Tennis Elbow Physiotherapy near Prince Edward

Tennis elbow involves the tendon that anchors the wrist extensor muscles to the outside of the elbow. Despite the older name of epicondylitis, the tissue changes are more about a tendon that has not kept up with what it is being asked to do than about ongoing inflammation. Symptoms alone cannot diagnose it — several problems produce pain in the same area — so an in-person examination is what separates a tendon problem from a joint, nerve or neck-referred one.

The typical picture is sharp pain on the outside of the elbow when gripping, carrying a bag, opening a jar, or holding a mouse, sometimes with an ache spreading into the forearm. It often builds gradually after a change in workload rather than after one incident. Other possible causes overlap here: radial nerve irritation, elbow joint problems and pain referred from the neck can all feel similar, which is why we test rather than assume the obvious label.

• Pain on the outside of the elbow when gripping or lifting
• Pain opening a jar, wringing a towel or turning a key
• Aching spreading down the forearm after computer or tool use
• Tenderness when pressing just below the bony point of the elbow
• Weaker grip because gripping hurts, rather than because the muscle has failed

We start with what changed: new tools, a new job, a heavier training block, a heavier load to carry, or a different keyboard. Then we test grip, wrist and forearm strength, load the tendon in a controlled way to confirm it reproduces your pain, and check the elbow joint, the nerves of the forearm and the neck. The point of that breadth is not thoroughness for its own sake — it changes what we would recommend.

• Your symptoms: exact location, what provokes them, and how long they linger
• Daily activities and function: carrying, cooking, housework, childcare, self-care
• Work or study demands: tools, keyboard and mouse setup, repetition and grip force
• Sleep: whether the elbow or forearm aches at night or affects your position
• Load and injury history: recent changes in training, hobbies or workload, previous episodes
• Movement: elbow, forearm and wrist range of motion, and neck movement
• Strength and control of grip, wrist extensors, forearm and shoulder-blade muscles
• Neurological and general screening: sensation, muscle power, nerve sensitivity, medical history and medicines

Tendons generally respond to load that is progressive and repeatable, so graded strengthening for the wrist, forearm and grip is usually central, alongside temporary changes to the tasks that irritate it most. Depending on the assessment, a strap or brace, hands-on treatment or acupuncture may be considered where you consent and they seem likely to help you tolerate the exercise. Your preferences and job demands shape the order. We do not use a fixed routine, and we adjust according to how you respond.

Complete rest often feels good for a fortnight and then disappoints, because the tendon loses capacity while the job stays the same. The more durable approach is to lower the peaks — carry with two hands, split heavy tasks, change grip size — while adding controlled loading. We agree how much next-day soreness is acceptable, give you a flare-up plan, and review grip comfort, strength and your daily activity tolerance at each visit before changing the load.

Most outer elbow pain is well suited to a physiotherapy assessment and a graded loading plan. Arrange a prompt medical review instead if the elbow is hot, swollen and you feel feverish, if pain began after a fall or direct blow and the joint will not straighten, if you have unexplained weight loss, or if you are losing grip strength in a way that is clearly getting worse rather than simply painful. Go to an emergency department the same day if the arm was injured and you cannot use it, if the elbow looks out of shape, or if the hand becomes cold, pale or increasingly numb.