Sports Rehabilitation

Tennis Elbow: Causes, Symptoms, and 5 Key Physiotherapy Exercises

Dr. Sandra Thomas (PT) - Physiotherapist Wayanad
Written by Dr. Sandra Thomas (PT)
22 July 2026
6 min read
Panamaram, Wayanad
Physiotherapist guiding wrist and forearm stretches for sports injury rehabilitation

Do you feel a sharp pain on the outside of your elbow when lifting a coffee cup, turning a doorknob, or shaking hands? You might be experiencing **tennis elbow** (clinically known as lateral epicondylitis).

Despite its name, tennis elbow affects far more non-athletes than athletes. It is a painful condition of the tendons that connect your forearm muscles to the bony bump on the outside of your elbow, caused by repetitive wrist extension and forearm rotation.

At **Physio Dynamics** in Panamaram, Wayanad, led by **Dr. Sandra Thomas (PT)**, we utilize evidence-based tendon loading protocols (eccentric exercise programs) to relieve pain and help extensor tendons heal naturally.

Important Note: Early stage treatment focus is on tendon offloading and reducing inflammation, while later stages focus on progressive eccentric loading. Always consult a physiotherapist before starting heavy resistive work.

What Causes Tennis Elbow?

Tennis elbow is caused by repetitive overload of the forearm extensor muscles (specifically the Extensor Carpi Radialis Brevis). Common causes include:

Occupational Overuse: Carpentry, plumbing, typing, painting, or stitching.
Sports: Improper tennis backhand technique, badminton, or squash.
Repetitive Lifting: Lifting heavy boxes with palms facing down.

5 Essential Exercises for Tennis Elbow Relief

1

Wrist Extensor Stretch

This stretch relaxes the tight forearm extensor muscles, relieving tension at their attachment point on the outer elbow.

How to Perform

  1. Extend your painful arm straight in front of you with your palm facing down.
  2. Use your other hand to gently pull your hand downward, bending at the wrist.
  3. Stop when you feel a comfortable stretch along the top of your forearm.
  4. Hold for 15-30 seconds. Do not bounce.
Hold 15–30 seconds  |  3 repetitions daily
2

Eccentric Wrist Extension (Tyler Twist)

Eccentric loading (strengthening a muscle while it is lengthening) is clinically proven to stimulate collagen production and repair chronic tendon damage.

How to Perform

  1. Rest your forearm on a table with your wrist hanging off the edge, palm facing down.
  2. Hold a very light dumbbell (1 kg) in your hand.
  3. Use your healthy hand to lift the weight up.
  4. Remove the healthy hand, and slowly lower the weight over a 4-second count using only the injured side.
10 repetitions  |  3 sets daily
3

Forearm Pronation & Supination

This exercise builds rotational strength in the forearm, helping to stabilize the elbow joint during twisting tasks.

How to Perform

  1. Sit down and rest your forearm flat on your thigh or a table, holding a light hammer or dumbbell by its base.
  2. Slowly rotate your forearm inward so your palm faces down (pronation).
  3. Slowly rotate your forearm outward so your palm faces up (supination).
  4. Keep the movement slow and controlled.
10 repetitions each way  |  2 sets
4

Soft Ball Squeezes (Grip Strength)

Improving grip strength is essential because tennis elbow patients suffer from a weak, painful grip. This exercise builds grip endurance safely.

How to Perform

  1. Hold a soft foam ball or a rolled towel in your hand.
  2. Squeeze the ball tightly using all your fingers.
  3. Hold the squeeze for 5 seconds.
  4. Slowly release. Repeat.
10–15 repetitions  |  2 sets daily
5

Wrist Flexor Stretch

Stretching the wrist flexors helps balance forearm muscle tension, reducing overall strain on the elbow joint complex.

How to Perform

  1. Extend your arm straight in front of you with your palm facing up.
  2. Use your opposite hand to gently pull your fingers downward toward the floor.
  3. Hold when you feel a stretch along the bottom of your forearm.
Hold 15-30 seconds  |  3 repetitions

How Physiotherapy Treats Tennis Elbow

If your elbow pain is persistent, professional physiotherapy can accelerate recovery. At **Physio Dynamics** (Panamaram, Wayanad), we offer:

Deep transverse friction massage (DTFM)
Dry needling to release forearm trigger points
Tendon offloading taping & counterforce bracing
Ultrasound therapy to reduce local inflammation

Frequently Asked Questions

Tennis elbow (lateral epicondylitis) is a painful tendon condition caused by repetitive wrist extension and forearm rotation, leading to micro-tears in the tendons on the outer elbow.

Yes. In fact, fewer than 5% of patients diagnosed with tennis elbow actually play tennis. It commonly affects plumbers, carpenters, computer operators, and painters.

Yes, Physio Dynamics provides dedicated home care physiotherapy visits across Wayanad for patients unable to visit our Panamaram clinic due to severe upper limb pain.

Get Lasting Relief from Elbow Pain

If outer elbow pain is making it hard to lift or grip, let our expert sports physiotherapists help you recover safely.

Sandra Thomas BPT - Founder Physio Dynamics Wayanad

Dr. Sandra Thomas (PT)

Founder & Chief Physiotherapist, Physio Dynamics | HCPC (UK) Registered

Sandra Thomas is a Bachelor of Physiotherapy (BPT) graduate and HCPC (UK) Registered Physiotherapist specializing in orthopedic post-surgical rehabilitation and sports recovery. She founded Physio Dynamics in Panamaram, Wayanad to provide evidence-based physical therapy care.