Tennis elbow aka lateral epicondylosis with Rosie Jones – Osteopath



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Tennis elbow is normally experienced as pain over the lateral (outside) surface of the elbow, it usually radiates up and down the arm a bit too. The pain is often described as insidious as it is not associated with trauma or a particular event. The elbow itself may swell and it is not uncommon to experience stiffness of the elbow first thing in the morning.

What causes tennis elbow?

There are lots of theories as to what causes tennis elbow but the current most supported view is that constant overuse of the extensor tendons of the wrist leads to microtears in these tendons. These tendons attach to just above the outside part of the elbow. In response to these microtears the body lays down tissue in order to repair the damaged tissue. However, as the tendons are under constant use, the reparative tissue doesn’t get a chance to fully repair and it remains as immature scar tissue. This immature scar tissue does not work as well as normal tissue and so it easily develops further microtears, and reinforces the problem. All these factors then predispose the problematic tissues to degeneration.

Tennis elbow - woman holding painful elbow isolated on white bac

Who does it affect?

Tennis players? Yes! Around 9% of tennis players experience this. This is due to the constant contraction of the extensor muscles in order to hit the ball away. It is more likely to occur on the dominant hand and this supports the theory that tennis elbow is a result of overuse.

Tennis elbow generally appears in people between the ages of 35-60, and is estimated to affect around 4-7 people of every 1000 in the general population.

Things that make you a bit more likely to develop lateral epicondylitis include being obese, smoking, repetitive movements of the arm and forceful activities (i.e tennis).

How do you fix tennis elbow?

According to the literature there are a variety of options open to you including: taking anti-inflammatory drugs, having injections of various kinds (steroids, autologous blood, platelet rich plasma, botulinum toxin A aka botox) and of course physical therapy.

I am of the opinion that most cases of lateral epicondylosis can be relieved if not resolved, through osteopathic treatment and stretching exercises. By massaging the extensor muscles the blood supply to those muscles will increase, this means that the muscle will be in a better state of health and stop pulling so hard on the tendons that attach it to the bone. So this leads to a more comfortable muscle and a looser tendon…then I would go on to treat the tendon itself, by applying massage and stretching to the tendon, the tendon will also increase its blood supply and become more supple and in better health. This means those microtears that are responsible for all the pain, will begin to heal and the tendon will start to act like a tendon again.

There is one other key recommendation: rest.

The one word nobody wants to hear…but the fact of the matter is that rest is invaluable. How is your tendon supposed to repair when it is constantly under demand? If you don’t rest your elbow you are fighting a losing battle.

Of course the sooner you deal with your lateral epicondylosis the better. The longer it has been around the more microtears there will be in the tissues and it will take longer for it to be resolved. Of course, there are lots of different explanations for elbow pain, including: nerve entrapment, bony lesions of the joint, instability of the elbow, osteoarthritis, trapped joint capsule, loose body or referred pain from the shoulder or cervical spine. If you are concerned about elbow pain it is worth giving me a call on 01792 224360.


McMurtrie, A., & Watts, AC. (2012) Tennis Elbow and Golfers Elbow Orthopaedics and Trauma Volume 26, Issue 5, Pages 337-344

For further information or to book an appointment call Rosie on 07540 453280 or visit





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