Tennis elbow is a painful degenerative injury of the wrist extensor tendons where they attach to the outer elbow. It usually comes from repeated gripping and wrist extension at work or in sport, not just from tennis. Graded strengthening and load management resolve most cases. SportsMed Physical Therapy treats tennis elbow at clinics across New Jersey and Connecticut.
What Is Tennis Elbow?
Tennis elbow, known medically as lateral epicondylitis or lateral epicondylalgia, is an overload injury of the common extensor tendon on the outside of the elbow. The tendon most often involved is the extensor carpi radialis brevis, which runs from the lateral epicondyle of the humerus down the forearm to help cock the wrist back and stabilize it during gripping. Despite the “-itis” in the older name, tissue studies show degeneration rather than true inflammation, which places tennis elbow within the family of tendinopathy conditions.
Tennis elbow affects roughly 1 to 3 percent of adults each year, most often between the ages of 35 and 55, and it strikes the dominant arm in about three quarters of cases. Only a small minority of patients are tennis players. Plumbers, carpenters, hairdressers, chefs, warehouse workers, dental hygienists and heavy computer users are all well represented, and it is one of the more common work-related upper limb complaints seen in northern New Jersey clinics.
What Causes Tennis Elbow?
Tennis elbow develops when the forearm extensor tendons are asked to do more repetitive work than they can recover from. Every time you grip something, the wrist extensors fire to hold the wrist steady, so grip-heavy tasks load the tendon even when the wrist is not moving much. Repeated small overloads produce microscopic tendon damage. If recovery time is too short, the tendon’s collagen becomes disorganized and pain sensitivity rises. Weak shoulder and scapular muscles, poor forearm endurance and awkward tool or racquet mechanics all shift more work onto the elbow.
Common causes and risk factors include:
- Repetitive gripping, twisting, wringing or hammering
- Sudden increases in racquet sport volume, or a grip size and string tension mismatch
- Manual trades involving screwdrivers, wrenches, scissors or knives
- Long hours of typing and mouse use with an unsupported forearm
- Lifting objects with the palm facing down and the elbow straight
- Reduced shoulder and scapular strength, which increases forearm demand
- Age 35 to 55, smoking, diabetes and previous elbow tendon problems
What Are the Symptoms of Tennis Elbow?
The hallmark of tennis elbow is a sharp or burning pain on the bony bump on the outside of the elbow that flares when you grip, lift or twist. Many people first notice it while shaking hands, turning a doorknob, pouring a kettle or lifting a coffee cup. Pain may radiate down the top of the forearm toward the wrist. Strength usually feels reduced because gripping hurts, and objects sometimes slip from the hand.
Typical symptoms include:
- Point tenderness just below the lateral epicondyle
- Pain with gripping, lifting, or turning a screwdriver or key
- Pain when the wrist is bent back against resistance
- Weak, unreliable grip and occasional dropping of objects
- Morning stiffness in the forearm that loosens with movement
- Discomfort that lingers for hours after aggravating tasks
Seek prompt medical attention if you have numbness or tingling in the hand, night pain that wakes you, elbow locking or giving way, significant swelling, or pain that follows a fall or direct blow.
How Is Tennis Elbow Diagnosed?
Tennis elbow is diagnosed through clinical examination. Your therapist palpates the lateral epicondyle to locate the tender point, then uses resisted wrist extension, resisted middle finger extension and grip strength testing to reproduce the pain. Grip force measured with a dynamometer, both with the elbow straight and bent, provides a useful baseline that can be retested over time. The neck, shoulder and nerve pathways are also screened, because cervical radiculopathy and radial nerve irritation can mimic elbow tendon pain.
Imaging is not routinely needed. Ultrasound or MRI may be ordered when symptoms persist beyond several months of good rehabilitation, when a tear is suspected, or when the diagnosis is unclear after examination.
How Physical Therapy Treats Tennis Elbow
Physical therapy is the first-line treatment for tennis elbow, and evidence consistently favors progressive resistance exercise over rest, bracing or injection alone. The goal is to reduce tendon sensitivity, then rebuild the capacity of the extensor tendon and the whole arm so it tolerates gripping again.
