Elbow pain

Tennis Elbow is the most common complaint due to the overuse and a repetitive strain injury of the outer part of elbow (the lateral epicondyle). It’s due to chronic or acute inflammation of tendons of the forearm, and damage or overuse of the forearm muscles and tendons




  • Pain and tenderness on the outer part of the elbow over the lateral epicondyle.
  • Pain from gripping and movements of the wrist, especially wrist extension (activities such as pouring a container of liquid, lifting with the palm down, sweeping)
  • Weakness of the forearm, a painful grip while shaking hands or turning a doorknob, and not being able to hold relatively heavy items in the hand
  • Morning stiffness of the elbow




Poor technique increases the chance for injury much like any sport

  • Decrease the amount of playing time if already injured or feeling pain in outside part of the elbow.
  • Stay in overall good physical shape.
  • Strengthen the muscles of the forearm: (Pronator quadratus, Pronator teres, and Supinator muscle)—the upper arm: (biceps, triceps, Deltoid muscle)—and the shoulder and upper back (trapezius). Increased muscular strength increases stability of joints such as the elbow



Moderate evidence exists demonstrating that joint manipulation directed at the elbow and wrist and spinal manipulation directed at the cervical and thoracic spinal regions results in clinical changes to pain and function



1. Vicenzino B, Cleland JA, Bisset L. (2007). "Joint Manipulation in the Management of Lateral Epicondylalgia: A Clinical Commentary". Journal of Manual & Manipulative Therapy 15 (1): 50–56.doi:10.1179/106698107791090132. PMC 2565595. PMID 19066643.

2. Herd CR, Meserve BB. (2008). "A Systematic Review of the Effectiveness of Manipulative Therapy in Treating Lateral Epicondylalgia". Journal of Manual & Manipulative Therapy 16 (4): 225-37. doi:10.1179/106698108790818288.PMC 2716156. PMID 19771195.



In conjunction with an exercise regimen of late, dry needling has been gaining popularity in various types of tendinopathies and pain of muscular origin. Even in lateral epicondylitis, Dry needling is widely employed by many physical therapists across the world. It is believed that dry needling would cause a tiny local injury in order to bring about various desirable growth factors in the vicinity.

Dry Needling is also aimed at eliciting local twitch response(LTR) in the extensor muslces, as in some cases of tennis elbow the extensor muscles of the forearm would harbor trigger points, which itself could be a major source of pain.