

Accessing care in the UK

Access physiotherapy via GP referral on the NHS, or directly through private clinics (often faster access). Insurance or employer health plans may help with costs.

FAQs

Do I need a scan?

Imaging is usually not required initially. Ultrasound/MRI may be useful if symptoms persist or other causes are suspected.

Can I keep training?

Usually—with load modification. Your physiotherapist will guide tolerable variations and volumes.

How many sessions will I need?

Many people attend 6–12 sessions over several weeks, adjusted to goals and progress.

Medical Disclaimer

This information is for educational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.