Tennis Elbow: Causes, Prevention & Treatment

by Onward Physical Therapy | February 25, 2023 |
Tennis Elbow: Causes, Prevention & Treatment

Tennis elbow is a painful condition where the tendon on the outside of the forearm becomes overloaded and painful. The term “tennis elbow” came to be because this injury is common in tennis players but, at Onward, we see this in weightlifters, CrossFit athletes, golfers, and more.

What Causes Tennis Elbow

Tennis elbow occurs when the strength of the tendon on the outside of your forearm is asked to do more than it was prepared for. This overload results in the tendon getting broken down and painful. A great example of this is a recreational tennis player that doesn’t play at all during the winter, and as soon as spring comes, they jump into hours of tennis. Their tendon wasn’t prepared for that volume of play and got irritated.

Preventing Tennis Elbow 

Preventing tennis elbow comes down to three main factors: training volume management, strength work, and general recovery.

The primary way to prevent tennis elbow is to be smart with any increases in activities that would load the forearm muscles. Don’t go zero to sixty, but add a bit more training every week to allow the tendon to adapt to the stressors placed on it.

Up next, we want strong tendons. Incorporating grip training into your exercise routine will help build up the tendon’s capacity and allow it to tolerate more activity. 

Finally, proper sleep and nutrition will allow your body to recover from your training to heal up and optimize your performance. 

What can be done to reduce pain once a patient has tennis elbow?

What if you’re past the point of preventing tennis elbow because you’re already in pain? The most common advice you’ll see online is to stretch the forearm muscles. But this advice is outdated and probably not your best treatment option.

As discussed above, tennis elbow is an issue where the tendon wasn’t prepared for what you asked it to do. And stretching doesn’t build strength or endurance in your forearm muscles, so it doesn’t get to the root cause of tennis elbow.

Instead, we want to focus on exercises to strengthen the forearm muscles to prevent and treat tennis elbow symptoms.

Wrist Extensions

A commonly prescribed exercise would be wrist extensions with a slow tempo. We want to load these up enough to create some mild discomfort. We’ll work that three times a week, separated by a rest day. 

View Video on YouTube here: https://www.youtube.com/watch?v=hpBZE-KJsj4

This will often be accompanied by other exercises that address your individual and sport-specific needs. For example, in CrossFit athletes, we often see tennis elbow a result of weakness in the lats. So we may program extra lat strength work such as straight arm pulldowns.


View Video on YouTube Here: https://www.youtube.com/watch?v=C-8av6MVtow

If you are tired of tennis elbow holding you back from the activities you love, an assessment by a sports physical therapist is always your best bet to get a custom program to heal up your tennis elbow as rapidly as possible.