Tennis Elbow: Causes, Symptoms & Treatment
Tennis elbow, also known as lateral epicondylitis, is a common condition that causes pain on the outside of the elbow. Despite its name, it doesn't only affect tennis players. It can develop in anyone who performs repetitive gripping, lifting, twisting, or wrist movements, including those working in manual jobs, exercising at the gym, or carrying out everyday tasks.
At VCF Physiotherapy, our experienced physiotherapists provide expert assessment and treatment for tennis elbow in Peterborough. We focus on reducing pain, restoring strength and function, and helping you return to work, sport, and daily activities as safely and efficiently as possible. Using evidence-based physiotherapy, we'll create a personalised treatment plan to support your recovery and reduce the risk of the condition returning.
What is Tennis Elbow?
Tennis elbow, also known as lateral epicondylitis or lateral epicondylopathy, is a condition affecting the wrist extensor tendons where they attach to the outside of the elbow. Although it was once thought to be primarily an inflammatory condition, it is now recognised as a tendon injury caused by repetitive overload.
Over time, repeated gripping, lifting, twisting, or wrist movements place excessive strain on the forearm muscles and tendons. This can lead to tiny microscopic tears and changes within the tendon, causing pain, reduced strength, and difficulty with everyday tasks. As the tendon becomes weaker, even simple activities such as lifting a kettle, opening a jar, shaking hands, or carrying shopping can become painful.
Without appropriate treatment, symptoms can persist for months and may gradually worsen. Physiotherapy focuses on reducing pain, improving tendon healing, restoring strength, and helping prevent the condition from returning.
Signs and Symptoms of Tennis Elbow
The symptoms of tennis elbow often develop gradually and usually affect the dominant arm, although either elbow can be affected. Pain may begin as mild discomfort but can worsen over time if the tendon continues to be overloaded.
Common signs and symptoms include:
Pain and tenderness on the outside of the elbow
Aching or burning pain that may spread into the forearm
Reduced grip strength, making it difficult to hold or carry objects
Pain when gripping, lifting, twisting, or extending the wrist
Discomfort when turning a door handle, opening jars, shaking hands, or using tools
Difficulty lifting everyday items such as shopping bags, kettles, or children
Morning stiffness when bending or straightening the elbow
Pain that worsens with repetitive activities and, in more persistent cases, may become constant or interfere with sleep
If left untreated, tennis elbow can make everyday tasks increasingly difficult. Early assessment and physiotherapy can help reduce pain, restore strength, and prevent symptoms from becoming long-term.
What Causes Tennis Elbow?
Tennis elbow is most commonly caused by repetitive strain rather than a single injury. Repeated gripping, lifting, twisting, or wrist movements place excessive stress on the wrist extensor tendons, leading to microscopic damage over time.
Common causes and risk factors include:
Repetitive work activities, such as typing, using hand tools, painting, plumbing, or manual labour
Playing racket sports, particularly with positional or technique misalignments or increased training volume
Frequent gripping, lifting, or carrying heavy objects
Lifting technique that applies strain to the elbow or repetitive wrist extension
Reduced strength, flexibility, or endurance of the forearm muscles
A sudden increase in activity levels without allowing the tendon time to adapt
Direct injury or trauma to the outside of the elbow (less common)
Although conditions such as arthritis, nerve irritation, or gout do not cause tennis elbow, they can produce similar symptoms and may need to be ruled out during a physiotherapy assessment. At VCF Physiotherapy, we'll identify the underlying cause of your elbow pain to ensure you receive the most effective treatment.
How Physiotherapy Helps Tennis Elbow
At VCF Physiotherapy, our tennis elbow treatment in Peterborough is designed to reduce pain, restore movement, improve tendon health, and build long-term strength. Every treatment programme is tailored to your symptoms, goals, and daily activities, helping you return to work, sport, and everyday life with confidence.
Reduce Pain and Settle Symptoms
In the early stages of treatment, our priority is to reduce pain, improve comfort, and create the right environment for recovery. Depending on your symptoms, treatment may include:
Advice on activity modification and symptom management
Ice application where appropriate
Soft tissue therapy
Joint mobilisation techniques
Transverse friction massage, when clinically indicated
Therapeutic ultrasound, where appropriate
Acupuncture or dry needling for pain relief, if suitable
Modify Aggravating Activities
Continuing to overload the tendon can delay recovery. We'll help you identify activities that are contributing to your symptoms and recommend practical strategies to reduce unnecessary strain without stopping you from doing what you enjoy.
