Tennis Elbow: Symptoms, Causes, and How Physiotherapy Can Help

Reviewed by the Physiotherapy Team at Waterloo Sports Medicine Centre   

What Is Tennis Elbow? 

Tennis elbow, or lateral elbow tendinopathy (LET), is a common condition involving the tendons that attach the forearm muscles to the outside of the elbow. Despite its name, you do not need to play tennis to develop it. 

Tennis elbow commonly causes pain and tenderness around the outside of the elbow, particularly during activities that involve gripping, lifting, twisting, or repetitive wrist movements. You may also notice reduced grip strength or difficulty with everyday tasks such as opening jars, carrying objects, or using a computer mouse. 

What Causes Tennis Elbow? 

Tennis elbow usually develops when the tissues around the elbow are exposed to more repetitive loading than they can currently tolerate. This can happen with sports, work, hobbies, or sudden increases in activity.  Common contributing factors include: 

• Repetitive gripping or lifting 

• Repeated wrist and forearm movements 

• Racquet sports or other throwing sports 

• Manual work or jobs involving tools 

• Increasing exercise or activity too quickly 

• Reduced strength or conditioning of the forearm muscles 

  
  

Despite the name, tennis accounts for only some cases. Anyone who regularly performs repetitive gripping or forearm movements can develop lateral elbow tendinopathy. 

How Can Physiotherapy Help Tennis Elbow? 

Physiotherapy is an effective non-surgical approach to managing tennis elbow. Your physiotherapist can assess your pain, grip strength, elbow and wrist movement, activity demands, and contributing factors before developing an individualized treatment plan. 

Exercise Therapy 

Treatment may include strengthening exercises for the wrist and forearm, as well as exercises that gradually increase the elbow's ability to tolerate everyday and sport-specific loads. 

• Wrist and forearm strengthening 

• Grip strengthening 

• Isometric exercises for pain management 

• Progressive resistance exercises 

• Shoulder and upper-limb strengthening 

• Sport- or work-specific exercises 

Activity Modification 

Completely resting the arm is not always necessary. Instead, your physiotherapist can help you identify movements or activities that are aggravating your symptoms and modify them while gradually rebuilding your capacity. 

This may involve temporarily changing how you grip, lift, train, or perform repetitive tasks before progressively returning to your usual activities. 

Manual Therapy 

Your physiotherapist may also use hands-on techniques, such as joint mobilization or soft tissue treatment, when appropriate. These techniques may be combined with exercise to help manage pain and improve movement. 

How Long Does Tennis Elbow Take to Heal? 

Tennis elbow can be persistent, and recovery is not always linear. Symptoms may improve gradually over several weeks or months rather than disappearing immediately. 

Importantly, persistent symptoms do not necessarily mean that the condition will continue indefinitely or that surgery is required. Your recovery time can depend on factors such as how long you have had symptoms, the demands placed on your elbow, your overall strength and conditioning, and how consistently you follow your rehabilitation program. 

The goal of physiotherapy is to gradually improve your elbow's capacity to handle the activities you need and enjoy, not simply to eliminate pain temporarily. 

When Should You See a Physiotherapist? 

Consider seeing a physiotherapist if elbow pain is: 

• Lasting for several weeks 

• Affecting your grip or strength 

• Limiting work, exercise, or sports 

• Getting worse with repetitive activities 

• Preventing you from performing everyday tasks comfortably 

Early assessment can help identify contributing factors and provide a structured plan for managing symptoms and returning to activity. 

Looking for Tennis Elbow Physiotherapy in Waterloo? 

At Waterloo Sports Medicine Centre, our physiotherapists provide individualized, evidence-based treatment to help manage tennis elbow, restore strength, and support a safe return to activity!