Monday 5th August, 2019
  Categories: General

Why tennis elbow won't heal, and what you can do about it

Tennis elbow
Tennis elbow is described as an overuse injury, but why won't it heal


Tennis elbow is a painful and disabling condition that is said to develop through overuse, but why does it then refuse to heal and defy treatment? The reason is that there is an often overlooked issue that creates stress on the elbow that contributes to the condition developing, then prevents it from healing.

In this article we discuss what that is, and what you can do about it.

What is tennis elbow

As the diagram shows a large number of forearm muscles are attached to a small bony bump at the side of your elbow called the lateral epicondyle. With so many muscles attached to such a small area it creates an area of high stress. If the muscles are overused the attachment can become inflamed or injured. It is called tennis elbow because it is common in tennis players, but it can happen to anyone and is called "Lateral Epicondylitis"

Signs and Symptoms

There will be pain and tenderness at the outside of the elbow. Pain will be brought on by activities that work the muscles at the back of your forearms, such as gripping or twisting. Although called tennis elbow, it is common in people who do any sort of repetitive activity using their forearm muscles. Examples include: trades people, production workers, and those who use keyboards.

Trigger point tightening causes muscle tears, attachment pain and "overuse injuries"

The overlooked cause

In our article Trigger point basics we discuss how overuse of muscles also cause trigger points to develop. As this diagram shows trigger points cause muscles to abnormally tighten, creating extra tension that results in stress on the attachments and potential tearing. Simply put, it is this abnormal tension plus the overuse that creates the stress upon the attachment causing it to become inflammed or injured. However, even if completely rested the continued tension caused by the trigger points will continue to stress the attachment, not allowing it to heal.

Tennis elbow needling
Overlooking the source of abnormal tension and sticking needles in the inured area

What happens when it is overlooked

If the abnormal tension caused by trigger points in your forearm muscles is contributing to your tennis elbow it will stop it from healing, or it will settle down but easily flare up again. When this happens too often treatment will be directed at the injured area. With the abnormal tension still on the area:

  • at best the treatment will just provide temporary relief
  • at worst it will cause the problem to flare up further.

Do you have this problem

Overuse almost invariably causes the development of trigger points in your forearm muscles, but there are things you can do to easily check.

Examine your forearm muscles

Examine (or have a professional) examine your forearm muscles for tightness and tender lumps.

Simple test to confirm it

This is a very simple test that involves first checking the tenderness at the elbow, treating the trigger points to remove the abnormal tension, then rechecking the elbow for tenderness. Please click on the image to watch a video which will show you the basics techniques. If the tenderness is reduced it means that trigger points are creating abnormal tension on your elbow preventing it from healing.

  • Step One: check the side of your elbow for tenderness
  • Step Two: treat trigger points using one of the two methods on the video
  • Step Three: re-check the tenderess at the side of your elbow. If the tenderness has reduced this confirms that the trigger points are causing abnormal tension, aggravating your injury.


Please keep in mind that this is for general information only. For specific advice please consult a professional familiar with your own needs.

Prevention and maintenance

Many occupations and sports require the repeated use of forearm muscles, so this condition is fairly common. We recommend that you use the techniques given in the video above to maintain your forearm muscles as a preventative measure, or to address minor issues early.

Once problems develop

Simple problems

If caught relatively early correcting it may be as simple as treating the forearm muscles plus temporarily restricting activity or using a brace. If the muscular condition has been there for a while the muscle may have itself lost strength and flexibility. In that case some stretching and strengthening exercises may be needed. Please note these are for rehabilitation purposes only. Although often given to relieve tennis elbow it makes no sense to treat an overuse injury by stressing it more.

More complex problems

The application of needles, laser and other therapy without taking care of the trigger points in the muscles is inappropriate. However, they may be useful to help assist the elbow to heal once this stress is removed.

We are continually adding more information on research and uses. Subscribe below to have us email them to you "hot off the press".

Dr Graeme

About Dr Graeme

Several years ago Dr Graeme, a Chiropractor practicing in Victoria, Australia was looking for a serious hand held massager his patients could use at home to get the extra quality massage they needed. The ones he found in the shops and on-line for home use looked nice but were not serious, and... read more

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