Tennis Elbow

Revolution Rehab

What is it?

Everyone is familiar with the term tennis elbow. But what exactly is damaged when we experience this injury? The structure in question is the lateral epicondyle as seen in the picture. There are a few different reasons we might get tennis elbow which we will discuss below.

The Anatomy

There are many muscles that originate from the forearm to control the fingers, hand and wrist. Below is an image of the wrist extensor muscles with the extensor carpi radialis brevis being the most common muscle impacted with this diagnosis. As the image below shows, there are a lot of structures in the area of the lateral elbow. In addition to muscles, there are tendons, bones, and ligaments which all could be damaged.

The Damage

The main question we have to ask is exactly what structure is damaged in the lateral elbow. A torn tendon or ligament. A bone bruise from a fall. Or muscle damage due to overuse can all cause pain in the lateral elbow. If the symptoms are muscular in nature then determining which muscle is the next step. Lets discuss how these injuries may happen and what steps to take depending on the involved structure.

How This Happens

A bone bruise or trauma directly to the lateral elbow can occur due to a fall. If you land on your elbow the trauma can cause inflammation and irritation to any of the structures in the area. A traumatic force when falling on an outstretched arm can also cause tearing of ligaments or muscles. The ulnar nerve travels along the lateral elbow and can also be irritated or damaged.

Lastly, and most commonly, are the muscles in this region. Whether from a tear or overuse the muscles can be damaged or irritated. When this occurs, there can be additional tugging on the attachment site at the lateral epicondyle causing inflammation. This is the biggest question that needs to be answered when treating. What is causing this additional stress at the attachment site. It can be different from person to person. One of the main causes for irritation at this site is due to overuse. When the wrist extensors fire repetitively this can cause unwanted stress at the lateral epicondyle resulting in pain.


Once the mechanism of injury is known we can progress to treating the pain and rebuilding the tissue in the best way possible. Using soft tissue mobilization, dry needling and cupping will help improve mechanics and reduce pain.

Once the pain and motion is addressed we can begin strengthening the muscles accordingly. When a muscle or joint is not working properly, over time it will become weak. So rebuilding the strength is a necessary part of the process. Starting with isometric activation to help with motor recruitment is the first step. Then working on concentric and eccentric muscle activation to help with strength training. Finally transitioning into work or sport specific activity to return to prior level of function.

When it is all said and done, knowing what was the original cause and how to correct for it will help prevent future issues. Addressing these issues early on is just as important as the initial phases.

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