Tennis elbow: step-by-step treatment for athletes

Tennis elbow is the most common injury in tennis and padel players, but it also affects office workers, musicians and manual laborers. If you’ve had pain on the outer side of your elbow for weeks, this article explains how to treat it and, above all, how to return to sport without relapsing.

What exactly is tennis elbow?

“Tennis elbow” is the common name for lateral epicondylitis: inflammation and degeneration of the tendons that attach to the epicondyle (the bony prominence on the outer side of the elbow). The tendon most affected is the extensor carpi radialis brevis.

Even though it’s called “tennis elbow”, only 5–10% of cases occur in tennis players. Most are people who perform repetitive wrist movements: padel players, golfers, climbers, office workers with prolonged mouse use, musicians, painters, electricians.

Key symptoms

  • Pain on the outer side of the elbow, which may radiate to the forearm and wrist.
  • Worsens when squeezing, gripping objects or shaking hands.
  • Pain when extending the wrist against resistance (turning a door handle).
  • Tenderness to touch over the epicondyle.
  • Loss of grip strength (classic test: lifting a chair by the backrest causes pain).
  • It usually gets worse in the afternoon after a day on your feet.

Causes and risk factors in athletes

Poor technique

The most common mistake: hitting the backhand with the elbow locked and the wrist bent (in tennis or padel). This loads the epicondyle directly. One lesson with a good coach usually spots this in 5 minutes.

Inadequate material

  • Paddle/tennis racket too heavy for your level.
  • Sweet spot that’s too small, forcing you to compensate with the wrist.
  • Very tight strings that generate more vibration.
  • Grip that is too small or too large.

Excessive volume without progression

Going from playing once a week to 3–4 days a week in just a few weeks is a recipe for epicondylitis. The 10% rule (don’t increase weekly volume by more than 10%) also applies to racket sports.

Forearm strength deficit

Weak forearms compensate with the epicondyle. Common in occasional players who don’t do specific strength training.

Step-by-step treatment protocol

Phase 1 (days 1–7): acute pain control

  • Sports rest from the activity that caused the injury. Not complete rest: keep moving the joint gently.
  • Ice for 15 minutes, 3–4 times a day during the first 2–3 days.
  • Application of BEIMAN Sport twice a day on the epicondyle and forearm muscles. The bio photonic formula acts on local inflammation in about 3 minutes with no risk from prolonged use.
  • Epicondylar elbow strap (band with pressure below the elbow) during daily activities. It reduces traction on the inflamed tendon.
  • Avoid prolonged oral anti-inflammatories: useful only if the pain is very intense, for a maximum of 2–3 consecutive days.

Phase 2 (weeks 2–4): mobility and stretching

  • Extensor stretch: arm extended, wrist bent downwards, gently pull with the other hand. 30 sec x 3 reps x 3 times a day.
  • Flexor stretch (wrist extended) to balance.
  • Self-massage with a foam roller or small ball on the forearm.
  • Continue using BEIMAN Sport daily.

Phase 3 (weeks 4–8): eccentric strengthening (CRITICAL)

Eccentric exercises are the gold standard for epicondylitis. Basic exercise:

  1. Rest your forearm on the table with your hand hanging down, palm facing the floor.
  2. Hold a light dumbbell (1–2 kg) in your hand.
  3. With the other hand, raise the dumbbell to the top position (wrist extended).
  4. Using only the affected arm, lower VERY SLOWLY (5 seconds) back to the starting position.
  5. Repeat 15 times. 3 sets. 2–3 days per week.

Mild pain during exercise (3–4/10) is acceptable. Sharp pain (more than 5/10) means you have overloaded it.

Phase 4 (weeks 8+): gradual return to sports

  • Start with gentle strokes at 50% power, 20–30 minutes.
  • Increase by 10% per session if there is no pain.
  • DO NOT start with competitive matches. Begin with controlled rallying only.
  • Maintain eccentric exercises as prevention.

Mistakes that make athletes relapse

  • Returning to sport too soon “because it doesn’t hurt at rest anymore.” Resting pain is the first to go, but the tendon is not yet ready.
  • Skipping eccentric exercises, thinking that rest alone is enough.
  • Not reviewing your technique with a coach.
  • Using unsuitable equipment (heavy racket, tight strings).
  • Taking anti-inflammatories to “numb the pain and be able to play”. This masks the problem and worsens the injury.

When to see a physiotherapist or doctor

  • Pain that persists for more than 6 weeks despite treatment.
  • Significant limitation in daily activities (you can’t hold a coffee mug).
  • Progressive loss of strength.
  • Tingling or loss of sensation in the hand.
  • Suspected tendon rupture (sudden snap + abrupt loss of function).

The physiotherapist can add techniques such as shockwave therapy, EPI (percutaneous electrolysis), dry needling or manual therapy.

Frequently asked questions

Can I keep playing padel/tennis with tennis elbow?

If you are in the acute phase (first week), no. From phase 2–3 you can play gently with an elbow brace and good stretching. Return to competitive play should be very gradual after 6–8 weeks.

Does the epicondylitis strap work?

Yes, especially to maintain everyday activity without pain while the tendon recovers. It doesn’t “cure” it but unloads the affected area by changing the traction point.

Is BEIMAN Sport suitable for chronic epicondylitis?

Yes. BEIMAN Sport can be used in acute and chronic tennis elbow. For chronic cases, always combine with specific eccentric exercises.

How long does it take to heal?

An acute epicondylitis that is properly treated: 4–6 weeks. A chronic case lasting months: 3–6 months with structured treatment. Pain relief is the fastest part; full tendon recovery is slower.

Should I get a cortisone injection?

Only in very resistant cases. Injections provide fast relief but there is evidence that they worsen the prognosis at 6–12 months compared with conservative treatment. It’s better to exhaust the full conservative protocol and consider PRP or EPI before corticosteroids.

Related resources

Cosmetic product for external use. Not a medicine. Does not replace professional medical diagnosis or treatment. If your epicondylitis does not improve within 6 weeks of treatment, see a physiotherapist or orthopedic specialist.

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