By Matt Brabner, Natural Balance Osteopath.

Although the excitement of Wimbledon has prompted me to write this, a key thing to know is that you don’t need to play tennis to experience ‘tennis elbow’…
‘Tennis elbow’ style pain at the outside of your elbow is normally caused by overuse of the joint. The muscles of your forearm and the tendons that attach them to the elbow can become painful due to increased load or repetitive use, most commonly from small, frequently repeated, movements when the muscles are under tension. This can of course be from the repeated hitting of a tennis ball with your racquet, but can also be from using a mouse, gardening, playing a guitar or even carrying a small but growing child.
The pain is most often, but not always, in your dominant arm.


Another thing to know is that ‘tennis elbow’ is also referred to as lateral elbow tendonitis or lateral epicondylitis, and that better describes what is going on…


Locally at the attachment of muscles to your elbow the repeated tension in the tendons can release inflammatory chemicals as the body attempts to heal the area where fibres have small micro tears. This gives the characteristic pain that can be very sharp and stabbing and can radiate to your forearm and upper arm. There is some debate over how long this inflammatory process lasts, but even with more persistent elbow pain there is believed to be the presence of some inflammation.


Often people with elbow pain have other factors in their presentation. The load on elbow movements can be increased if for example there is muscle or joint restriction in your upper back or shoulder(s). So, if you are not moving as well as you could in your body as a whole, then your elbow could be having to work harder. Therefore looking more broadly to understand your daily pattern of work, exercise etc. is important to help work with you to plan a treatment program.
Stress and shallower/upper rib breathing can also impact shoulder and therefore elbow function. So those of you in highly stressful desk-based situations take note. See here for some breathing advice if that rings true!


Not all elbow pain is ‘tennis elbow’, for example if you are experiencing any pins and needles or trouble gripping with your hand you should seek further advice.


Ideally, if the pain is starting to worry you, you should see someone to check your symptoms; be that your GP, osteopath, physiotherapist or clinical massage therapist. All can help with assessing you and discussing treatment and healing options.
However, in the meantime, a few simple ideas that MAY help…


So, it is tennis season, take some time out to watch some tennis, eat some strawberries and cream, do something you enjoy. Make sure you stand up to cheer and clap, don’t just sit in the chair watching, move and enjoy.


If you do have any lateral elbow pain or stiffness then there are a few exercises you can do anywhere (even sat watching the tennis!) that can help locally plus improve mobility of your back and shoulders.


This exercise below could help. Ideally you need a Theraband FlexBar but, if not, just a hand towel rolled up so you can twist it, as shown in the video, is a good start.


Great to do standing or when at your desk, these help keep the whole shoulder complex supple and mobile.


Perfect for when you have been sat down for more than an hour or so. Keeping your mid back mobile will help the shoulders and in turn elbow, by reducing any tightness or muscle strain in the links from your spine to your arms.


Please feel free to contact me if you have any questions on elbows or broader aches and pains on 07879 604818 or email


You can read more about Matt Brabner here.


Tendons – time to revisit inflammation.
Rees, J.D., Stride, M., Scott, A. (2014).
British Journal of Sports Medicine; 48: 1553-1557