Tennis Elbow (Lateral Epicondylitis)


The elbow consists of three bones, the humerus, ulna, and radius. At the distal end of the humerus, there are two condyles, the medial and lateral epicondyles. This is a condition of the lateral epicondyle of the distal humerus. Also known as tennis elbow and often caused by overuse. It is an inflammation or microtearing of the extensor tendons on the outside of the elbow, which often results in pain and decreased function. The muscle most commonly impacted is the Extensor Carpi Radialis Brevis (ECRB). Often, pain increases during wrist or long finger resistive extension activities as well as tight gripping.


  • Overuse injury
  • Occupations requiring repetitive tasks such as using a paint brush, operating a chainsaw, hammer, or screwdriver, dentists, electricians, carpenters, or musicians.
  • Playing racquet sports such as tennis or racquetball due to weak shoulder and wrist muscles, or from improper backhand strokes


  • Dull pain over outside of the elbow
  • Tenderness to touch over outside of the elbow
  • Weakness with wrist extension and gripping
  • Pain with resisted wrist or long finger extension


  • Maintain strength and range of motion, especially if you are doing repetitive activities
  • Avoid repetitive movements if possible. If not, take breaks for rest and stretching
  • Warm up before doing activities that cause stress
  • Ensure you are using proper form when playing racquet sports or during other repetitive activities. Keep your wrist as neutral as possible.

Diagnostics Tests

  • X-rays are taken to check the bones and joints to ensure there are no fractures or degenerative changes
  • An MRI can help determine inflammation or microtearing of the tendons
  • Palpation around elbow to determine where pain and tenderness are present
  • Resistive wrist extension and long finger extension to make note of pain in elbow

Medical Treatment

  • Rest and taking a break from repetitive activities that are causing pain
  • Ice
  • Anti-inflammatory medications
  • Wrist splint to decrease repetitive wrist extension and put the tendons at rest
  • Counterforce brace on forearm to assist during resistive exercises
  • Surgical debridement of the lateral epicondyle, if conservative treatment fails

Hand Therapy Interventions

  • Education on activity adaptation to avoid pain, decrease inflammation, and avoid recurrence of condition
  • Modalities for pain management such as heat, ice, ultrasound, and infrared laser
  • Massage and soft tissue mobilization to release extensor muscle tightness
  • Range of motion/stretching of elbow and wrist
  • Kinesiotaping
  • Strengthening exercises, once pain and inflammation have decreased

Elbow Injuries

Tennis Elbow


Golfer's Elbow

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