Lateral Epicondylalgia (Tennis Elbow)
Elbow - Pathology
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.
Biomechanical 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
- Level 1: Isometrics and pain-free mobility
- Level 2: Eccentric loading
- Level 3: Concentric strength
- Level 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 syndrome
- Cervical radiculopathy
- Lateral collateral ligament sprain
Related Patterns
- pain with grip
- limited wrist extension
- limited wrist flexion
- limited forearm pronation
- limited forearm supination
Related Exercises
- wrist extensor isometric
- wrist extensor eccentric
- forearm extensor stretch
- forearm extensor smr
Related Assessments
- cozen test assessment
- mill test assessment
- maudsley test assessment
- pain free grip test assessment