What causes tennis elbow?

HotbotBy HotBotUpdated: July 4, 2024

Tennis elbow, or lateral epicondylitis, is a common condition that affects the tendons around the outside of the elbow. Despite its name, this painful condition affects not only tennis players but also individuals who engage in various activities that involve repetitive arm and wrist motions. Understanding the root causes of tennis elbow is essential for prevention and effective treatment.

Understanding Tennis Elbow

Tennis elbow arises when the tendons that join the forearm muscles to the outside of the elbow become inflamed. This inflammation is typically due to overuse or repetitive stress. The primary muscle involved is the extensor carpi radialis brevis (ECRB), which helps stabilize the wrist when the elbow is straightened.

Primary Causes of Tennis Elbow

Repetitive Motion

The most common cause of tennis elbow is repetitive motion. Activities that involve the same motion over and over can strain the tendons, leading to micro-tears and inflammation. This is particularly prevalent in sports such as tennis, badminton, and squash but also in other activities like painting, typing, and using hand tools.


Overuse of the forearm muscles can lead to tennis elbow. This is often seen in individuals who perform repetitive tasks for extended periods without adequate rest. The constant strain on the tendons can result in chronic injury and inflammation.

Contributing Factors

Improper Technique

Using improper technique during physical activities can significantly increase the risk of developing tennis elbow. For example, in tennis, using a backhand stroke with poor form can place excessive stress on the forearm muscles and tendons, leading to injury.

Poor Equipment

Using equipment that is not suited to one's body or the specific activity can also contribute to tennis elbow. In tennis, for instance, using a racquet that is too heavy or has the wrong grip size can place undue stress on the tendons, increasing the risk of injury.

Age and General Health

Age is another factor in the development of tennis elbow. It is most common in adults between the ages of 30 and 50. Additionally, general health conditions such as obesity or diabetes can increase susceptibility to tendinopathies, including tennis elbow.

Occupational Risks

Tennis elbow is not limited to athletes. Many occupations that require repetitive arm and wrist movements are at risk. Some of these include:

  • Manual Laborers: Workers in construction, plumbing, and carpentry often perform repetitive tasks that can strain the forearm muscles.
  • Office Workers: Typing and using a mouse for long periods without breaks can lead to repetitive strain injuries, including tennis elbow.
  • Musicians: Playing instruments such as the violin, guitar, or piano can involve repetitive motions that contribute to the condition.

Pathophysiology of Tennis Elbow

The underlying pathophysiology of tennis elbow involves micro-tearing and degeneration of the tendon, rather than inflammation. This condition, known as tendinosis, involves the breakdown of collagen within the tendon, leading to pain and dysfunction. Repeated stress and overuse prevent the tendon from healing properly, resulting in chronic pain.

Rarely Known Small Details

Genetic Predisposition

While not widely recognized, there is some evidence to suggest that genetic factors may play a role in the development of tennis elbow. Individuals with a family history of tendinopathies may be more susceptible to developing the condition.

Vascular Factors

Limited blood flow to the tendons can contribute to the development of tennis elbow. The tendons around the elbow have a relatively low blood supply, which can hinder the healing process and increase the risk of chronic injury.

Psychosocial Factors

Psychosocial factors, such as stress and job dissatisfaction, can also contribute to the development of tennis elbow. Chronic stress can lead to muscle tension and poor ergonomic practices, increasing the risk of injury.

The causes of tennis elbow are multifaceted, involving a combination of repetitive motion, overuse, and other contributing factors. Understanding these causes can help in the prevention and effective management of this painful condition. By addressing the underlying factors, individuals can reduce their risk and improve their overall quality of life.

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