TennisElbow
Lateral elbow pain from degeneration of the common extensor tendon. One of the most common upper limb tendinopathies — and one that responds well to shockwave combined with a loading program.
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What is Tennis Elbow?
Tennis elbow — medically termed lateral epicondylalgia or lateral epicondylitis — is a degenerative condition affecting the common extensor tendon at its attachment on the lateral epicondyle of the humerus (the bony prominence on the outer side of the elbow). The extensor carpi radialis brevis (ECRB) is most commonly involved.
Despite the name, tennis elbow is not exclusive to tennis players. It is one of the most common upper limb conditions seen in clinical practice, affecting manual workers, desk workers, tradespeople, and recreational athletes alike — anyone who performs repetitive forearm, wrist, and gripping activities.
Like other tendinopathies, chronic tennis elbow involves degeneration of the tendon tissue rather than active inflammation. This is why it often doesn't respond well to prolonged rest, anti-inflammatories, or repeated corticosteroid injections alone — the tendon needs a stimulus to remodel and rebuild its structural integrity.
Common Symptoms
Tennis elbow has a recognisable symptom pattern. If these sound familiar, shockwave may be worth discussing.
Why Shockwave for Tennis Elbow?
Tennis elbow is a well-established indication for shockwave therapy, with a meaningful evidence base supporting its use — particularly for chronic presentations and those who have not responded to injection.
How We Treat Tennis Elbow
Shockwave is one component. The loading program is what ensures the improvement lasts. Here's how we structure treatment.
Assessment & Diagnosis
We confirm the diagnosis clinically, assess grip strength, wrist extensor load tolerance, and identify contributing factors — forearm muscle tightness, shoulder weakness, workstation setup, or sport-specific technique issues. We also screen for other causes of lateral elbow pain including radial nerve entrapment and posterior interosseous nerve involvement.
Shockwave Treatment
Using the BTL-6000 SWT, we apply targeted shockwaves to the common extensor tendon at the lateral epicondyle. Treatment is precise and focused on the area of maximum tendon degeneration. A typical course involves 3–6 sessions spaced one week apart.
Isometric Loading for Pain Management
In the early phase, isometric wrist extension exercises are used to reduce tendon pain rapidly. These can be performed at work or before activities that aggravate symptoms — providing a practical pain management tool during the treatment period.
Progressive Wrist Extensor Strengthening
A progressive eccentric and isotonic wrist extensor loading program — the core of the rehabilitation — that drives collagen synthesis and tendon remodelling. Load is progressed systematically based on symptom response, typically over 8–12 weeks.
Activity & Workload Management
We'll review the activities and movements that are driving your symptoms and advise on modifications — whether that's workstation ergonomics, grip technique, equipment changes, or training load adjustments. Addressing the load that caused the problem is as important as treating the tissue itself.
Shockwave + Loading = Lasting Results
The evidence for tennis elbow consistently shows that progressive tendon loading is essential for long-term recovery. Shockwave creates the healing environment — the exercise program drives the structural change.
Sustained wrist extension against resistance, held for 30–45 seconds. Rapidly reduces lateral elbow pain and can be used as a practical pain management strategy during work or sport. Can be performed even when symptomatic.
Progressive wrist extensor exercises performed through range with increasing load — typically using a dumbbell or resistance band. Eccentric loading (slow lowering phase) is particularly important for tendon remodelling. Load is progressed systematically over weeks.
Progressive return to gripping, lifting, and sport-specific activity — including racquet sport technique where applicable. We use grip strength benchmarks and symptom monitoring to guide the return to full activity safely.
Key Studies & Evidence
Peer-reviewed publications supporting shockwave therapy for lateral epicondylalgia (tennis elbow).
A comprehensive update on shockwave therapy covering biological mechanisms and clinical evidence across musculoskeletal conditions including lateral epicondylalgia. Published in EFORT Open Reviews.
View on PubMed →A narrative review examining the evidence for combining shockwave with exercise programs for tendinopathy — the clinical rationale underpinning our combined treatment approach at SportsFit.
View on PMC →These references are provided for informational purposes. Individual responses to treatment vary. This information does not constitute medical advice.
FAQ — Tennis Elbow & Shockwave
This is a very common presentation. Corticosteroid injection provides short-term relief but doesn't address the underlying tendon degeneration — and repeated injections can weaken tendon tissue over time. Shockwave addresses the tissue directly and is a well-supported next step for recurrent or injection-resistant tennis elbow. The addition of a structured loading program alongside shockwave is what produces durable results.
Absolutely — the name is misleading. Tennis elbow is one of the most common upper limb conditions in tradespeople, office workers, manual labourers, and anyone who performs repetitive gripping or wrist extension activities. The sport is irrelevant.
A typical course involves 3–6 shockwave sessions spaced one week apart, alongside a progressive loading program. Response varies depending on symptom duration and how consistently the exercise program is followed. We'll give you a realistic picture at your initial assessment.
In most cases, yes — with some load modification where possible. We'll advise on what to reduce or modify in the 24–48 hours after each shockwave session, and work with you on practical strategies to reduce the aggravating load during the treatment period. Complete work cessation is rarely necessary or practical.
No referral needed. Book a free call or an initial appointment directly online.
Not Sure If Shockwave Is Right for Your Elbow?
Book a free call with one of our physios. We'll ask about your symptoms and give you an honest answer — no obligation to proceed.
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No referral needed · Five Dock, Inner West Sydney · Health fund rebates available