Tennis Elbow

Tennis is a great game to watch and even better to play. Whether you are a serious player or someone who just likes to have a knock around more socially, it can lead to problems that if not caught early, can lead to significant lay off through injury. Here, we will outline a couple of key problems faced by tennis players, with some tips to manage the problems.

Lateral Epicondylitis/Tennis Elbow

This condition is relatively common in those who play racket sports, and those who work in manual jobs requiring repetitive use of the wrist are most at risk. The structures at fault in tennis elbow are the tendons that attach the muscles of the forearm to the bone. Studies have shown changes within the tendon unit that is associated with a tendinopathy.

Symptoms include:

  • Pain over the lateral aspect (outside) of the elbow and forearm when grasping or twisting.
  • A pattern of gradual worsening.
  • Gradual weakening in gripping activities.


Sport injury treatment for tendinopathies can be difficult to say the least, but key points involve ascertaining whether it is an acute (new) or chronic (old/reoccurring) injury.

If it is a new episode or the first incidence of Tennis Elbow the key points of management are:

  • Identify the aggravating factor and decrease its impact by either cessation of the activity or adapting the way you perform it.
  • Rest and ice are important factors in allowing inflammation and pain to settle.  Ice packs can be placed over the site of injury for 15-20 minutes at a time and up to 3-4 times a day.
  • Regular stretching of the affected muscle group.
  • Gradual strengthening of the affected muscles that may have become weaker through disuse.
  • Gradual return to modified activities that previously aggravated the condition over 2-3 weeks.

If it is a persistent or chronic incidence of Tennis Elbow the key points of management are:

  • Again identify the aggravating factor and adapting your environment to decrease its affect on the condition.
  • Begin stretching and strengthening activities.  Strengthening the wrist muscles can be done in a variety of forms.  Static and Theraband activities may be of some use.

Further to this management, treatment options available to those with chronic or persistent Tennis Elbow are listed below:

  • Soft tissue friction.  Painful, but aims to initiate an inflammatory response and invoke healing.
  • Acupuncture.
  • Platelet rich plasma injection.
  • Extracorporeal Shockwave Therapy.

Shoulder Impingement

This occurs commonly in sports that require repeated overhead movements. In tennis serving may be the main aggravating problem. It involves the acromion of the shoulder blade and the head of the humerus, (the upper arm bone).   These two structures can ‘pinch’ structures that run between them, commonly the subacromial bursa (a little sac of fluid that protects the joint) or the tendons of the rotator cuff muscles, that control the movement within the joint. This leads to inflammation and pain.


The condition of shoulder impingement is relatively complex due to the nature of the shoulder joint. It is often a combination of rotator cuff dysfunction and poor scapular (shoulder blade) mechanics that lead to the condition, combined with overuse.

The essentials of management of this condition are:

  • Decrease inflammation through use of ice and relative rest from current aggravating activities.
  • Improve mechanics of the shoulder joint, through passive stretches and strengthening the rotator cuff musculature.
  • Improve scapular mechanics and control through a combination of pulley and back strengthening activities.
  • Gradual return to sport alongside a maintenance program of strength and flexibility.

If you have any ongoing problems whilst playing sport and want to discuss your current problem please contact us at either location on the telephone numbers above.

Wyndham Health