Hein Viljoen
Physiotherapy
Tennis elbow is more common than many people realise. Research estimates that it affects 1-3% of adults each year, particularly the dominant arm. While many people associate it with racquet sports, physiotherapists regularly see the condition in office workers, gym-goers, tradesmen, parents, and golfers, as well as anyone performing repetitive gripping or lifting tasks.
The condition usually develops gradually through repeated strain on the tendons around the outside of the elbow. Activities involving repetitive wrist movement or gripping against resistance can slowly overload the tendon. In tennis players, factors like poor technique or heavy racquets may contribute, but the same type of strain can happen during everyday work and daily activities, too.
One of the biggest problems with tennis elbow is that the early symptoms are often easy to ignore. This is why many people continue pushing through discomfort, even as simple tasks become frustrating or painful.
Tennis elbow (lateral epicondylalgia) is the irritation and overload of the tendons on the outside of the elbow. Despite the name, it is not always caused by sport, and it is not simply an inflammatory condition.
Current research suggests that tennis elbow is more closely linked to tendon overload and reduced tendon capacity over time. In other words, the tendon gradually struggles to cope with the demands being placed on it.
Some of the most common activities that can lead to tennis elbow are:
One of the earliest signs is usually a mild ache on the outside of the elbow.
In the beginning, you might only notice pain with specific movements, like:
Because the discomfort often comes and goes, many people assume it will settle on its own. However, pain during gripping or lifting activities is often an early sign that the tendon is becoming overloaded.
Another early warning sign is grip weakness in every task, like:
Interestingly, research has shown that reduced grip strength is one of the most common clinical signs of tennis elbow, and it can appear before severe pain develops.
The elbow or forearm may also feel stiff after rest, especially first thing in the morning.
Many people describe a tight or pulling sensation that improves slightly once they start moving. While this can seem harmless, it is often a sign that the tendon is struggling to recover properly between activities.
In the early stages, symptoms are often linked to repetitive activities rather than constant pain. Typing, lifting children, gym training, or racquet sports may trigger discomfort that settles afterwards. Unfortunately, this temporary improvement often leads people to believe the problem is not serious.
Research suggests that repeated loading without enough recovery is one of the biggest contributors to ongoing tendon pain.
A common pattern with tennis elbow is pain that improves with rest but returns quickly when activity resumes. Rest may temporarily calm symptoms, but the tendon’s ability to tolerate load often remains reduced unless it is properly rehabilitated.
Ignoring tennis elbow for too long can make recovery more difficult and prolong symptoms unnecessarily. The earlier the condition is identified, the easier it is to manage with physiotherapy.
Want to learn more about the treatment of tennis elbow? Read the next blog in this series: How long does tennis elbow really take to heal?
If lifting your morning coffee suddenly feels like an effort, it might be time to visit one of our physios. Click here to book with Hein Viljoen Physiotherapy.
Reference: Bisset L, Coombes B. “Tennis Elbow.” BMJ Clinical Evidence, 2011.
