5 Best Tennis Elbow Therapies in Physiotherapy

Tennis elbow, or lateral epicondylitis, is a prevalent overuse injury affecting the lateral elbow tendons, often causing pain and discomfort

5 Best Tennis Elbow Therapies in Physiotherapy

Tennis elbow, or lateral epicondylitis, is a prevalent overuse injury affecting the lateral elbow tendons, often causing pain and discomfort during routine activities. Effective management of this condition is vital for patient recovery and return to normal function.

Various physiotherapy interventions have been developed to alleviate symptoms and promote healing. This article outlines the five best tennis elbow therapies, which include:

  • Manual therapy techniques to improve joint mobility and reduce pain.
  • Ultrasound treatment to enhance tissue healing.
  • Eccentric strengthening exercises to reinforce tendon resilience.
  • I was taping and bracing strategies to offload stressed tendons and support the affected area.

Each therapy is grounded in clinical evidence, aiming to provide the most beneficial outcomes for patients suffering from tennis elbow.

Understanding Tennis Elbow

In the context of physiotherapeutic interventions, it is essential first to delineate the condition known as tennis elbow, or lateral epicondylitis, characterised by pain and tenderness outside the elbow.

This musculoskeletal disorder primarily involves the extensor carpi radialis brevis tendon, a critical component of the elbow anatomy. Overuse or repetitive strain of the forearm muscles, which attach to the lateral epicondyle of the humerus, leads to microtears and inflammation.

Evidence-based practice underscores the significance of injury prevention strategies, which include ergonomic adjustments and strength training exercises, to mitigate the risk of developing this condition.

Effective management of tennis elbow necessitates a comprehensive understanding of the anatomical structures involved, thus ensuring targeted and appropriate therapeutic interventions.

Manual Therapy Techniques

Several manual therapy techniques have proven effective in alleviating the symptoms associated with tennis elbow, targeting the affected tendons and muscles to reduce pain and improve function.

Joint mobilisation is one such approach where the physiotherapist applies precise movements to the elbow's articulations, enhancing mobility and decreasing stiffness. This technique often addresses the proximal radioulnar and humeroulnar joints, which can contribute to symptomatic relief.

Soft tissue massage is another critical modality, focusing on the extensor muscles of the forearm. Therapists can promote circulation, facilitate healing, and alleviate muscular tension by employing specific massage strokes.

The application of soft tissue techniques has been supported by literature, indicating a reduction in local inflammation and an increase in tendon repair processes, underscoring their role in a comprehensive therapeutic strategy for tennis elbow.

Ultrasound Treatment

Ultrasound treatment's ability to penetrate the tissues profoundly makes it a widely utilised modality in physiotherapy for managing tennis elbow symptoms. This non-invasive intervention leverages sound waves to deliver deep heating to soft tissues, enhancing blood flow, accelerating tissue repair, and alleviating inflammation. The thermal effects of ultrasound therapy contribute to pain modulation, promoting patient comfort and functional improvements.

Clinical evidence supports the application of ultrasound in the treatment protocol for lateral epicondylitis, particularly when combined with other therapeutic interventions. Precise dosimetry is critical, with parameters tailored to the individual's condition severity and response to treatment. Physiotherapists must employ evidence-based practices to optimise the therapeutic outcomes of ultrasound, ensuring its integration into a comprehensive management plan for tennis elbow.

Eccentric Strengthening Exercises

Eccentric strengthening exercises, where patients actively lengthen muscles under tension, are a cornerstone of physiotherapy for effectively treating tennis elbow. These exercises involve a controlled and gradual increase of load on the tendons, encouraging adaptation and healing. Research has consistently demonstrated that eccentric strengthening alleviates pain and improves functional outcomes in individuals with lateral epicondylitis.

Incorporated within a comprehensive treatment plan, eccentric exercises enhance muscular endurance, increase flexibility, and contribute to grip enhancement. By carefully modulating exercise intensity and progression, physiotherapists ensure that patients engage in activity that stimulates recovery without overloading the affected tissues.

Flexibility training is often paired with eccentric exercises to optimise the range of motion, further preventing injury recurrence and facilitating a return to pre-injury activities.

Taping and Bracing Strategies

Beyond the efficacy of eccentric strengthening exercises, taping and bracing strategies are integral to tennis elbow management, providing support and stability to the affected area. These methods reduce tendon strain, alleviate pain, and facilitate healing. They should be applied by professionals who understand the biomechanics of the elbow to ensure proper technique and effectiveness.

  1. Kinesiology Taping: This method enhances proprioception and supports the muscles without restricting the range of motion. It can also aid in reducing inflammation by decompressing the layers of fascia.
  2. Compression Therapy: A technique involving bracing with compression to increase blood flow, reduce swelling, and relieve pain. It can be combined with heat applications to promote tissue elasticity and healing.
  3. Adjustable Braces: Braces with adjustable straps allow for customised pressure and support, helping to offload the affected tendon and manage activity-related stress.


In conclusion, effective management of tennis elbow through physiotherapy incorporates a multimodal approach.

Manual therapy techniques, ultrasound treatment, and eccentric strengthening exercises constitute the cornerstone of therapeutic interventions.

Taping and bracing strategies augment these treatments, offering additional stability and symptom alleviation.

Evidence suggests combining these therapies yields the best outcomes, underscoring the importance of a comprehensive, individualised treatment plan for patients suffering from this common yet debilitating condition.

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