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Commonly referred to as tennis elbow, lateral epicondylitis (on the outside of the elbow) often has nothing to do with tennis but can be linked to repetitive movements of the forearm causing a pull on the tendon of the elbow through increased continual muscle contraction. The whole condition is most commonly underpinned by problematic biomechanical issues of the neck, shoulder, wrist or, also the elbow joint itself.

tennis elbow photo

An osteopath is well equipped to diagnose and treat tennis elbow, or golfers elbow which is a similar manifestation occurring on the medial epicondyle. (inside the elbow)

The problem with the treatment of such a condition is understanding the cause and progression. The same treatment for every elbow is not enough to resolve the problem, there needs to be an understanding of the progression, or worsening of the condition over time.

Usually the condition is present long before the person actually starts to feel the pain, and usually only pain on touch, or bumping door frames while walking through doors. Then pain on shaking hands, making business meet and greets a nightmare, followed by continuous pain, especially at night. This is a sign of the level of inflammation and the chronic state of the area, especially the tendons. The treatment must be tailored accordingly.

In my experience as an osteopath and tennis coach, the cause of tennis elbow in a tennis player is that they don’t move their feet into the correct position, but the cause of tennis elbow in other patients is multilayered and all areas need to be addressed: neck mobility allowing the nerves to work properly, posture, tension of the shoulder blade muscles compared to the chest muscles, the sliding of the shoulder blade over the back, triceps weakness and biceps tension, reduced elbow extension, wrist restriction and the big one, the movement between the two forearm bones. All  this, and more, as we must take into account past injuries and problems that may influence all of the above.

I enjoy treating tennis and golfers elbow, it is rarely the same from one person to the next, and rarely only the elbow.


By Dr Simon Duncan, experienced osteopath and qualified tennis coach.