More Than Just an Elbow Problem
Tennis elbow, or lateral epicondylitis, involves the tendons that attach to the outside of the elbow. These tendons connect to the muscles you use every time you grip, twist, or lift something with your hand. When those tissues become overloaded, pain tends to show up right at the bony point on the outer elbow, and it can spread into the forearm.
What catches a lot of people off guard is that the elbow itself isn’t usually the whole story. The tendons at the elbow are often just the point where strain accumulates. How the wrist, forearm, shoulder, and even the neck manage load all play a role in how much demand gets placed on that one spot.
It’s also worth knowing that tennis elbow isn’t really an inflammatory condition in most cases, despite what the name suggests. It’s more of a tissue tolerance issue, where the tendon’s capacity hasn’t kept up with the demands being placed on it. That’s an important distinction because it changes how you approach treatment.
You don’t need to be an athlete for this to develop. Repetitive gripping at work, prolonged mouse and keyboard use, lifting with a straight arm, or even something as simple as carrying groceries can be enough to tip things over.
The encouraging part is that tennis elbow generally responds well to the right combination of load management and progressive strengthening. It may take some patience, but understanding what’s driving it is the first step toward getting on top of it.
What Leads to Tennis Elbow?
Tennis elbow usually develops when the tendons on the outside of the elbow are asked to handle more than they’re currently conditioned for. It’s rarely a single event. More often, it’s the result of repeated stress that builds up over time without enough recovery in between.
Common contributors may include:
How We Assess Tennis Elbow
It starts with a conversation about what you’re experiencing. When the pain started, what activities bring it on, how it affects your grip, and whether it’s been getting worse over time. Details like whether it flares with typing, lifting a kettle, or shaking hands all help us narrow things down.
From there, we assess how the elbow, wrist, and forearm are actually functioning. This typically involves testing grip strength, evaluating the tendons through specific loaded positions, and looking at how the wrist extensors respond to resistance. These hands-on tests are often more telling than imaging when it comes to understanding what’s going on at the tendon.
We also look beyond the elbow itself. The shoulder, upper back, and wrist all influence how force is distributed through the forearm. If there’s stiffness or reduced control elsewhere in the chain, it can increase the demands placed on those tendons at the elbow, and that’s often part of the picture.
The goal is to understand how much load the tendon can currently handle and where the gap is between that and what your daily life or training is asking of it. Imaging is rarely needed early on, but may be considered if symptoms aren’t responding as expected or if there’s a reason to rule out something else.
Tennis Elbow Treatment in Burlington
It’s Not About Resting and Hoping
Treatment is shaped around what you need your arm to do. Whether that’s getting back to the gym, working pain-free at a desk, or just being able to pour a cup of coffee without wincing, your goals guide the plan.
Because tennis elbow is primarily a load tolerance issue, treatment focuses on gradually rebuilding the tendon’s capacity to handle demand. This may involve progressive strengthening of the wrist extensors and forearm muscles, improving grip endurance, and carefully reintroducing the tasks that have been aggravating your symptoms.
Simply resting it and waiting for the pain to go away often isn’t enough, and in some cases it can actually make things worse by allowing the tendon to decondition further. The goal is to find a level of activity the tendon can tolerate right now and build from there in a structured, progressive way.
Hands-on treatment, including soft-tissue work and joint mobilization, can help reduce pain and improve how the elbow and forearm move in the short term. Techniques like shockwave therapy may also be considered for tendons that have been slow to respond. But lasting improvement typically comes from building strength and learning how to manage load over time.
Education plays a central role at Burlington Sports Therapy. Understanding how to modify your grip, adjust your workstation, and pace your return to activity can make a meaningful difference in preventing setbacks and building long-term resilience. When appropriate, our chiropractic, physiotherapy, and massage therapy team works together to support your recovery from multiple angles.
How We Help at Burlington Sports Therapy
Tennis elbow often responds best when care addresses more than just the point of pain. Depending on what’s contributing to your symptoms, treatment may combine strengthening, joint mobility work, and soft-tissue techniques to rebuild the tendon’s capacity and get you back to using your arm with confidence.
Physiotherapy
Progressive tendon loading is often central to tennis elbow recovery. Physiotherapy may include targeted strengthening of the wrist extensors and forearm muscles, grip endurance work, and a gradual return to the activities that have been causing pain.
Chiropractic Treatment
When stiffness or restricted movement through the wrist, elbow, or upper back is adding strain to the forearm tendons, chiropractic care may focus on restoring mobility through those areas. Attention is often given to how the elbow, shoulder, and wrist are sharing load during gripping and lifting tasks.
Massage Therapy
When the forearm muscles become tight, overworked, or sensitized, soft-tissue treatment may help reduce tension and improve how the muscles around the elbow function. Techniques like Active Release Technique and Graston Technique can be especially useful for chronic tendon-related conditions.
What Tennis Elbow Recovery Looks Like
Tennis elbow recovery takes time, especially when symptoms have been building for a while. The plan is progressive and adapts based on how your tendon responds to increased load and activity.
Common Tennis Elbow Questions
These are some of the questions we hear most often from people dealing with elbow and forearm pain.
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