Return to play from tennis elbow
Tennis elbow—clinically known as lateral elbow tendinopathy—causes pain around the outside of the elbow. Despite its name, it is not limited to tennis players. It can affect anyone whose work, sport, or daily activities repeatedly load the wrist and forearm muscles.
What causes tennis elbow?
Tennis elbow commonly develops when the wrist-extensor tendons are exposed to more load than they are prepared to tolerate. In tennis players, contributing factors may include:
A sudden increase in playing frequency or intensity
Repetitive late contact or off-center ball striking
Excessive gripping or wrist tension
Changes in racket, strings, or technique
Limited strength or endurance through the forearm, shoulder, or trunk
Symptoms often include tenderness on the outside of the elbow and pain with gripping, lifting, backhands, or using a racket in general.
Should you stop playing tennis?
Complete rest is rarely the long-term solution. Rest may temporarily reduce pain, but it does not rebuild the tendon’s ability to tolerate tennis.
Instead, treatment usually involves temporarily adjusting the amount and intensity of play while progressively strengthening the wrist, forearm, and upper extremity. Current clinical guidelines recommend resisted wrist-extensor exercises as a central part of rehabilitation. Manual therapy may also provide short-term pain relief when combined with exercise.[1]
What does rehabilitation involve?
An individualized rehabilitation program may include:
Load management: Reducing aggravating activities without unnecessarily stopping all movement.
Progressive strengthening: Gradually loading the wrist extensors, grip, elbow, shoulder, and trunk.
Movement assessment: Identifying technique or movement patterns that may repeatedly overload the elbow.
Tennis-specific progression: Reintroducing groundstrokes, serves, practice volume, and match play in stages.
Bracing or taping may help manage symptoms temporarily, but these tools should support—not replace—progressive exercise.
Corticosteroid injections can provide short-term relief, but research has found poorer long-term outcomes and higher recurrence rates in some patients.[2,3] This is why quick pain relief should not be confused with restored tendon capacity.
When should you seek help?
Consider an evaluation if your pain continues to worsen, affects everyday gripping or lifting, or prevents you from playing despite modifying your activity. Because neck problems, nerve irritation, joint conditions, and other injuries can also cause lateral elbow pain, an accurate assessment matters.
At Courtlete Sports Rehab & Performance, we look beyond the painful area. We assess your strength, workload, movement, and tennis mechanics to help you reduce pain, rebuild capacity, and return to the court with confidence. Book a free discovery call to find out more!
This article is for general education and is not a substitute for an individualized medical evaluation.
References
Lucado AM, Day JM, Vincent JI, et al. Lateral elbow pain and muscle function impairments: Clinical practice guidelines. Journal of Orthopaedic & Sports Physical Therapy. 2022;52(12):CPG1–CPG111. https://doi.org/10.2519/jospt.2022.0302
Coombes BK, Bisset L, Brooks P, Khan A, Vicenzino B. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: A randomized controlled trial. JAMA. 2013;309(5):461–469. https://doi.org/10.1001/jama.2013.129
Smidt N, van der Windt DAWM, Assendelft WJJ, Devillé WLJM, Korthals-de Bos IBC, Bouter LM. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: A randomised controlled trial. The Lancet. 2002;359(9307):657–662. https://doi.org/10.1016/S0140-6736(02)07811-X
