Tennis Elbow

If you perform a search on “tennis elbow” you will come across a plethora of information on the topic, therefore this will be direct and to the point. Here is a step-by-step guide to understanding and correcting your issue.


If you have anything from a dull ache to a sharp pain on the outside of your elbow, odds are that you have caused inflammation of a tendon and developed the condition. The first step in correcting it is to understand why you got it in the first place.

The first possibility is that you did something unusual and traumatic. For example, did you bang your elbow against a door and it has hurt ever since? Did you hit a backhand from an awkward position and suddenly felt a sharp pain out of nowhere? If this is where the pain has arisen from, then it is an “acute” condition and it is the most easily treated. In this case, you did something which caused inflammation out of nowhere, however playing tennis can prevent that inflammation from subsiding.

If the situation is “chronic,” then it’s a problem of repetitive overuse. In other words, you have been doing something over and over that is causing the inflammation. Like acute, it does not necessarily have to arise from tennis. Consistently painting, using a chainsaw, carrying heavy items…they can all bring it on as well.


Let’s start with the acute problem. The trick here is to get ALL of the inflammation down. Once you do that, you will be as good as new! Do the following all at the same time:

  • The first step is to ice it MULTIPLE times right away after injuring or using. Ice will help to keep the inflammation down after you have immediately aggravated it.
  • The obvious next step is rest. Yes, you are a tennis player and you want to be on the court, but pushing your luck will only risk making things worse. Because everyone is different, it’s difficult to say exactly how much time off you will need, but at a bare minimum you should not play or use that arm for ANYTHING that puts stress on the joint for at least a week. Two weeks would be twice as good, but it may take significantly longer. You have to listen to your body
  • At the same time, take an anti-inflammatory such as Ibuprofen or aspirin. This will typically make it feel much better, but DO NOT play with it just because it feels better.You need to get all of the inflammation down and not 50%, 60% or 80%. 100%!
  • Some people cure their tennis elbow in a matter of days by simply doing some consistent forearm stretches daily. The key word is “consistent.” Perform stretches three times per day and be faithful.
  • Lastly, put a heating pad on the affected area once a day to increase the circulation and the healing process. This may seem counterintuitive when juxtaposed to the use of ice until you understand the logic. Ice is used only after you have stressed the joint and increased the inflammation. Heat is used when the arm has been at rest in order to increase the blood flow. You would not want to increase blood flow immediately after an injury.

Hopefully the above steps will cure your condition. If not or if you have a chronic problem, then let’s go to the next phase:

  • If your issue is chronic, then you would still follow the same steps above. The additional piece to keep in mind is that you have to identify whatever the repetitive motion is that is causing you pain and cease. Additionally, if you are certain that the issue lies with your tennis stroke, then take a 30-minute lesson with a tennis professional who you trust and have him/her take a close look at the stroke that is causing you discomfort. You may get lucky and be able to stop the pain simply through a correction in your stroke technique.
  • If you are still having symptoms after following the steps in the above section, then yes, you must take the time to contact an orthopedist. Don’t put it off because you will only prolong your misery. From there, the doctor will do one of two things. Either you will be referred to a physical therapist or the he/she will administer a shot of cortisone into the affected area. Definitely speak to your physician about the cortisone, especially if you feel your issue is from unresolved acute issues. Cortisone is a very powerful anti-inflammatory and it will almost always give at least some if not complete relief. It’s a very safe remedy provided it’s not used too much. Most doctors limit injections into a joint to only two or three. This is because cortisone is a type of catabolic steroid that actually breaks down tissue. Do it too much and the tendon will rupture.
  • If the doctor sends you to PT, the therapist will provide you with additional stretches as well as some exercises to try and strengthen the area around the joint. Ultrasound and other higher tech solutions will be incorporated as well.

Still having issues? If you have taken all of those steps and you are still having problems, then it’s time to escalate this to another level:

Ask your physician for an MRI. X-rays show what’s happening with bone structure, but MRIs show what is happening with the soft tissue and that’s what we are concerned with. Unfortunately because of health care costs, a lot of doctors try to avoid MRIs and they can only order them after other steps have been taken. At this point, the orthopedist should not have a problem doing that. It will help to confirm precisely what and where the problem is. If the MRI confirms the diagnosis, then there is a minimally invasive procedure that removes the scar tissue which many doctors feel is cause of chronic tennis elbow. It is called Tenex and was actually featured on the show, “The Doctor’s”. You can watch the segment by clicking here.