Tennis Elbow Physiotherapy in West Perth
Tennis elbow responds well to the right treatment — but left unmanaged or poorly managed, it can drag on for months or years. At PhysioLogix we assess it properly, treat it directly, and build a rehabilitation program around getting you back to full use of your arm without the guesswork.
What is Tennis Elbow?
Tennis elbow — lateral epicondylalgia — is a condition affecting the tendons that attach the forearm extensor muscles to the lateral epicondyle, the bony prominence on the outside of the elbow. Despite the name, it has nothing to do with tennis for the majority of people who develop it. It's caused by repetitive or sustained loading of the wrist and forearm extensors — common in trades, office work, gym training, and any activity involving gripping, lifting, or repetitive wrist movements.
The condition is not primarily inflammatory. The tendon undergoes degenerative changes — alterations to its collagen structure and extracellular matrix — that reduce its capacity to handle load. This is why anti-inflammatory medications and rest alone rarely produce lasting resolution. The tendon needs to be progressively loaded and rehabilitated to rebuild its capacity, not simply rested.
What is Tennis Elbow?
Pain and tenderness at the outside of the elbow, often extending into the forearm. Weakness in the forearm and grip. Pain with activities involving gripping — opening jars, typing, using tools, carrying bags. Pain with wrist extension movements or resisted finger extension. Symptoms that are typically worse with activity and improve with rest in the early stages, but can become more constant as the condition progresses.
Tennis Elbow vs Golfer's Elbow — What's the Difference?
Tennis elbow and golfer's elbow are both tendinopathies of the elbow but affect different sides. Tennis elbow (lateral epicondylalgia) affects the tendons on the outside of the elbow, driven by the wrist extensor muscles. Golfer's elbow (medial epicondylalgia) affects the tendons on the inside of the elbow, driven by the wrist flexor and pronator muscles.
Gripping, lifting, and repetitive wrist extension cause tennis elbow. Repetitive wrist flexion, forearm pronation, and gripping with a bent wrist cause golfer's elbow. The treatment approach is similar for both — progressive loading, load management, and hands-on treatment — but the specific muscles and exercises targeted are different.
PhysioLogix treats both conditions. If you're unsure which one you have, a thorough assessment will identify it clearly before treatment begins.
Not All Elbow Pain is Tennis Elbow
Several other structures in and around the elbow can produce similar symptoms — including nerve irritation from the cervical spine or the radial nerve, referred pain from the neck or shoulder, and posterior interosseous nerve entrapment. At PhysioLogix, assessment includes ruling out these alternative diagnoses before treatment begins. We regularly see patients who have been told they have tennis elbow when the actual driver is cervical nerve root irritation or a combination of conditions — and treating the wrong thing is why some cases don't respond.
How We Treat Tennis Elbow at PhysioLogix
Assessment first — we establish exactly where the pain is coming from, what activities are loading the tendon, and what the contributing factors are. Grip strength, wrist extensor function, and cervical screening are all part of the initial assessment.
Load management — the first step in treatment is identifying and modifying the activities creating excessive tendon load. This doesn't mean stopping everything, but it does mean understanding what the tendon can and can't handle at its current capacity and adjusting accordingly.
Exercise rehabilitation — progressive loading of the wrist extensor tendons is the cornerstone of tennis elbow treatment. The primary approach involves eccentric and isometric loading of the wrist extensors — exercises that load the tendon through a controlled range of motion and progressively increase the demand on the tissue over time. Wrist extensor loading, grip strengthening, and forearm rotation exercises are typically incorporated alongside the loading program. Programs begin conservatively and advance systematically — every exercise is explained and written up with photos, descriptions, sets, reps, and frequency so you know exactly what you're doing between sessions and why.
Hands-on treatment — soft tissue release to the forearm extensor muscles addresses the tightness and trigger points that commonly accompany lateral epicondylalgia. Cervical and thoracic joint mobilisation is included where there is a cervical contribution. Dry needling is used to stimulate the affected forearm musculature where indicated, promoting tissue healing and reducing pain.
Frequently Asked Questions
How long does tennis elbow take to resolve?
This depends on how long it has been present and how well managed it has been. Acute presentations caught early can resolve in six to eight weeks with the right program. Chronic tennis elbow that has been present for months or years takes longer — but consistent engagement with a progressive loading program produces reliable results over time.
Can tennis elbow resolve without physiotherapy?
Some mild cases do resolve without treatment, particularly if the aggravating activity is identified and reduced early. However, untreated or poorly managed tennis elbow frequently becomes chronic — with some cases persisting for one to two years or longer. Physiotherapy consistently accelerates recovery and reduces the risk of recurrence by addressing the underlying tendon changes and load factors rather than waiting for spontaneous resolution.
Should I rest completely with tennis elbow?
Not entirely. Complete rest removes the pain stimulus but doesn't rehabilitate the tendon. The goal is to manage load intelligently — reducing activities that provoke symptoms while maintaining a progressive exercise program that rebuilds tendon capacity. We'll guide you on exactly what to avoid and what to continue.
Do I need imaging for tennis elbow?
Not usually. Tennis elbow is a clinical diagnosis. Ultrasound can confirm tendon changes but rarely changes the treatment approach. We'll advise you if imaging would be useful for your specific presentation.
Can tennis elbow come back?
It can — particularly if the underlying load factors haven't been addressed. The late stage of rehabilitation focuses specifically on building the tendon's capacity to handle the demands that caused the problem in the first place. If your job or training involves repetitive forearm loading, the program is designed around returning to those activities without re-injury.
What is the difference between tennis elbow and golfer's elbow?
Tennis elbow affects the outside of the elbow and is caused by wrist extensor overload. Golfer's elbow affects the inside of the elbow and is caused by wrist flexor and forearm pronator overload. Both are treated with progressive loading and hands-on physiotherapy, but the specific muscles and exercises targeted are different. PhysioLogix treats both — assessment will confirm which one you have.
Where is PhysioLogix located?
6/567 Newcastle Street, West Perth WA 6005. We see patients with tennis elbow from Subiaco, Leederville, North Perth, Nedlands, Mount Hawthorn, and across the inner Perth suburbs. Free street parking is available directly outside with no time limits during clinic hours.
Do I need a referral?
No referral is required. Book directly online using the button bellow Cliniko or call 0450 075 955.
Dealing with elbow pain that's not getting better on its own? Call us on 0450 075 955 and we'll tell you what's likely driving it.