Lateral Epicondylalgia (Tennis Elbow)
Lateral epicondylalgia (tennis elbow) is an overuse tendinopathy of the common wrist extensor origin at the lateral epicondyle, typically provoked by gripping and wrist extension.
Elbow - PathologyBiomechanical Mechanism
Repeated loading of wrist extensors (especially ECRB) leads to tendon degeneration and pain with resisted extension or gripping tasks.
Clinical Rationale
Tendinopathies respond best to progressive loading and symptom-guided dosing rather than rest alone.
Practical Solution
Begin with pain-modulated isometrics and progress to eccentric/concentric loading with gradual return to gripping tasks.
Common Compensations
- Avoided or painful grip
- Reduced wrist extension strength
- Elbow flexion substitution during load
Correctives
- Load management and graded exposure
- Eccentric and isometric wrist extensor loading
- Forearm mobility and soft tissue work
Progression
- 1Level 1: Isometrics and pain-free mobility
- 2Level 2: Eccentric loading
- 3Level 3: Concentric strength
- 4Level 4: Task-specific grip and sport work
Regression
- Reduce gripping volume
- Lower resistance
- Shorter lever positions
Red Flags
- Night pain not improving
- Neurological symptoms
- Severe swelling or trauma
Differential Diagnosis
Radial tunnel syndromeCervical radiculopathyLateral collateral ligament sprain
Related Assessments
cozen test assessmentmill test assessmentmaudsley test assessmentpain free grip test assessment
Related Exercises
wrist extensor isometricwrist extensor eccentricforearm extensor stretchforearm extensor smr