Early care focuses on calming symptoms without shutting the arm down: isometric wrist extension holds, activity modification, grip technique changes and sometimes a counterforce strap or wrist splint for short periods. Manual therapy at the elbow and wrist, along with mobilization with movement, often gives immediate short-term relief that makes exercise easier. As pain settles, therapy moves into heavy slow resistance and eccentric wrist extension, forearm supination and pronation work, and grip endurance training. Because the shoulder and scapula influence forearm load, rotator cuff and scapular strengthening are included in nearly every program. Hand and occupational therapy adds custom splinting, dexterity work and tool or keyboard modification, and general physical therapy covers the shoulder and neck contributions. Job-related cases are supported through workplace injury rehabilitation, and racquet and throwing athletes finish with a return to sport program that restages serving, groundstrokes and grip loads.
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How Long Does Recovery Take?
Most people with tennis elbow improve substantially within 6 to 12 weeks of consistent rehabilitation, and many are back to normal work and sport by three to four months. Cases that have been present for over a year, or that involve heavy manual work with no ability to modify tasks, can take six months or more. Recovery is faster when you keep grip loads within tolerance, do the strengthening program at least three days a week, and adjust tools, racquet grip size or workstation setup. It slows with repeated flare-ups, smoking, poorly controlled diabetes and long periods of complete rest.
Tennis Elbow Treatment Near You in New Jersey and Connecticut
SportsMed has clinics across New Jersey and Connecticut, so elbow and hand therapy is close to home for most patients. Our northern New Jersey clinics serve Clifton on Main Avenue, Paterson, Newark, Elizabeth, Union City, North Bergen, Bayonne and Jersey City near Journal Square. Central New Jersey patients are treated in Woodbridge and Edison, and shore patients in Toms River. In Connecticut, tennis elbow is treated at our Stamford clinic and in Bridgeport. Across both states we cover Bergen, Essex, Hudson, Middlesex, Monmouth, Morris, Ocean, Passaic and Union Counties, plus Fairfield and New Haven Counties. Explore our New Jersey physical therapy locations or Connecticut clinics, search the full location list, and schedule your evaluation today.
Frequently Asked Questions About Tennis Elbow
Q: Do I have to stop playing tennis or working to recover?
A: Usually not completely. Most people improve by reducing the aggravating load rather than eliminating it, then rebuilding grip strength. Your therapist will set limits on volume, grip force and technique, and adjust racquet or tool setup. Total rest often makes the tendon weaker and delays return to full activity.
Q: Does a tennis elbow brace actually work?
A: A counterforce strap worn just below the elbow can reduce pain during gripping for many people, and a wrist splint can help at night or during heavy tasks. Braces are helpful short-term aids, not cures. They work best alongside a progressive strengthening program rather than as a standalone treatment.
Q: What is the difference between tennis elbow and golfer’s elbow?
A: Tennis elbow affects the wrist extensor tendons on the outside of the elbow and hurts with gripping and lifting palm-down. Golfer’s elbow affects the flexor tendons on the inside of the elbow and hurts with gripping and wrist flexion. Both are tendon overload injuries treated with graded loading.
Q: Which exercises help tennis elbow the most?
A: Slow, heavy wrist extension with a dumbbell or band, eccentric lowering, forearm supination with a hammer or wrench, and sustained grip work are the mainstays. Shoulder blade and rotator cuff strengthening reduces forearm demand. A therapist sets the starting weight so exercise produces mild, tolerable discomfort only.
Q: Can tennis elbow come back after it heals?
A: Recurrence is possible, especially if grip loads return to previous levels without maintaining strength. Continuing two short forearm and shoulder sessions per week, adjusting tools or racquet grip size, and increasing new activities gradually all lower the risk. Most people who keep a maintenance routine stay symptom-free.
A: Most plans, including Medicare, cover post-surgical physical therapy. New Jersey and Connecticut permit direct access, but after surgery we coordinate with your surgeon and many plans request a referral or authorization. Our staff verifies your benefits before the first appointment.
Q: Is there a SportsMed clinic near me for elbow pain?
A: SportsMed has clinics across New Jersey and Connecticut, including Clifton, Paterson, Newark, Elizabeth, Jersey City, Woodbridge, Edison, Toms River, Bridgeport and Stamford. Use the online location finder to search by town or ZIP code, then book with the clinic that best fits your schedule.
Elbow pain that flares every time you grip something is treatable, and it responds best when loading starts early and progresses sensibly. Our physical and hand therapists will test your grip, identify the aggravating tasks and build a plan around your work or sport.
Book an appointment with SportsMed Physical Therapy at a clinic near you.Reviewed by the SportsMed Physical Therapy clinical team. Last updated: August 2026.