Lateral tendinosis or lateral epicondylitis is often described in layman’s terms as tennis elbow. Tennis elbow is a painful condition that can arise from overuse or repetitive motions of the arm and wrist. Although excessive tennis playing (hence the layman’s term) can lead to these symptoms, other professions such as carpentry, plumbing, painting, and animal butchery can cause this condition to develop as well. How do you know where your elbow pain is coming from?

Elbow Anatomy

The elbow is a hinge joint where the upper arm bone (humerus) meets the bones of the forearm, the ulna, and the radius bone. This area is an important juncture that houses muscles, tendons, ligaments, and nerves, all of which allow the use of the arm, wrist, hand, and fingers.

The lateral epicondyle is the bump that can be felt on the outside of the elbow. The extensor carpi radialis longus, one of the five main muscles that control wrist movements, is attached at the elbow along with the extensor carpi radialis brevis, a shorter muscle responsible for wrist extension and abduction.

Other muscles include the extensor carpi ulnaris (attached to the ulnar bone), the extensor digitorum, which assists in the extension of four of the fingers, and the extensor digiti minimi, responsible for the extension of the fifth digit (little finger).  The posterior interosseous nerve is an extension of the radial nerve (located in the upper arm). The posterior interosseous nerve innervates the forearm. This nerve plays an important role in sending and receiving messages from the cervical (neck) region. Ultimately, it acts as a communication passageway to/from the brain to the forearm and beyond (to the hand and fingers).

Symptoms of Lateral Epicondylitis

Lateral epicondylitis is caused by the repeated contraction of the muscles attached to the elbow. Over time this repetitive motion creates tiny tears within the tendons on the outside of the elbow near the lateral epicondyle (the bump on the outside elbow joint). Overuse of these muscles and tears in the tendons can eventually cause pain and inflammation in this area.

Individuals who develop this condition can experience symptoms from movements such as turning a doorknob or shaking a person’s hand. They may even experience symptoms from a simple gesture such as holding a coffee cup. If left untreated, eventually they may experience arm weakness, along with a noticeable decrease in (hand) grip strength, making it very difficult to use their arm, wrist, hand, and fingers for even the most basic tasks.


While minor cases of tennis elbow may resolve with rest and some NSAIDS, some people may require more care. This may be due to the nature of the type of work they perform. Some types of employment require individuals to continually make repetitive movements of their elbow and forearm. This means these areas must be strong enough to support such repetitive activities.

A trained physical therapist can help these latter types of patients with a comprehensive physical therapy program. Initially, a physical therapist may use ultrasound and gentle massage. They may also use stretching of key muscles, all designed to help relieve pain. As a patient’s elbow pain decreases, a physical therapist will introduce other exercises designed to improve the range of motion within the elbow area as well as increase strength in adjacent muscles. A physical therapist will also make suggestions on how to improve posture and technique for motion. This is so the patient will learn proper form, so they don’t have a recurrence of symptoms in the future.


There are many non-invasive, effective treatments available to treat elbow pain. Please contact Cawley Physical Therapy and Rehab at 570-208-2787 to begin the journey back to health and wellness.