What is Elbow Pain / Tennis Elbow?

Research has shown that at some point in their careers nearly 50 percent of tennis players suffer from a painful condition called lateral epicondylitis (Elbow pain / Tennis Elbow), which affects the elbow caused due to repetitive motions or strenuous overuse of the tendons around the elbow.

This ‘tennis elbow’ is commonly observed in people who play tennis and other racket sports. Golfers and cricketers are equally susceptible as are people in jobs that use repetitive motions involving the arm and elbow. Its incidence is higher in people between 30 and 50 years of age. (Gulf News February 22, 2017)

Elbow pain is most often the result of tendinitis, which can affect the inner or outer elbow. Elbow pain has many other causes including trauma, arthritis, and bursitis.

Elbow Pain / Tennis Elbow


In this article, you will learn about the tennis elbow. What is it and what are the causes and symptoms and how to treat tennis elbow.


Tennis elbow is also known as lateral epicondylitis. It is the most common overuse syndrome in the elbow. In this condition, there is inflammation in the extensor group of muscles at the level where they are originating (lateral epicondyle of humerus).

The main muscle involved is the extensor carpi radialis. It should be remembered that only 5-8% of people suffering from lateral epicondylitis relate the injury to tennis! Contractile overloads that chronically stress the extensor tendons near the attachment on the humerus bone are the primary cause of epicondylitis.

It mostly happens in people who do repetitive upper extremity activities such as computer use, heavy lifting, forceful forearm pronation and supination, and repetitive wrist extension motion.

You can commonly see this chronic condition in other sports such as squash, badminton, baseball, swimming, and field throwing events. Some other professions are also involved such as electricians, carpenters, gardeners, desk-bound jobs also commonly present with this condition.

Symptoms of tennis elbow

The most prominent symptom of tennis elbow is pain, this pain can be produced by palpation on the extensor group of muscles origin on the lateral epicondyle of the humerus.

The pain can radiate upwards in the upper arm and downwards along the outside of the forearm and in some cases even to the third and fourth fingers.

Furthermore, it has been seen that there is a weakness in wrist extensor muscles. A person will feel constant pain, which prohibits any activity.



There are 2 physical tests that can confirm the diagnosis. These include:

  • Mill’s test- a patient is seated with the upper extremity relaxed at the side and the elbow is in extension. The examiner passively stretches the wrist in flexion and pronation. If pain is increasing by this activity that means you are positive for tennis elbow.
  • Maudsley’s test- The examiner will resist the extension of the third digit of the hand while palpating the lateral epicondyle. A positive test is indicated by pain is increasing over the lateral epicondyle.

Differential diagnosis

There are many conditions in the elbow that can mimic like tennis elbow for example; cervical radiculopathy, redial tunnel syndrome, fracture of olecranon, or redial head and elbow osteoarthritis. We should check for all these conditions for differential diagnosis.

Treatment of tennis elbow

Biomechanical caused by joint restrictions should be corrected with joint mobilization to specific restrictions identified during the examination. Electrotherapy is very helpful in reducing pain. apply an ice pack for 10-20 mines, twice a day in an acute case of tennis elbow.

Stretching and strengthening exercises to correct the imbalance in muscles, start endurance, and coordination exercises after relieving the pain.

Splinting may be an effective adjunct to physical therapy management in regaining loss of motion for capsular restrictions.

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