Condition guide
Tennis Elbow (Lateral Epicondylalgia) Treatment in Kent
Tennis elbow rarely comes from tennis. It comes from any activity that repeatedly loads the wrist and forearm — mouse work, DIY, painting, guitar, weightlifting, childcare. It's a load-management problem more than an inflammation problem, and it responds beautifully to the right combination of load, hands-on treatment and, where needed, shockwave.
What is Tennis Elbow?
Tennis elbow — properly called lateral epicondylalgia — is a load-tolerance problem at the common extensor tendon on the outside of the elbow. The tendon has been asked to do more than it can currently handle; the pain is your nervous system asking you to change something.
Typical Symptoms
- Sharp or burning pain on the outside of the elbow
- Pain triggered by gripping, lifting a kettle, shaking hands or turning a doorknob
- Tenderness right on the bony point on the outside of the elbow
- Weakness in grip — dropping things is common
- Pain that lingers for hours after a triggering activity
Common Causes & Triggers
- Sudden increase in wrist-and-forearm load (new job, DIY project, gym programme change)
- Sustained gripping or repetitive keyboard/mouse work with a compromised setup
- Racket-sport technique issues that overload the wrist extensors
- A period of general deconditioning after illness or lockdown-style inactivity
How We Treat Tennis Elbow at Bluebell
- 1
Assessment — we test grip strength, range, and specific loaded movements to grade severity and plan load.
- 2
Manual therapy — soft-tissue work on the forearm and radial nerve mobilisation where relevant.
- 3
Focused shockwave — strong evidence for stubborn or long-standing cases.
- 4
Progressive tendon loading — the real driver of long-term recovery. We start with isometric holds (they're pain-relieving) and progress through eccentric and heavy-slow loading.
- 5
Ergonomic and technique review — desk setup, gym cues, racket technique.
Honest Recovery Timeline
Straightforward, recent-onset tennis elbow usually settles in 4–8 weeks. Long-standing cases (6+ months of pain) typically take 8–16 weeks — often faster with shockwave added to the loading programme.
When Tennis Elbow Needs Urgent Medical Attention (Not Physio)
- •Pins and needles down the forearm, this could be a nerve problem rather than the tendon.
- •Sudden weakness with a snap or pop, worth ruling out a tear.
- •Night pain that is not related to load, see your GP.
- •Elbow pain straight after significant trauma, with deformity, swelling or an inability to move the joint, go to A and E.
- •A hot, swollen elbow with fever or feeling generally unwell, or unexplained weight loss, seek urgent medical review.
Tennis Elbow — Common Questions
Should I rest my elbow completely?
No — that's the classic mistake. Complete rest weakens the tendon further. We modify the load so you can keep working and training while the tendon rebuilds.
Do I need a steroid injection?
Usually not. Steroid injections can help pain short-term but tend to give worse 12-month outcomes than exercise alone. We only recommend injections when structured loading and shockwave haven't helped and function is severely affected.
Is shockwave worth it for tennis elbow?
For stubborn or long-standing cases, yes — the evidence is strong when combined with loading. Recent-onset tennis elbow often responds to loading alone.
How do I stop it coming back?
The key is keeping the tendon stronger than the demand you put on it. Once it's settled we build a short maintenance routine (5–10 minutes, twice a week) that keeps it robust.
Will an elbow brace help?
A counterforce brace can reduce pain during aggravating activities in the short term — but it doesn't fix the underlying load-tolerance problem. Useful as a bridge, not a solution.