Elbow Orthopaedic Rehabilitation
Tennis Elbow
- Pain on the outer elbow
- Pain gripping, lifting or twisting
- Tenderness over the bony point on the outside of the elbow
- Weak grip
Quick answer
Tennis elbow is overload of the tendons attaching to the outer elbow, causing pain on gripping, lifting and twisting. Despite the name, most people who get it do not play tennis. It responds to progressive strengthening rather than rest, typically over eight to twelve weeks.
Typical recovery
8–12 weeks with loading; longer if left to rest
A typical range, not a promise — how long it takes depends on how long it has been going on, and on what you do between appointments.
Tennis elbow — lateral epicondylitis — is degeneration and overload of the tendons that extend the wrist, where they attach to the bony point on the outside of the elbow. Most sufferers have never held a racquet. Plumbers, cooks, hairdressers, carpenters and anyone who grips repeatedly are far more typical.
What it feels like
Pain over the outer elbow, sometimes spreading down the forearm. Gripping is the giveaway: lifting a kettle, turning a doorknob, shaking hands, wringing out a cloth. The bony point is tender to press. Grip strength drops noticeably.
Why rest is the wrong instinct
The tendon is not inflamed in the way the "-itis" suffix suggests — it is degenerated and under-conditioned. Complete rest reduces pain temporarily and leaves the tendon weaker, which is precisely why tennis elbow so reliably returns in people who treat it by stopping.
Tendons adapt to load. The treatment is controlled, progressive loading.
How physiotherapy helps
- A graded strengthening programme for the wrist extensors, beginning at a level the tendon tolerates
- Assessment of the shoulder and neck, which frequently contribute
- Hands-on treatment to the forearm and elbow for symptom relief alongside the loading
- Modifying grip, tool handles and technique so the tendon is not re-overloaded daily
- A counterforce brace, which helps some people during the painful phase
How long it takes
Eight to twelve weeks of consistent loading for most people. Long-standing cases take longer. Progress is judged on function — what you can grip and lift — as much as on pain.
Medically reviewed by Kapil Kumar, BPT, MPT, Orthopaedic Physiotherapy · Last reviewed September 2026