What is tennis elbow?
Tennis elbow is pain on the outer side of the elbow, where the tendons that lift and straighten the wrist attach to the bone. The tendon is overloaded, so it becomes sore and less able to take strain. The medical name is lateral epicondylalgia or lateral elbow tendinopathy.
It is a tendon problem, not an inflamed joint. Our glossary entry on tendinopathy explains what that means for recovery. The inner-elbow version is on our golfer’s elbow page.
What does it feel like in everyday Ipoh life?
You feel a sharp or burning ache on the outer elbow when you grip and lift. Picking up a full kettle, turning a key, shaking hands and squeezing a wet cloth can all do it.
The common triggers here are not tennis. Carrying heavy shopping bags from the wet market, keeping a firm grip on a wok handle, hours of mouse work, painting a ceiling and wringing out the mop or laundry are all suspects.
Badminton players feel it on a backhand shot, and gardeners feel it after a morning with a parang or secateurs.
Who is it most likely to affect?
It appears most in working-age adults, and it usually comes from repeated wrist and grip work rather than a single injury. The load has usually been building for weeks before the ache shows up.
A recent jump in activity is a familiar story. Perhaps you have started a new job, taken up a racket sport again, or spent a weekend renovating. Our blog on tennis elbow at work covers desk and workshop settings.
What does a physiotherapist check first?
We ask what hurts, when it started and what you were doing at the time. Then we press on the elbow, test the grip and put the wrist through its movements.
We check:
- the exact spot, and whether resisted wrist extension reproduces the pain.
- grip strength compared with the other hand.
- the neck and shoulder, since the pain can come from there.
- nerve signs in the forearm and hand, which can look similar.
- how you grip, type and carry in your normal day.
If the findings suggest a nerve problem or another cause, we say so and guide you.
What helps tennis elbow?
The approach we rely on is gradual loading of the tendon. The tendon needs to be used to recover, so we choose exercises that are hard enough to build strength but not so hard that they flare the pain.
Here is a typical order:
- Reduce the activities that clearly flare it, and keep the rest of the day normal.
- Start with gentle holds of the wrist, called isometric exercises.
- Add slow lifting and lowering of a light weight, called eccentric exercise.
- Build grip strength and then return to your tasks.
We review it at every visit and adjust the load. Hands-on techniques from our manual therapy can ease the forearm muscles, and an elbow strap can help during activity if you want one.
What can I do this week?
Take some load off the tendon without stopping everything.
- Carry bags with the palm facing up or in the crook of your arm, not by the handles with a tight grip.
- Hold cups and kettles with both hands.
- Use a thicker, padded grip on tools and the mouse, and adjust your desk. Our guide to workplace ergonomics can help.
- Keep the wrist straight when you type and avoid curling it up.
- Warm the forearm with a warm towel before activity.
If an exercise sharpens the pain for hours, stop and ask for advice.
When should I see a doctor first?
Go to the emergency department after a fall or knock if the elbow looks out of shape or you cannot straighten it. Go too if the arm is hot, red and swollen, or if there is a fever.
See a doctor if there is numbness or tingling in the hand, if pain keeps you awake at night, or if it does not improve with a good exercise plan. Hospital Raja Permaisuri Bainun, Fatimah Hospital and Pantai Hospital Ipoh can assess these.
How do home sessions in Ipoh work?
A physiotherapist comes to your house, sees the tasks that bother your elbow in your own kitchen or home office, and teaches exercises you can repeat daily. Home visits are available across Ipoh now, and our Canning Garden centre is opening soon.
Prices are quoted on WhatsApp after a short description. See how home physiotherapy works for the steps.