Physical Therapy for Tennis Elbow: Exercises and Techniques for Recovery

Tennis elbow is a condition characterized by inflammation or micro-tears in the tendons that connect the forearm muscles to the outer part of the elbow. This ailment commonly results from repetitive stress on the affected area, such as when engaging in activities like painting or playing tennis.

Tennis elbow is treated with self-care measures, such as rest, ice therapy, and medication, in cases where the injury is mild and diagnosed early. Creating and implementing an effective tennis elbow physical therapy plan will help alleviate the excruciating pain and other symptoms. 

Studies show that physical exercises will strengthen the muscles, gently stretch the tendons and allow them to heal. Read on to discover more about the role of physical therapy in tennis elbow recovery.

Causes of Tennis Elbow

Unlike the name, the occurrence of tennis elbow is not limited to tennis players. Various causes and repetitive activities can develop tennis elbow. These causes are as follows.

  • Repetitive Activities: Occupations like landscaping, gripping, painting, and construction will damage the tendons and cause inflammation.
  • Sports Injury:  Players in baseball, tennis, basketball, and volleyball are more prone to developing tennis elbow.

Symptoms of Tennis Elbow

The following are the common signs and symptoms of tennis elbow, which might vary depending on the severity of the injury.

  • Pain on the outside of the elbow.
  • Pain progressing with lifting heavy objects.
  • Pain when moving wrist or shaking hands.
  • Weakened gripping of forearms.
  • Burning sensation in the wrist that worsens at night.
  • Numbness or stiffness while extending the arm.
  • Swollen and tender joints.

Diagnosis of Tennis Elbow

Diagnosing the condition will help you plan a personalized tennis elbow physical exercise plan that suits your needs and goals.

  • Physical Examination

Your healthcare professional will complete a physical examination and examine the previous medical history. They will ask you to perform certain arm movements and apply light pressure to the outside of the elbow to know the condition’s root cause. 

  • Imaging Tests 

X-ray: It shows a two-dimensional image of the elbow to detect joint damage.

Magnetic Resonance Imaging – MRI scans offer the intricate image of the injury or swelling in the bones, cartilage, tendons, and ligaments due to sports activities.

Electromyography – EMG assesses the muscles and motor neurons that control the elbow joints and detect abnormalities.

Physical Therapy for Tennis Elbow

Rest and Ice

Rest your affected elbow and arm as long as possible. Avoid activities or movements that worsen your pain, like gripping things or lifting heavy objects. 

Besides, applying cold or ice packs on the injured area will temporarily relieve your pain. Use it for 15 minutes and repeat it every couple of hours throughout the day. 

Strengthening Exercises

  • Wrist Extension Stretch

Practicing wrist extension stretches will build strength, increase mobility and prevent further injury in your elbows. They focus on strengthening the muscles around the wrists and are often prescribed for patients to regain their range of motion. 

  • Eccentric Wrist Extension

Research shows that eccentric wrist strengthening exercises are an effective intervention approach to relieve pain from tennis elbow pain. An eccentric contraction will lengthen the muscles to build muscle strength, which is the key to the body’s adaptations.

  • Forearm Pronation and Supination

Pronation and supination exercise is the forearm rotation that allows better orientation for hand movements. The muscle involved in the exercise provides you with a substance mechanical advantage to enhance functionality.

  • Grip Strengthening Exercises

Grip-strengthening exercises are the best way to gain muscle strength. While performing the exercise, most muscles between the elbow and upper part of the forearm will gain maximum isometric strength and flexibility. 

Stretching Exercises

  • Wrist Flexor Stretch

Simple wrist flexor stretches will improve the overall health and flexibility of your joints, muscles, and tendons. It also loosens your wrists, hands, forearms, and fingers by relieving muscle tension or pressure.

  • Wrist Extensor Stretch

Wrist extensor stretch involves the expansion and contractions of muscles in our wrists, fingers, and forearms. It is one of the low-impact exercises for tennis elbow that will increase your range of motion and prevent the risk of injury during any sports or activities. 

  • Forearm Stretch

Performing forearm stretches will help you maintain the balance between the length of the extensors and flexors, thereby preventing injury in the forearms. Stretching out your forearms deals with the wrist, fingers, and elbow movements, giving you more control and flexibility over the upper body. 

  • Triceps Stretch

Triceps stretch for tennis elbow recovery is proven effective in improving flexibility, lengthening the muscles, and enhancing the range of motion. It also boosts blood circulation and loosens the connective tissue to heal the injury promptly. 

Manual Therapy

  • Massage Therapy

Massage therapy reduces swelling, improves circulation, and increases mobility in the injured elbow. The massage’s gentle stroke and friction stimulate collagen formation in the damaged tendon. Simply put, it will accelerate the healing process rather than simply taking a rest.

  • Trigger Point Therapy

Elbow pain is associated with certain trigger points in the elbow muscles. The practitioner will locate the exact point by palpation technique. Then they will apply certain pressure sustained for around 60 seconds to increase the tissue’s resistance. 

  • Myofascial Release Therapy

Every muscle, never, and organ is encompassed by Fascia, a connective tissue that surrounds the structure of the human body. Incorporating myofascial release therapy will improve blood circulation and increase muscle activation, restoring the healing ability. Therefore, the patient with tennis elbow will have less pain.

  • Ultrasound Therapy

Ultrasound therapy such as ESWT (Extracorporeal shock wave therapy) is designed to induce a prompt healing response in the body to restore the damaged tissues. The approach focuses on the elbow and forearm, which will reduce the discomfort and pain caused by the tennis elbow.


Tennis elbow is a common condition that will make it challenging to perform even simple daily life activities. If you experience pain, stiffness, or any other symptoms, following physiotherapy exercises for tennis elbow will help address your pain and restore your active mobility. The key is to do them steadily and carefully, ensuring you are not straining your elbow joints.

Tennis elbow can be properly treated and prevented by following a healthy exercise regime. Even though some exercises can be done by yourself at home, it is best to consult a professional therapist to achieve the best results and restore your complete range of motion.

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