Tennis Elbow
Specialised care for complex joint issues
What is Tennis Elbow?
Tennis elbow, medically called lateral epicondylitis, is a condition where the tendons on the outer side of the elbow become irritated, inflamed, or develop microscopic tears. These tendons connect forearm muscles that straighten your wrist and fingers to the elbow bone.
Although it’s known for affecting tennis players, it can occur in anyone who repeatedly uses their forearm muscles in similar ways.
- The extensor carpi radialis brevis (ECRB) tendon is commonly involved.
- Small tears in the tendon can build up over time, especially without rest.
Cause and Symptoms of Tennis Elbow
Tennis elbow is usually caused by repetitive wrist and arm motions, especially when gripping, lifting, twisting, or bending the wrist. Over time, these repeated stresses overwhelm the body’s ability to heal micro-injuries, leading to tendon degeneration.
Other contributing factors may include overuse, poor technique, inadequate rest, or improper equipment.
Common symptoms include:
- Pain or burning sensation on the outer part of the elbow, often worsening when lifting, gripping, or twisting the wrist.
- Weak grip strength, e.g. trouble holding cups, opening jars, or shaking hands.
- Stiffness, swelling, or discomfort that may spread down into the forearm or wrist, sometimes worse at night.
Diagnosing Tennis Elbow
Diagnosing tennis elbow usually begins with a thorough history and physical examination. Your doctor will ask about your symptoms, daily activities, sports participation, and any recent injuries.
During the exam, specific movements may be tested to reproduce pain, such as extending the wrist or gripping against resistance.
In most cases, additional tests aren’t required, but imaging may be used if symptoms are severe, persistent, or to rule out other conditions.
Treatment
Non-Surgical Treatments for Tennis Elbow
If you have mild symptoms, Tennis Elbow can often be treated at home through conservative measures, including:
- Resting the arm and ceasing involvement in activities that worsen pain
- Immobilising the arm using a brace or splint to reduce tissue stress
- Place palm in the upwards direction when lifting objects to reduce forearm strain
- Reduce swelling by placing ice on the elbow
- Consuming anti-inflammatory medications available over-the-counter (including Ibuprofen)
- Completing light exercises designed to stretch the wrist and elbow, promoting healing
These non-surgical treatments relieve the symptoms of the majority of patients. However, if these measures have been ineffective after approximately 6 months, visit your GP and request a referral to Dr Oscar Brumby-Rendell.
Steroid or Therapeutic Injections For Tennis Elbow
Therapeutic injections, such as steroid injections, may be recommended by Dr Brumby-Rendell, depending on the severity of your condition. Steroids (including cortisone) are anti-inflammatory medicines that can effectively reduce symptoms when administered into the affected area.
The injection is administered with the guidance of imaging (i.e., an ultrasound), which allows the medication to enter the correct location. As it contains anaesthetic, the injection is less painful; however, mild discomfort may be experienced as the injection is administered, and swelling and redness may arise.
Post-injection, the area must be protected and forceful arm motion avoided for a few days.
There are some risks associated with therapeutic injections, and as such, this medication may not be the best option for all patients. Your suitability for therapeutic injections will be assessed by Dr Brumby-Rendell, and you will be referred for this procedure if he deems the treatment suitable.
Surgical Treatment: Arthroscopic Surgery for Tennis Elbow
Dr Brumby-Rendell may recommend surgery if your symptoms remain after a prolonged period or if your condition brings you severe pain and interferes with your daily life.
The damaged tendon is addressed in surgery. This may constitute the reparation or reattachment of tears, cutting the tendon, and/or removing bone spurs or tissue causing symptoms.
Open surgical release is the standard surgery that treats Tennis Elbow. However, Dr Brumby-Rendell implements arthroscopic (keyhole) techniques, as they bring many advantages that open release methods do not offer.
The advantages of arthroscopy, commonly known as keyhole surgery
- Reduced pain after surgery
- Quicker healing periods
- Decreased likelihood of infection
- Minimised trauma to soft tissue
- Faster recommencement of everyday life
Elbow arthroscopy also allows Dr Brumby-Rendell to view the elbow joint's inside and identify and treat other elbow conditions. This cannot be done with open surgical release methods.
The most important difference between the two surgeries is that multiple tendons must be released in open surgery, whereas only the affected tendon is released in arthroscopy. This reduces post-operation weakness and leads to an earlier recommencement of sporting activities.
Long-term outcomes of elbow arthroscopy
The long-term outcomes of this surgery will be discussed with you during your pre- and post-operation appointments with Dr Brumby-Rendell. Elbow arthroscopy has an excellent prognosis. Your individual recovery journey may be influenced by your injury's severity, the specifics of your surgery, and your obedience to post-surgery recommendations made by medical staff.
Recovery Time
Recovery from tennis elbow involves gradual return to activity with guided therapy to restore strength, flexibility, and endurance. Early rehabilitation helps improve outcomes and reduce stiffness or persistence of symptoms.
- After pain is controlled, gentle stretching exercises for the wrist and forearm begin, often combined with manual therapies (e.g. massage).
- Strengthening follows, targeting not just the tendon but the whole forearm, and sometimes shoulder and wrist, to improve how the forces are handled throughout the limb.
- Gradual return to functional tasks and sports or work-activities, adjusting technique or load to avoid re-injury. Use of braces or straps during this phase can help.
It may take months before full recovery. Many patients see significant improvements by 6 months, though mild discomfort can linger.
Full strength and function like driving may take longer if the condition was severe or treatment delayed.
Yes. Prevention involves using proper technique, warm-up exercises, gradually increasing activity intensity, ensuring tools or equipment are appropriate (e.g. correct racquet grip size, ergonomic tools), and allowing rest days to let tissue repair micro-damage.
About Tennis Elbow Surgery
Dr Brumby-Rendell specialises in disorders like tennis elbow, with a focus on diagnosing both early and long-standing tendon problems, giving patients precise treatment plans.
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Comprehensive Assessment & Individualised Treatment: Every patient is assessed not just for symptoms, but also for biomechanics, technique, equipment, and lifestyle factors. Treatment is tailored – whether you need conservative management, advanced therapies, or in rare cases surgery.
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Evidence-Based Techniques & Supportive Rehabilitation: Dr Brumby-Rendell uses up-to-date, research-backed methods (e.g. PRP, shockwave therapy, structured rehab protocols) rather than relying solely on passive treatments. You’ll receive guidance throughout rehab to minimise recurrence and restore full function.
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Patient-Centred Care: Clear communication, setting realistic expectations, working closely with physiotherapists, and ensuring you understand the timeline, risks, and roles in your recovery.
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