Tennis Elbow

I’m sure we have all heard the term “tennis elbow” before. Especially with the US Open wrapping up this past weekend. Tennis elbow is the common term for “lateral epicondylitis,” which is inflammation of the lateral epicondyle of the elbow.

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What is Epicondylitis?

Epicondylitis is inflammation of the elbow where the wrist extensor muscles attach. Excessive use of the muscles (especially with performing back hands) will pull on the tendon and create inflammation and pain. Patients will then start to notice pain with any activity that uses that hand like lifting and shaking someones hand. That is usually why the pain persists so long with this injury. It’s hard to not use your hand. Every time you do, it’s like poking a bruise that you can’t see. You activate the muscles, the muscle pulls on its attachment to the elbow, and you create more inflammation in the tendon. 

Certain other activities and positions can also cause pain. Patients will commonly complain of pain with sleeping or when they first get up in the morning. The reason being, when we sleep our wrist is usually in a bent position. That position will put an extra stretch on the muscle and tendon as we sleep. That constant tugging of the tendon will lead to more inflammation and pain. 

Could it be Nerve Pain?

What a great question! The answer is yes. Your radial nerve runs right next to the lateral epicondyle. 

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Sometimes when the nerve is irritated it can present as “tennis elbow.” Typically if your nerve is involved you will get more tingling or pain into the hand as well as in the elbow. It’s always a good idea to double check though to be sure the true cause of your pain isn’t missed. 

How do I Make it Better?

If you get pain with sleeping the best thing to do is wear a splint at night. I recommend this to all my patients because it allows your injury to heal while you are sleeping rather than get worse. A resting splint at night is all you should need. It is irritating to wear at first but worth it in the end. 

If you are getting pain due to your radial nerve being irritated you want to perform this exercise.

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It will help to add length and mobility to the nerve. That should help to calm the pain sensitivity down and allow you to do more with your hand. Do two sets of 10 repetitions, through a pain free range of motion, twice a day. 

If you have true epicondylitis you want to increase the strength and flexibility of the tissue. Perform these three exercises, twice daily, to increase your wrist extensor strength and flexibility. That will help to strengthen the tissue, decrease the inflammation, and allow you to get back to your Serena-esk back hand pain free.

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Racquet Fit:

One final point about tennis elbow. If you get pain when you are playing tennis but don’t get pain otherwise, it’s a possibility your racquet is not fit to you correctly. Simple things like racquet weight, and grip size can have an effect on pain in your elbow. It’s always a good idea to make sure someone fits you properly to allow you to play as much as you can without pain. 


I hope this helps answer why you might have elbow pain and what you should do about it. If you have any questions don’t hesitate to contact me. Thank you for reading!