Tennis elbow: pain in the elbow

Tennis elbow is a painful condition in which the forearm muscles attached to the elbow joint are irritated due to overuse. In the past, tennis elbow mainly occurred in people who played tennis without proper warm-up. Nowadays we see it more in people who work behind the computer. In most cases, tennis elbow will go away on its own with a number of attention points.

What is tennis elbow?

Tennis elbow often develops in people who play tennis, hence the name tennis elbow. But this is of course not a condition: others can also contract tennis elbow. Tennis elbow is an irritation of the forearm muscles attached to the elbow joint. Another name is also tennis elbow or epicondylitis lateralis humeri. Tennis elbow is not the same as golfer’s elbow, although the two can occur simultaneously.

Origin of the condition

Anyone can get tennis elbow. People over 35 years old have a greater risk of this. This is because the tendons become stiffer with age. In general, people over the age of 60 develop tennis elbow less often, because this group of people puts less strain on the arm. Stress and smoking is a risk factor for everyone. Half of patients with tennis elbow have weak tendons from an early age. This is often only discovered when an injury occurs.
Tennis elbow occurs due to overload of the forearm muscles, the hand extensors. People often think of a sudden major overload, but long-term minor overloads also contribute to tennis elbow. In most cases, the patient has a tendon that is too weak and cannot handle the overload. In general, a long-term mild overload is more harmful than a sudden, major, but one-off overload.
Lifting objects overhead is a risk factor. Overhand means; the palm facing downwards, as if the hand were a grabber at the fair. In addition, tennis elbow is also caused by playing tennis, where the racket is held overhand and the arm is twisted. The problem often lies in working with an extended arm. In both cases, the cause can often be found in the blood flow to the tendon: it is not sufficiently supplied with oxygen and nutrients.

Tears in the muscles and tendons

When overloaded or heavily loaded, muscle and tendon tissue is damaged. Small tears occur in the muscles and tendons. Often this cannot be felt. In themselves, these cracks are not a problem at all; the body is able to recover these quickly. However, something can go wrong during recovery, causing the brain to receive incorrect information and the muscles to stiffen. Irritation occurs, causing a non-bacterial inflammation at the tendon attachment. We especially see this when there is a major overload for a short period of time. With a small overload for a longer period of time, the muscles will adapt to the strange activity that is required of the muscles. This gives the muscles continuous tension, even at rest. This also places the tendon attachment under slight pressure. If this lasts long enough, irritation and later inflammation of the tendon attachment occurs.


Tennis elbow is often easy to recognize: picking up a heavy object overhand causes pain. The outside of the elbow hurts. This can be felt during movement, later also during rest. It hurts when the outside of the elbow joint is pressed. Stretching the elbow can be painful. Pain is often felt when one pushes against something with the flat of the hand, with the arm extended. Usually the arm that one works with most is affected, but in some cases both arms are affected. This is especially seen in athletes who use both arms simultaneously. In general, the complaints are worst in the morning and disappear somewhat as the muscles are made flexible through exercise.

Treating tennis elbow

Tennis elbow often does not heal on its own. This has to do with the poorer blood flow to the tendon that has developed. Healing can only take place when the tendon receives sufficient oxygen and nutrients. The problem often lies in the rest we take with tennis elbow. Due to the pain, the arm is no longer loaded, which means that even less oxygen is supplied to the muscles and tendons.
It is often thought that tennis elbow is an inflammation. This is partly true. In the first few weeks there is clearly inflammation of the tendon attachment. Anti-inflammatories may work, but tennis elbow does not always heal. Anti-inflammatories therefore do not always give the desired result.
Some doctors decide to cast a cast or wear a brace. Disappointing results are also being achieved here. This weakens the tendon attachment even more, which is not favorable for recovery. It is possible to use a supporting band, the Tubigrip, during recovery. The belt is worn when necessary, for example during work. It is recommended to remove the band as much as possible while resting. Injecting cortisone can sometimes provide relief, but even now tennis elbow does not always heal.
In 95 percent of cases, surgery helps. Surgery is never the first choice but is only performed when other treatments do not work. Tennis elbow can be treated surgically in various ways. Sometimes the bone tip, plica material or irritated tendon tissue is removed. Sometimes the tendon attachment is moved or the nerve is exposed. This depends on the precise problem. An operation is only performed after one to several years. An attempt is often made in advance to apply a brace or plaster or to apply physiotherapy. Targeted therapy can cure tennis elbow by strengthening the tendon attachment and relaxing the muscles. Strength training cures tennis elbow in many cases. Strength training uses a weight (500 grams is sufficient), an elastic band or an elastic band. It is important that tension is built up so that the muscles have to take action. This promotes the blood supply of the tendon attachment. Recovery occurs faster. The physiotherapist can help you perform good exercises.