Physical Therapy for Tennis Elbow

What is Tennis Elbow?

Lateral epicondylitis, better known as tennis elbow, is a painful condition characterized by pain and tenderness in the elbow and the forearm. Despite its name, tennis elbow doesn’t only happen to those who play racket sports.

Tennis elbow is an overuse injury. When the forearm muscles are constantly contracted and released, these motions can result in tiny tears in the arm’s tendons. The tendons that attach the forearm muscles to the bony bump on the outside of the elbow are impacted, resulting in muscle strain and, ultimately, tennis elbow.

Signs and Symptoms

Perhaps the most obvious symptom of tennis elbow is pain in the elbow. Pain is typically concentrated around the outside of the elbow but can radiate down the forearm to the wrist in some more severe cases. Some patients report that pain appears or worsens at night.

Weakened grip is another common tennis elbow symptom. Patients may find it difficult or impossible to grip objects, turn doorknobs, or shake hands with others. Symptoms often appear in the dominant arm alone, but the condition may impact both arms at once.

Causes of Tennis Elbow

Tennis elbow is often caused by repetitive movements in the arm and elbow. While these movements may come from playing sports, they are also seen in professions like cooking, construction, plumbing, and painting.

The most common cause of tennis elbow is overuse. Specifically, tennis elbow often involves one key muscle: the extensor carpi radialis brevis (ECRB). This muscle is largely responsible for stabilizing the wrist when the elbow is straightened. When the ECRB is overused, it can become weakened, resulting in the microscopic tears that characterize tennis elbow.

The ECRB is located near the most central point of the elbow, and this location can leave the muscle at increased risk of injury. When the elbow is bent and straightened, the muscle is forced to rub against bones, which can gradually cause wear and tear, leading to tennis elbow.

Risk Factors

Individuals of any age or profession can potentially develop tennis elbow. However, those between the ages of 30 and 50 are at the highest risk of developing the condition.

As mentioned earlier, there are some professions that come with an increased risk of tennis elbow. Cooks, butchers, painters, and plumbers are a few of the groups that perform repetitive arm movements daily and may be at higher risk of the condition.

Athletes who play racket sports like tennis, squash, and badminton may be at increased risk of developing tennis elbow, particularly if they are using improper form when swinging.

Tennis Elbow Treatment Options

When you visit Hicksville Physical Therapy, our doctors can often diagnose tennis elbow with a simple physical exam. If there’s a chance that another condition is causing your symptoms, your physician may run tests like X-rays or MRIs to confirm your diagnosis.

Tennis elbow can often resolve itself within a few days of light treatment. However, if you find that your condition is not improving within a week, it’s recommended to see a professional. Hicksville Physical Therapy can offer physical therapy treatment in Nassau County and the surrounding area.


Tennis elbow treatment often begins with pain management. Over-the-counter pain relievers are often enough to relieve discomfort. It’s also important to rest the arm and elbow, which can mean taking a break from the activity that caused the condition in the first place. Regular application of ice (about 15 minutes three to four times per day) can also help.

Once you’re able to return to your regular activities, you may need to modify your movements to prevent pain and reduce the risk of developing tennis elbow again. You might also benefit from the use of an assistive device like a brace or a forearm strap.

Even if typical treatment methods don’t work, there are a few more intensive treatment options before you need to consider surgery. Your physician may suggest injections to help relieve pain; some common options include Botox, platelet-rich plasma (PRP), and prolotherapy (which involves an irritant of some form).

Another treatment option is ultrasonic tenotomy, also known as the TENEX procedure. Your doctor will use an ultrasound to insert a needle into the skin and into the tendon where the damage is concentrated. The needle vibrates quickly because of the ultrasonic energy, and the damaged tissue turns into liquid and can be removed from the arm.


Surgery may be necessary if you’ve been undergoing non-surgical treatment for six to 12 months and haven’t seen an improvement in your symptoms. Your doctor will explain all your treatment options and which surgical procedure will be most effective in your case. Luckily, most tennis elbow surgeries are performed on an outpatient basis and don’t require you to stay overnight in the hospital.

Often, open surgery is recommended for treating tennis elbow. Your surgeon will make an incision over the elbow to remove the tendon’s damaged portion and reattach the healthy section of tendon back to the bone.

Physical Therapy

Physical therapy can be an effective treatment for tennis elbow all on its own, but it is also often recommended after surgery. Either way, physical therapy in Hicksville involves strengthening exercises to help you rebuild the muscles in the forearm and regain your range of motion.

Physical therapy and any concurrent treatment will be aimed at preventing the tendon from further breakdown. Our team will show you how to perform your everyday activities without damaging your elbow further. We will examine how you move and perform specific activities and suggest alternative ways to move. If you are an athlete, we can also look at your sports equipment (like your racket) to determine alterations that can help protect the elbow.

Throughout your physical therapy program, you may also undergo ice treatment or electrical stimulation to promote healing. All in all, physical therapy programs for tennis elbow typically last four to six weeks. In more severe cases, patients may need to attend physical therapy for up to six months.

For more information about tennis elbow treatment in Long Island, contact Hicksville Physical Therapy today.

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