MOTION WORKS

What is Tennis Elbow (Lateral Elbow Tendinopathy)?

Tennis elbow, clinically known as lateral elbow tendinopathy, is a condition affecting the common extensor tendon of the forearm, most commonly the extensor carpi radialis brevis (ECRB).

It is characterised by pain on the outside of the elbow, particularly with gripping, lifting, or repetitive wrist and forearm use.

Current peer-reviewed evidence shows that tennis elbow is primarily a degenerative tendinopathy rather than a purely inflammatory condition. This means the tendon’s structure becomes overloaded over time, leading to microtearing and impaired healing capacity rather than simple inflammation.

Why Padel Players Are at High Risk

Padel is one of the fastest-growing sports in the UK, including at venues such as Padel Farm York. However, it carries a significant risk of developing lateral elbow tendinopathy due to its movement and loading demands.

Key risk factors in padel include:

• High repetition of forehand and backhand strokes

• Continuous gripping of the racket

• Rapid reaction times increasing forearm tension

• Smaller court size leading to higher shot frequency

• Inadequate recovery between sessions

  
  

Research in racket sports consistently shows that repetitive gripping and wrist extension under load are major contributors to tendon overload in the lateral elbow.

The Real Problem: It is Not Just Inflammation

Tennis elbow is often misunderstood as an inflammatory condition. However, modern evidence shows that it is primarily a failed tendon healing response.

Key pathological features include:

• Collagen disorganisation within the tendon

• Microtearing from repeated overload

• Neurochemical sensitisation contributing to pain

• Reduced tendon load tolerance over time

  
  

This explains why rest alone is often ineffective for long-term recovery.

Evidence-Based Treatment Approach

The most effective treatment strategies are centred around load management and progressive rehabilitation rather than passive treatments alone.

Load Management (Most Important Factor)

Reducing tendon overload is the first and most important step in recovery.

Recommendations include:

• Temporarily reducing padel frequency

• Avoiding playing through pain above a mild level

• Modifying grip size or racket characteristics if needed

• Reducing heavy gripping exercises in the gym

  
  

Load control is consistently shown to be the most important factor in tendon recovery outcomes.

Exercise-Based Rehabilitation

The most effective rehabilitation approach includes progressive loading of the tendon.

Evidence supports:

• Eccentric wrist extensor exercises

• Isometric holds for short-term pain relief

• Heavy slow resistance training to improve tendon capacity

  
  

These approaches aim to restore tendon structure and load tolerance over time.

Pain and Symptom Management

Although inflammation is not the primary driver, symptom management can support recovery.

Options include:

• Short-term ice application after activity for pain relief

• Short-term use of anti-inflammatory medication if appropriate

• Temporary activity modification rather than complete rest

Bracing

Counterforce braces may provide short-term symptom relief during activity by reducing strain on the extensor tendon. However, research shows that their effects are typically temporary and should be used as an adjunct rather than a primary treatment strategy.

Manual Therapy and Chiropractic Care

At Motionworks Chiropractic in York, treatment may include:

• Soft tissue therapy to the forearm musculature

• Joint mobilisation of the wrist, elbow, and upper limb

• Assessment of shoulder and cervical spine biomechanics

• Correction of movement patterns contributing to overload

  
  

Manual therapy is most effective when combined with active rehabilitation and load management.

Why Tennis Elbow Persists in Padel Players

Persistent or recurrent tennis elbow in padel players is often due to underlying factors rather than the elbow alone.

Common contributing factors include:

• Returning to sport too quickly

• Continuing high training loads without progression

• Poor scapular and shoulder control

• Reduced wrist and forearm capacity

• Unaddressed kinetic chain dysfunction

  
  

Tennis elbow is often a whole upper-limb and movement system problem rather than an isolated elbow injury.

Local Treatment in York: Motionworks Chiropractic

Motionworks Chiropractic provides evidence-based assessment and treatment for sports-related injuries, including padel-related tendon pain.

We regularly support patients from:

• York

• Easingwold

• Malton

• Padel Farm York

  
  

Our clinical approach focuses on:

• Reducing pain and irritation

• Restoring tissue capacity

• Rebuilding load tolerance

• Preventing recurrence through movement correction

Key Takeaways

• Tennis elbow is a load-related tendinopathy rather than simple inflammation

• Padel significantly increases risk due to repetitive gripping and high shot volume

• The most effective treatment is load management combined with progressive strengthening

• Passive treatments alone are not sufficient for long-term recovery

• Addressing biomechanics and training load is essential for prevention

When to Seek Treatment

You should seek assessment if:

• Symptoms persist beyond two to three weeks

• Grip strength is reduced

• Pain affects performance in padel or gym training

• You are modifying technique due to discomfort

Early intervention significantly improves recovery outcomes and reduces the risk of chronic tendinopathy.

Final Message

If you are experiencing elbow pain while playing padel at Padel Farm York or training in York, Easingwold, or Malton, early assessment and evidence-based management can significantly reduce recovery time and prevent long-term issues.

Motionworks Chiropractic focuses on restoring function, improving performance, and preventing recurrence through a structured, evidence-based approach to rehabilitation.