Fixing Your Tennis Elbow: Practical Strategies Backed by Science
Tennis elbow — clinically known as lateral epicondylitis — is a common overuse injury that affects the tendons on the outside of the elbow. Despite its name, it doesn’t just affect tennis players. It can impact anyone who performs repetitive gripping, wrist extension, or lifting activities.
In this article, we break down what causes tennis elbow, and more importantly, how to recover from it with proven, science-backed methods.
🧼 What Is Tennis Elbow?
Tennis elbow is a tendinopathy, not an inflammatory condition as once thought. It involves degeneration and microtears in the extensor carpi radialis brevis (ECRB) tendon (Kraushaar & Nirschl, 1999). Pain is typically localised at the lateral epicondyle of the elbow and may radiate down the forearm, particularly during resisted wrist extension or gripping.
This condition is often associated with:
Repetitive wrist extension or gripping tasks
Poor load management
Underdeveloped tendon capacity and strength
✅ Key Principles for Rehabilitation
1. Modulate Inflammation and Reduce Irritation
While tennis elbow is degenerative, not inflammatory, acute flare-ups can still benefit from strategies that reduce pain and local irritation. These may include:
Load modification
Compression
Gentle movement to maintain blood flow
📃 Isometric contractions have been shown to reduce pain in tendinopathy by modulating cortical inhibition (Rio et al., 2015).
2. Isometric Strengthening
Start with pain-free isometric holds for wrist extension. These can help manage pain while reintroducing tendon loading.
Hold a light weight (or band) in a neutral wrist position
Gently extend the wrist and hold for 30–45 seconds
Perform 3–5 repetitions daily
📊 Isometric loading at 70% MVC can reduce tendon pain and improve motor drive (Rio et al., 2015).
3. Slow Eccentric Training
Once isometric loading is tolerated, progress to eccentric wrist extension exercises:
Use a light dumbbell
Support the forearm on a bench or thigh
Use the opposite hand to assist the lift
Lower slowly over 3–5 seconds
📊 Eccentric training promotes tendon remodelling and improves load tolerance in chronic tendinopathy (Stasinopoulos & Stasinopoulou, 2006).
4. Strengthen Surrounding Structures
Many cases of lateral epicondylitis involve weakness or compensation at the shoulder and wrist.
Strengthen grip endurance
Add shoulder stabilisation and scapular control work
📊 Proximal control and kinetic chain reinforcement have shown benefit in resolving persistent lateral elbow pain (Lucado et al., 2012).
5. Lifestyle Considerations: Reduce Alcohol Intake
Alcohol can impair tendon healing by disrupting collagen synthesis and increasing systemic inflammation.
📃 Chronic alcohol exposure impairs tendon healing and reduces collagen integrity (Pingel et al., 2017).
🏋️♂️ Summary
Tennis elbow doesn’t need to be a long-term setback. By applying the right type of load at the right time, and supporting recovery through smart lifestyle changes, you can reduce symptoms and restore tendon function.
Start with isometrics, progress to eccentrics, strengthen around the joint, and stay consistent.
For more support or a personalised rehab programme, visit theconditioninghub.com or reach out to our team today.
📃 References
Kraushaar B, Nirschl RP. (1999). Tendinosis of the elbow (tennis elbow): clinical features and findings of histological, immunohistochemical, and electron microscopy studies. J Bone Joint Surg Am.
Rio E, Kidgell D, Purdam C, et al. (2015). Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. Br J Sports Med.
Stasinopoulos D, Stasinopoulou K. (2006). Comparison of effects of eccentric training and passive stretching on patients with tennis elbow. Clin Rehabil.
Lucado AM, Glaviano NR, Saliba SA. (2012). A systematic review of the role of proximal strengthening in the management of lateral epicondylalgia. J Sport Rehabil.
Pingel J, Wienecke J, Kongsgaard M, et al. (2017). Alcohol consumption impairs tendon healing: A preclinical study. J Orthop Res.