Tennis Elbow

Despite the name, most people with tennis elbow have never picked up a racquet. It’s an overuse injury of the tendons on the outside of the elbow, and it’s just as common from manual work, gripping tools, or repetitive computer use as it is from sport.

What causes it

Tennis elbow (lateral epicondylitis) develops when the tendons attaching the forearm muscles to the outside of the elbow are repeatedly overloaded, small amounts of damage accumulate faster than the tendon can repair itself. Common triggers include repetitive gripping, lifting with the wrist extended, manual trades work, typing, and racquet sports where the technique loads the forearm repeatedly.

Typical symptoms

• Pain and tenderness on the outside of the elbow
• Pain that worsens with gripping, lifting, or twisting motions (turning a door handle, shaking hands, lifting a kettle)
• A weak grip
• Pain that can radiate down the forearm
• Symptoms that build gradually and worsen with continued use rather than settling on their own

Why it lingers if left alone

Tendon injuries like tennis elbow heal slowly because tendon tissue has a limited blood supply compared to muscle. Continuing the aggravating activity without addressing it, “working through it”, tends to keep the tendon in a constant state of re-irritation, which is why symptoms that started mild can become a persistent, months-long problem if not properly managed early.

What we assess

We check grip strength, forearm flexibility, and the specific movements that reproduce your pain, along with a look at what’s likely driving the overload (work tasks, sport technique, or repetitive daily activities), since resolving tennis elbow properly usually means addressing that underlying load, not just the sore tendon.

Treatment approach

Treatment typically combines manual therapy and IASTM to address tightness and restriction in the forearm muscles, dry needling for particularly tight or overloaded tissue, and a specific, progressive loading exercise programme for the tendon, which is the single most evidence-supported way to actually rehabilitate tendon injuries like this one, not just rest.

Managing the activity that caused it

Complete rest isn’t usually the answer, tendons need some load to heal well, just not the aggravating amount. We help you find a manageable level of activity to continue with during treatment, and practical adjustments (grip size, technique, workstation setup) to reduce ongoing strain.

When to get it assessed

If elbow pain has lasted more than two to three weeks, or is affecting your grip strength and ability to work, it’s worth a proper assessment rather than waiting for it to resolve on its own, tennis elbow that’s left untreated for months typically takes considerably longer to resolve than one caught and treated early.

Realistic timelines

Tendon injuries genuinely take longer to resolve than muscle strains, tendon tissue heals more slowly due to its limited blood supply, so we’re upfront that meaningful improvement in tennis elbow typically takes several weeks to a few months of consistent, progressive loading, not a handful of sessions. Sticking with the loading programme, even once pain starts easing, is what prevents it from flaring straight back up.

Getting started

Alpha Physiotherapy is on PWD Road, Media Town, Rawalpindi. Book an assessment and we’ll build a treatment plan targeted at your specific tendon and the load that’s overloading it.