Tennis Elbow After a Backhand: Why Your Outside Elbow Hurts
You step onto the tennis court, prepare for a backhand, and strike the ball.
At first, everything feels normal. Then you notice an uncomfortable sensation along the outside of your elbow.
Perhaps the pain appears only when hitting backhands. Maybe gripping your racket becomes uncomfortable, or you notice soreness when picking up a coffee mug later that day.
For recreational tennis players throughout Cumming and Forsyth County, these symptoms may indicate a condition commonly called tennis elbow.
The medical term is lateral elbow tendinopathy, sometimes referred to as lateral epicondylitis.
Although tennis is associated with the condition, it can also affect golfers, pickleball players, gardeners, and people who perform repetitive gripping activities.
At Backsmart Health Chiropractic, Dr. Gregory King evaluates musculoskeletal complaints that can interfere with sports and everyday activities.
Understanding the potential causes of outside elbow pain is important before deciding how to manage it.
What Exactly Is Tennis Elbow?
Tennis elbow involves pain associated with the tendons that attach the forearm’s wrist-extensor muscles to the outside of the elbow.
One commonly involved structure is the extensor carpi radialis brevis tendon.
This tendon helps stabilize the wrist during gripping and other hand movements.
When repetitive loading exceeds the tissue’s current tolerance, tendon-related pain may develop.
Despite the traditional term epicondylitis, persistent tennis elbow does not necessarily involve a primarily inflammatory process.
Instead, it can involve changes in tendon structure, sensitivity, and loading capacity.
The 2022 clinical practice guideline published in the Journal of Orthopaedic & Sports Physical Therapy describes lateral elbow tendinopathy as a condition that can involve tendon changes, muscle-function impairments, and altered pain processing. PubMed+1
Why Can a Tennis Backhand Trigger Elbow Pain?
The backhand stroke requires coordinated movement of the shoulder, elbow, forearm, and wrist.
During ball contact, the wrist-extensor muscles help control the racket and stabilize the hand.
A player may experience greater forearm loading when repeatedly striking the ball with a poorly controlled wrist position or when using equipment that does not suit their playing style.
Sudden increases in practice volume may also contribute.
For example, someone who normally plays once a week may develop symptoms after participating in several lengthy matches over a weekend.
However, no single stroke mechanic explains every case of tennis elbow.
The problem may involve a combination of training volume, grip demands, tissue capacity, and individual factors.
Five Common Signs of Tennis Elbow
1. Pain on the Outside of the Elbow
The most recognizable symptom is tenderness around the bony prominence on the outer elbow.
The discomfort may extend into the upper forearm.
2. Pain When Gripping a Racket
Gripping activates muscles connected to the irritated tendon.
Some players notice discomfort when holding the racket firmly or attempting a powerful backhand.
3. Pain When Lifting Everyday Objects
Lifting a coffee mug, carrying groceries, or using a screwdriver can reproduce symptoms.
This happens because everyday gripping and wrist stabilization load many of the same tissues involved in tennis.
4. Reduced Grip Confidence
A painful elbow may make it difficult to grip firmly.
This does not always indicate permanent weakness or significant tissue damage.
Pain itself can temporarily interfere with muscle performance.
5. Symptoms That Return After Playing
Some people experience little discomfort during a match but notice increased soreness afterward or the following day.
This delayed response can provide useful information about whether current activity levels exceed tissue tolerance.
Is Every Case of Outer Elbow Pain Tennis Elbow?
No.
Several conditions can resemble lateral elbow tendinopathy.
Radial tunnel syndrome may cause pain farther down the forearm. Cervical nerve irritation can sometimes produce arm symptoms, particularly when accompanied by tingling, numbness, or weakness.
Elbow arthritis, ligament injuries, and other local conditions may also produce discomfort.
Pain after a fall or sudden injury requires consideration of fractures or other structural injuries.
A clinical examination helps determine whether symptoms are consistent with tendon-related pain or another condition.
What Does Research Recommend for Tennis Elbow?
Conservative management frequently involves progressive exercise, activity modification, and education.
The 2022 lateral elbow clinical practice guideline provides recommendations for assessment and treatment of adults with lateral elbow pain.
Exercise programs may include progressive strengthening of the wrist extensors and other relevant muscles, with manual therapy considered as an adjunct for selected patients. American Academy of Orthoptists
The goal is not simply to eliminate discomfort temporarily.
It is to improve the ability of the affected tissues to tolerate meaningful activities.
The appropriate exercise intensity and progression depend on symptoms, physical capacity, and clinical findings.
Six Ways to Manage Tennis-Related Elbow Discomfort
Reduce Aggravating Strokes Temporarily
If repeated backhands consistently increase symptoms, consider reducing the number or intensity of those strokes.
Complete inactivity is not always necessary.
Some individuals can continue modified tennis activities while beginning rehabilitation.
