If your elbow has been aching for weeks – or months – you’re not alone. Tennis elbow is one of the most common overuse injuries we see at BOOST PHYSIO, affecting everyone from office workers and keen gardeners to gym-goers and, yes, the occasional tennis player.
Most people try the same 2 things: rest it or push through it, hoping it settles. And for many, neither of those approaches gives lasting relief.
The reason? What your tendon actually needs to heal is almost the opposite of what feels intuitive.
What is tennis elbow?
Tennis elbow (lateral epicondylalgia) is an overuse injury affecting the tendons on the outside of the elbow – specifically where the wrist extensor muscles attach to the bony prominence known as the lateral epicondyle. Repetitive gripping, lifting or twisting movements cause tiny microtears in the tendon over time, leading to pain, weakness and that tell-tale tenderness on the outer elbow.
It’s most commonly seen in people aged 35-55. Despite the name, fewer than 5% of cases are related to tennis – you’re just as likely to develop it from typing, decorating, gardening or repeated lifting.
The counter-intuitive science: why an overuse injury needs exercise
Here is where most people get stuck – and understandably so.
If tennis elbow is caused by overuse, surely the answer is to stop using it?
It feels completely logical. You’ve been gripping, lifting and repeating the same movements until something breaks down. Of course the answer is to rest. Give it a break. Let it heal.
Except tendons don’t work like that. And understanding why changes everything.
Tendons are not muscles
Muscles have a rich blood supply. When you strain a muscle, blood rushes in carrying oxygen and nutrients, inflammation does its job, and healing is relatively rapid. Tendons are different. Their blood supply is sparse – by design, because tendons need to be dense and strong rather than soft and pliable. This means that when a tendon becomes irritated or develops microtears, passive rest doesn’t bring the healing response you’d expect.
Rest reduces pain temporarily – but it doesn’t fix the underlying tendon. And the longer you rest, the more the tendon deconditions: it loses stiffness, loses tolerance to load, and becomes even more vulnerable when you return to normal activity. For many people, several weeks of rest followed by a return to work or sport triggers a flare-up that feels worse than the original injury. This is why.
|
Rest reduces pain – but it doesn’t repair the tendon. Load does.
|