This may include:
Improving your workstation ergonomics
Reducing repetitive gripping or lifting tasks
Modifying sport, gym, or work activities during recovery
Adjusting equipment or changing hand position where appropriate, such as alternating computer mouse use
Strengthening and Rehabilitation
Progressive strengthening is one of the most effective treatments for tennis elbow and often begins early in your rehabilitation. Your personalised exercise programme may include:
Wrist extensor and flexor strengthening exercises
Grip strengthening
Forearm, biceps, and triceps conditioning
Progressive tendon loading exercises
Functional strengthening to prepare you for everyday activities
Restore Movement and Flexibility
Improving flexibility and restoring normal movement can help reduce stiffness and improve arm function. Your treatment programme may include:
Targeted stretching exercises
Joint mobilisation techniques
Mobility exercises for the wrist, elbow, and shoulder
Return to Work and Sport & Work-Specific Rehab
As your pain settles and strength improves, we'll progress your rehabilitation to safely prepare you for your usual activities and reduce the risk of recurrence.
This may include:
Balance, proprioception, and co-ordination exercises
Weight-bearing and functional upper limb exercises
Sport-specific rehabilitation
Work-specific strengthening and movement retraining
Self-Management Tips
Alongside physiotherapy, there are several simple steps you can take to support your recovery and reduce strain on the tendon:
Modify or reduce activities that aggravate your symptoms
Apply ice (wrapped in a cloth) for 15–20 minutes after activities to relieve pain and inflammation
Perform the exercises prescribed by your physiotherapist consistently
Gently massage the forearm muscles to help reduce muscle tension
Take appropriate pain relief if recommended by your GP or pharmacist
Take regular breaks from repetitive tasks at work or during hobbies
Gradually return to normal activities rather than pushing through pain
Preventing Tennis Elbow
Although tennis elbow can recur, maintaining good tendon strength and managing repetitive loads can significantly reduce your risk.
To help prevent tennis elbow:
Use efficient lifting and movement techniques
Strengthen and stretch your forearm muscles regularly
Increase activity or training levels gradually
Avoid prolonged repetitive gripping or wrist movements where possible
Take regular breaks during work, sport, or other repetitive activities
Warm up before sport or exercise and allow adequate recovery afterwards
When to See a Tennis Elbow Physio in Peterborough
If your elbow pain is persistent, is getting worse, or is affecting your work, sport, or everyday activities, it's a good idea to seek professional advice. Early physiotherapy can help reduce pain, improve tendon function, and prevent symptoms from becoming long-term.
At VCF Physiotherapy, we'll carry out a thorough assessment to confirm whether your symptoms are caused by tennis elbow or another condition. We'll then develop a personalised treatment plan tailored to your goals, helping you recover safely and return to the activities you enjoy.
Most people recover successfully with physiotherapy and a structured rehabilitation programme. More invasive treatments, such as injections or surgery, are only considered when appropriate and are generally reserved for cases that have not responded to comprehensive conservative treatment.
FAQs
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Recovery varies depending on the severity of the condition and how long symptoms have been present. Many people notice significant improvement within 6–12 weeks with appropriate physiotherapy and a structured exercise programme. More persistent cases may take several months to fully recover.
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Yes. Physiotherapy is considered one of the most effective first-line treatments for tennis elbow. Treatment focuses on reducing pain, improving tendon health, restoring strength and function, and helping to prevent symptoms from returning.
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In most cases, yes. Staying active is encouraged, but you may need to modify activities that place excessive strain on the tendon. Your physiotherapist will advise you on which exercises are safe to continue and provide a personalised rehabilitation programme to support your recovery.
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Most cases of tennis elbow can be diagnosed through a detailed assessment and physical examination. Scans such as ultrasound or MRI are not usually necessary unless another condition is suspected or your symptoms are not improving as expected.
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Some cases may improve with time, but symptoms can persist for many months if the underlying tendon overload is not addressed. Early physiotherapy can help speed up recovery, restore strength, and reduce the likelihood of the condition returning.