Review Your Racket and Grip
A qualified tennis instructor or racket professional may help assess equipment fit, grip size, string tension, and stroke mechanics.
Equipment changes are not guaranteed to resolve symptoms, but they may reduce unnecessary strain in some players.
Introduce Progressive Wrist-Extensor Strengthening
A rehabilitation program may begin with comfortable isometric exercises and progress toward controlled wrist extension using light resistance.
Exercises should not cause substantial or progressively worsening symptoms.
Manage Overall Playing Volume
Avoid dramatically increasing match frequency or practice duration.
A gradual return to tennis allows the elbow to adapt to increasing demands.
Consider Temporary Symptom-Relief Strategies
A forearm counterforce strap may provide short-term comfort for some individuals.
Cold therapy may also help manage soreness.
Neither approach replaces progressive rehabilitation.
Allow Adequate Recovery
Tendon-related symptoms can persist when the affected tissues are repeatedly overloaded without sufficient recovery.
Monitor how the elbow responds during activity and over the following day.
The NHS describes pacing, appropriate strengthening, equipment review, and temporary supports among conservative approaches to tennis elbow. NHS Fife
When Should You Seek Professional Evaluation?
Consider evaluation when elbow pain persists despite reasonable activity modification, interferes with work or recreation, or repeatedly returns.
Seek prompt medical assessment after significant trauma or when pain occurs with marked swelling, redness, fever, substantial weakness, or progressive neurological symptoms.
A sudden injury accompanied by a pop, bruising, or loss of function may require assessment for a tendon or ligament injury.
Can Chiropractic Care Help Tennis Elbow?
The appropriate care depends on the diagnosis.
At Backsmart Health Chiropractic, Dr. Gregory King can evaluate relevant musculoskeletal findings, including elbow movement, muscular tenderness, and associated neck or upper-extremity symptoms.
For selected patients, conservative recommendations may include activity modification, appropriate rehabilitation exercises, and manual therapy directed at relevant musculoskeletal restrictions.
However, chiropractic adjustments are not a proven standalone cure for lateral elbow tendinopathy.
Progressive exercise-based rehabilitation remains an important component of care.
When symptoms suggest a significant tendon injury, nerve condition, fracture, or another disorder outside the appropriate scope of conservative treatment, medical referral is indicated.
Learn more about physiotherapy and rehabilitation exercises and chiropractic adjustments at Backsmart Health Chiropractic.
Experienced Chiropractic Care for Active Adults in Cumming
Backsmart Health Chiropractic serves patients throughout Cumming, Forsyth County, Alpharetta, Milton, and nearby North Georgia communities.
Dr. Gregory King brings more than 30 years of chiropractic experience and reports treating over 30,000 cases.
The practice received Best of Forsyth Chiropractor recognition for five consecutive years, 2021–2025.
These credentials reflect professional experience and community recognition rather than guaranteeing a particular treatment outcome. Back Pain, Neck Pain, Sciatica
Whether you enjoy tennis, pickleball, golf, or other recreational activities, understanding the cause of persistent musculoskeletal pain can help you make informed decisions about care.
Frequently Asked Questions About Tennis Elbow
Can a one-handed backhand cause tennis elbow?
A one-handed backhand can place demands on the wrist-extensor muscles, particularly with repetitive strokes. However, tennis elbow can also occur in players using two-handed backhands.
Should I stop playing tennis completely?
Not necessarily. Some players can continue modified activity, but significant or worsening symptoms warrant reducing the aggravating workload and obtaining appropriate guidance.
How long does tennis elbow take to improve?
Recovery varies. Some cases improve within weeks, while persistent tendon-related symptoms can require several months of progressive rehabilitation.
Will an elbow brace cure tennis elbow?
A brace may provide temporary symptom relief, but it does not replace strengthening and load management.
Do I need an MRI?
Imaging is not routinely required for typical uncomplicated tennis elbow. It may be considered when the diagnosis is uncertain, symptoms are atypical, or a significant injury is suspected.
Can tennis elbow occur without playing tennis?
Yes. Repetitive gripping, lifting, tool use, and other activities can produce similar tendon-related symptoms.
Schedule Your FREE Consultation in Cumming, GA
If elbow discomfort or another musculoskeletal complaint is interfering with your daily activities, Dr. Gregory King can discuss your symptoms and help determine whether chiropractic evaluation or referral is appropriate.
Backsmart Health Chiropractic
Dr. Gregory King, D.C.
5610 Bethelview Road, Suite 300A
Cumming, GA 30040
Phone: (770) 888-4288
Website: backsmarthealth.com
Online scheduling: Schedule My FREE Consultation
Serving Cumming, Forsyth County, ZIP codes 30040 and 30041, and surrounding North Georgia communities.
Medical disclaimer: This article provides general educational information and does not replace individualized diagnosis or treatment.