Commonly referred to as “tennis elbow”, extensor tendinopathy refers to degeneration and inflammation of the tendons on the outside of the elbow (usually the Extensor Carpi Radialis Brevis tendon). These tendons connect the forearm muscles to the arm bone and assist in moving the wrist, hand and fingers.

Extensor tendinopathy is a common injury associated with activities requiring repetitive use of the wrist and hand. Overuse of the forearm muscles can lead to microscopic tears, degeneration and subsequent inflammation. Pain may also be referred from the joints and nerves arising from the neck region.

Symptoms generally occur gradually and are typically associated with unaccustomed activity, repetitive computer use or recent changes in work or sporting equipment/technique.

Once established, elbow pain is typically aggravated by everyday activities including picking up a cup, opening a door and any repetitive gripping activities. Night pain may also be present.

  • Localised ache and tenderness over the lateral (outside) aspect of the elbow (typically 1-2cm below the elbow joint), with associated tightness in the forearm muscles
  • Possible stiffness and night pain
  • Restriction in forearm rotation
  • Pain with resisted wrist extension and repetitive exercise
  • Pain with gripping and grasping tasks
Extensor tendinopathy can be a stubborn condition to manage, requiring a combination of treatment modalities to achieve resolution.

  • Basic principles of RICE (Rest, Ice, Compression, Elevation) during the initial stages of the injury
  • Deep tissue massage, trigger point therapy and acupuncture to the thickened tissues around the elbow
  • Mobilisation of the lower facet joints in the neck
  • Regular stretching and strengthening of the forearm muscles
  • A brace may be required to reduce the force transmitted through the elbow tendons. The brace should be worn during all repetitive work or sporting activities.
  • Correct technique and postural alignment of the wrist can reduce aggravation of symptoms. This may include the use of ergonomic aids for computer operators and reviewing specific techniques for athletes.
  • A cortisone injection may be required in more severe cases
Avoid activities that involve repetitive use of the wrist or forearm. Common aggravating activities include; sustained gripping, prolonged typing/mouse use and tasks involving repetitive forearm rotation.