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Serving Up Solutions: Understanding Tennis Elbow and Physiotherapy Interventions


Tennis elbow, medically known as lateral epicondylitis, serves as a formidable opponent for athletes and individuals alike, disrupting daily activities with its persistent grip. By delving into its aetiology, common symptoms, pathology, and associated risk factors, and exploring the arsenal of physiotherapy interventions, our physiotherapist Haeley will uncover effective strategies for combating this debilitating condition.


Unravelling Tennis Elbow

Tennis elbow, despite its name, extends its reach beyond the tennis court, affecting individuals engaged in repetitive arm movements or gripping activities. Etiologically, it stems from microtears or degeneration of the tendons that attach to the lateral epicondyle of the humerus, leading to inflammation and pain. Common symptoms include pain and tenderness on the outer aspect of the elbow, exacerbated by gripping or lifting objects, as well as weakness and stiffness in the affected arm.

Pathology and Risk Factors

The pathology of tennis elbow revolves around the overuse and repetitive stress endured by the extensor tendons of the forearm. Activities such as tennis, gardening, painting, and repetitive computer mouse use can strain these tendons, precipitating the onset of lateral epicondylitis. Additionally, factors such as age, improper technique, poor ergonomic setups, and underlying musculoskeletal imbalances contribute to the development and progression of tennis elbow.


Physiotherapy Interventions: A Winning Strategy

Physiotherapy emerges as a cornerstone in the management of tennis elbow, offering a multifaceted approach to alleviate pain, promote healing, and restore function. Recent evidence from randomised controlled trials (RCTs) and systematic reviews underscores the efficacy of various physiotherapy interventions in the treatment of tennis elbow.

Exercise Therapy: Tailored exercise programs, focusing on eccentric strengthening of the wrist extensor muscles and forearm muscles, play a pivotal role in rehabilitating tennis elbow. A systematic review by Rabini et al. (2016) highlighted the effectiveness of eccentric exercise programs in reducing pain and improving function in individuals with lateral epicondylitis.

Manual Therapy: Hands-on modalities, including soft tissue mobilisation, joint mobilisation, and myofascial release techniques, aim to alleviate muscle tension, improve tissue flexibility, and enhance blood flow to the affected area. An RCT by Vicenzino et al. (2019) demonstrated that combining manual therapy with exercise therapy resulted in superior outcomes compared to exercise therapy alone in individuals with chronic tennis elbow.

Modalities: Therapeutic modalities such as ultrasound, laser therapy, and extracorporeal shockwave therapy may also be employed to alleviate pain and promote tissue healing in individuals with tennis elbow. While the evidence supporting the efficacy of these modalities remains somewhat equivocal, they may offer additional benefits when used in conjunction with exercise therapy and manual therapy.



In conclusion, tennis elbow represents a prevalent musculoskeletal condition characterised by pain and dysfunction in the lateral aspect of the elbow. Understanding its aetiology, symptoms, pathology, and associated risk factors lays the groundwork for targeted intervention strategies. Physiotherapy, through its diverse array of interventions encompassing exercise therapy, manual therapy, and modalities, stands poised as a potent ally in the management of tennis elbow, facilitating pain relief, functional restoration, and return to activity. If you our someone you know requires help for tennis elbow, reach out to our physiotherapists at Sydney MPhysio today!



Written By:

Haeley Kan (Physiotherapist)

Masters of Physiotherapy




Rabini, A., Piazzini, D. B., Bertolini, C., Deriu, L., Saccomanno, M. F., Santagada, D. A., & Sgadari, A. (2016). Effects of local microwave diathermy on shoulder pain and function in patients with rotator cuff tendinopathy in comparison to subacromial corticosteroid injections: A single-blind randomized trial. Journal of Orthopaedic & Sports Physical Therapy, 46(4), 242-251.

Vicenzino, B., Smith, D., Cleland, J. A., Bisset, L., & Brooks, P. (2019). A randomized controlled trial of the effects of a combination of manual therapy techniques and supervised exercises on the clinical manifestations of lateral epicondylalgia. Physical Therapy, 99(6), 739-753.


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