39) Tennis Elbow: How Physiotherapy Can Fix It For Good, Forever

Tennis elbow can strike even if you’ve never touched a racquet. This painful condition affects the outer part of your elbow and can make everyday tasks – like lifting a kettle or typing – feel impossible. In this blog, we’ll break down the causes, symptoms and most effective physiotherapy treatments to help you get lasting relief.

What is Tennis Elbow?

Tennis elbow, or lateral epicondylalgia, is a condition caused by overuse of the forearm muscles that attach to the outside of the elbow. Despite the name, most people who get tennis elbow don’t play tennis. It’s more common in people who do repetitive wrist and hand movements – think tradies, desk workers, baristas, or anyone who loves DIY.

The pain comes from tiny tears and degeneration in the tendons that attach to the lateral epicondyle (the bony bump on the outside of your elbow). It’s your body’s way of saying, “Oi, give this arm a break!”

Symptoms of Tennis Elbow

The most common symptoms include:

Pain or burning on the outside of the elbow
Weak grip strength
Pain that gets worse with wrist or hand activity
Discomfort when lifting, shaking hands, or turning a doorknob
Tenderness around the lateral epicondyle

It often develops gradually, starting as a niggle and turning into a full-blown ache that doesn’t go away.

Common Causes

Tennis elbow typically comes from:

Repetitive motions like typing, painting, plumbing, using a screwdriver
Poor lifting technique (especially twisting motions with the wrist)
Overtraining without adequate recovery – common in gym-goers and athletes
Poor posture, especially if you’re at a desk all day
Sudden increase in activity levels (e.g., weekend warriors doing heaps of garden work or DIY)

Diagnosis – How Do You Know It’s Tennis Elbow?

Physiotherapists diagnose tennis elbow by doing a thorough history and clinical exam. We’ll often:

Palpate (press) the outside of your elbow
Test grip strength
Ask you to extend your wrist against resistance
Assess shoulder, neck and wrist movement

In some cases, we’ll also check your neck – referred pain or nerve irritation from the cervical spine can mimic elbow issues.

Imaging like ultrasound or MRI is rarely needed unless your symptoms don’t improve or there’s something unusual about your case.

If you think you may have a different elbow injury, read our blog on common elbow injuries.

Why Physiotherapy is the Gold Standard for Tennis Elbow

Physiotherapy is backed by research as the most effective conservative treatment for tennis elbow (Coombes et al., 2015). We focus on three main things:

Pain relief
Load management
Tendon rehabilitation and strengthening

Let’s unpack each of those…

1. Pain Relief Techniques

When you first come in, your elbow might be too painful to do much. That’s where we pull out our toolkit:

Manual therapy: Hands-on techniques to reduce tension in the forearm muscles
Soft tissue release: Targeting trigger points to ease tightness
Dry needling: For deeper muscle relaxation
Ice or heat therapy: Depending on your symptoms
Taping or bracing: Offloads the tendon and lets it rest

We’ll also give you advice on modifying your daily activities so you’re not aggravating it constantly.

2. Load Management – Not Just Rest!

Contrary to what some people think, complete rest isn’t the answer. Tendons need to be loaded – the trick is finding the right load.

We’ll guide you through:

Reducing high-impact or repetitive tasks
Modifying gym routines
Alternating tasks at work to avoid overload
Using ergonomic tools (especially for tradies or hairdressers)

It’s a bit of trial and error, but that’s where expert physio advice makes all the difference.

3. Strengthening and Tendon Rehab

Once your pain settles, the real work begins – rebuilding tendon capacity.

We use a graded program that might include:

Isometric holds (great early on for pain relief)
Eccentric exercises like wrist extension with weights
Progressive resistance training with dumbbells or resistance bands
Shoulder and postural strengthening (because weakness here can overload the elbow)
Functional tasks specific to your work, sport or hobbies

A full rehab program usually runs for 6–12 weeks, but many patients start to feel better much sooner.

Do Injections Work?

Cortisone injections were once common, but studies show they only give short-term relief and can actually delay long-term recovery (Bisset et al., 2006). That’s why we ALWAYS recommend physio first – it’s safer and more effective long-term.

Shockwave Therapy – The New Kid on the Block

In stubborn or chronic cases, we might use shockwave therapy – a non-invasive treatment that stimulates healing in the tendon. It’s especially useful when pain’s been hanging around for months. Some clinics (including ours) offer this if needed.

Real Patient Story: Peter’s Elbow Comeback

Peter, a 48-year-old cabinetmaker from Allambie, came to us after dealing with elbow pain for nearly 4 months. It started as a mild ache while sanding and lifting tools, but it got so bad he couldn’t even grip a coffee cup without pain.

When he first saw us, Peter rated his pain 7/10 and said he was struggling to work a full day. We assessed him and confirmed tennis elbow, with marked tenderness at the lateral epicondyle and weakness in grip strength.

Over 8 weeks, we worked through:

✅ Manual therapy and dry needling to reduce muscle tension
✅ A tailored strengthening program – starting with isometric holds and progressing to eccentric loading
✅ Activity modifications at work
✅ Education on tendon load and recovery

By week 4, Peter said his pain had halved. By week 8, he was back on the tools full-time and no longer needed his brace. These days, he pops in for gym sessions in our clinic to stay strong and prevent flare-ups.

How Long Does Recovery Take?

Most people see significant improvement in 6–12 weeks, especially if they start treatment early. Chronic cases can take longer, but with the right guidance, you can get back to full strength – pain-free.

Can Tennis Elbow Come Back?

Yes, but it’s less likely if you:

Finish your full rehab program
Address postural issues and muscle imbalances
Use correct lifting and tool-handling techniques
Build up activity gradually if returning to sport or work

That’s why our focus isn’t just on fixing the pain – we work with you to build resilience and prevent recurrence.

Should You See a Physio or GP First?

You can go straight to a physiotherapist – no referral needed. We’re trained to assess, diagnose, and treat musculoskeletal conditions like tennis elbow.

If we think you need imaging, further medical tests, or another opinion, we’ll refer you on – but in most cases, physiotherapy is the first and best step.

Don’t Let Elbow Pain Drag On

Tennis elbow can be stubborn, but it’s also very treatable – especially with early physio intervention. Don’t wait for it to become chronic or start affecting your work, sport or sleep.

We’ve helped dozens of locals recover from tennis elbow and get back to the things they love – pain-free.

Give us a call today on 9806 3077, or book online, just CLICK HERE.

References

Coombes, B. K., Bisset, L., & Vicenzino, B. (2015). Management of lateral elbow tendinopathy: One size does not fit all. Journal of Orthopaedic & Sports Physical Therapy, 45(11), 938–949.
Link
Bisset, L., Beller, E., Jull, G., Brooks, P., Darnell, R., & Vicenzino, B. (2006). Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ, 333(7575), 939.
Link
Better Health Channel – Tennis Elbow
Physiopedia – Lateral Epicondylitis

Let us help you power through the pain and take control of your recovery.

Call us today on 9806 3077, or CLICK HERE to book online.