Lateral humeros epicondylitis / Tennis elbow

If you experience elbow pain during sports or your daily routine, you might be suffering from lateral or medial epicondylitis, also known as “tennis/ golfer’s elbow”. It’s commonly caused by repetitive arm & wrist motions, ie overloading of the elbow - and not just in athletes. Read more about causes, typical symptoms & treatment options.

Pierre Schydlowsky Specialist MD in rheumatology

Tennis elbow vs golfer’s elbow

Epicondylitis is a condition involving pain in your elbow, sometimes also in your forearm and/or wrist. It’s typically caused by overloading the tendons on the outer and inner side of the elbow. This condition often appears in one of two variations:

  • Tennis elbow, which is on the outside of the elbow, ie lateral epicondylitis
  • Golfer’s elbow, which is on the inside of the elbow, ie medial epicondylitis

The terms “tennis elbow” and “golfer’s elbow” are perhaps misnomers, as these conditions are not limited to athletes. They typically occur as the result of manual labor injuries, especially from tasks involving many repetitive wrist movements (e.g. carpentry or painting). In a sports, as the names suggest, practitioners affected by the conditions tend to be tennis, badminton or golf players.

Causes

In most cases, tennis elbow and golfer’s elbow is the result of too much pressure (or a combination of heavy pressure and repeated movements) on the wrist extensors. Wrist extensors are the part of your wrist that allows it to bend backwards.

Vibrations from using a tennis racket, a hammer or other tools are frequent culprits. Small repetitive exertions of pressure, such as using a computer mouse or typing on a keyboard for several hours, are other common causes.

Symptoms

It is common for the pain to appear a few days after performing the activity triggering the condition. Your pain will increase if you continue activities involving pressure on the wrist.

You may experience pain as a buzzing sensation. In the case of tennis elbow, you may feel pain in the outside of the elbow. In the case of golfer’s elbow, you may experience discomfort on the inside of the elbow instead. The pain will often radiate down into the lower part of your arm towards the wrist area.

Read more about wrist pain in our full article about wrist sprains.

Read about other common elbow injuries in our elbow injury guide.

Diagnosis and treatment

Relief

Tennis and golfer’s elbow are caused by overloading and straining the body. The first step in treating an injury caused by overload is to relieve the damaged tissue. You can achieve this by limiting the load you put on your wrist when you bend it upwards. Especially focus on this when resistance or weight are involved as you move your wrist.

This can be difficult because of the way we normally use our wrists i.e. by bending our wrists upwards when we carry objects. Instead, try to lift/carry the object with your elbow facing outwards and the palm of your hand facing straight ahead or up. This feels unnatural, but it will help you to relieve pressure on the outer side of your elbow.

Exercise

Perform mobility, strength and stability exercises to increase blood circulation and then follow with stretching exercises. Using bandages for epicondylitis may result in significant short-term pain relief. In mild cases, elbow training can be initiated immediately.

To ensure a complete recovery, you should undergo a three-month training program. Continuous exercising will help to prevent relapses. If you experience too much pain to be able to exercise, then some injections of adrenal cortex hormone may be helpful. In the rare instance that the condition does not respond to traditional forms of treatment, you may have to resort to surgery.

Exercises for Lateral humeros epicondylitis / Tennis elbow

  1. Tennisball I
    None

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    • Take a tennis ball or a ball of similar softness with a large cut along its side.
    • Squeeze the tennis ball for 2-3 seconds while holding the elbow slightly bent.
    • Perform 3 sets of 8 repetitions with each arm.
  2. Hand towel I
    None

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    • Stand up.
    • Grab a small towel or something similar.
    • Make a fist while squeezing the towel with your fingers.
    • Perform 3 sets of 3 repetitions.
  3. Wrist flexion stretch III
    30 sec. x 3 sets

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    • Make sure your palm is pointing towards the floor.
    • Pull your hand backwards with the other arm.
    • Hold the stretch for 30 seconds and perform 3 repetitions with each arm.

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About the author

Pierre Schydlowsky is a specialist MD and Ph.D. of rheumatology with a diploma in sports medicine. He has published multiple research papers on shoulder and ski injuries and is teaching various advanced courses in sports medicine at Danish Universities.