Tennis elbow is one of the most stubborn musculoskeletal conditions we treat at Denovo Physio & Rehab in Preston — and despite the name, fewer than 1 in 10 sufferers actually play tennis. If you have nagging pain on the outside of your elbow when gripping, lifting a kettle or typing, you almost certainly have lateral epicondylitis, also known as lateral elbow tendinopathy.
Here is what causes it, why it lingers for months when left alone, and exactly how our combined approach — shockwave therapy, manual therapy and structured loading — gets you back to pain-free function.
What Is Tennis Elbow?
Tennis elbow affects the common extensor tendon — the group of tendons that attach your wrist extensor muscles to the bony bump on the outside of your elbow (the lateral epicondyle). When this tendon is overloaded, microscopic damage builds up faster than the body can repair it, leading to a tendinopathy: a condition of tendon degeneration rather than simple inflammation.
Tennis elbow affects 1–3% of adults each year, most commonly between the ages of 35 and 55, and the dominant arm is usually affected.
Tennis Elbow Symptoms
- Pain on the outer side of the elbow, sometimes spreading into the forearm
- Weak grip strength — struggling to hold a mug, twist a key or carry shopping
- Pain when shaking hands or lifting with the palm down
- Stiffness in the elbow first thing in the morning
- Sharp pain when straightening the wrist against resistance
What Causes Tennis Elbow?
Tennis elbow is almost always an overload injury. The most common triggers we see in our Preston clinic include:
- Repetitive gripping at work — tradespeople, mechanics, hairdressers, chefs
- Long hours on a keyboard and mouse with poor desk setup
- Sudden increases in DIY, gardening or weight training
- Racquet sports with a heavy grip or poor technique
- Age-related changes in tendon quality after 40
Why Does Tennis Elbow Last So Long?
Tendons heal slowly. Unlike muscle, tendon tissue has a poor blood supply and remodels over weeks, not days. The biggest mistake we see is the cycle of rest, return to activity, flare-up, rest again. Without structured loading, the tendon never adapts and the pain returns every time you use your arm normally.
Research now clearly shows that complete rest is not the answer. Tendinopathies respond to a controlled combination of advanced treatment and progressive load — and that is exactly what our Preston clinic delivers.
How Denovo Physio Treats Tennis Elbow in Preston
At Denovo, your tennis elbow treatment combines four core services that work together to break the chronic pain cycle and rebuild a healthy tendon.
1. Shockwave Therapy — The Game-Changer for Chronic Tennis Elbow
For tennis elbow that has lasted more than 3 months, our Extracorporeal Shockwave Therapy (ESWT) service is one of the most effective treatments available. The acoustic pressure waves stimulate tendon repair at a cellular level, increase local blood flow, break down disorganised tendon tissue and restart stalled healing. NICE supports the use of shockwave therapy for chronic tendinopathies. Most patients have 3–5 sessions, one week apart, with noticeable improvement by session 3. Learn more on our Shockwave Therapy page.
2. Manual Therapy
Our hands-on manual therapy approach addresses every contributor to your elbow pain. This includes soft tissue release of the wrist extensors, joint mobilisation of the radiohumeral joint, trigger point release of the brachioradialis, and neural glides where the radial nerve is involved. Manual therapy works alongside shockwave to reduce pain quickly and prepare the tendon for the next phase of loading.
3. Advanced Electrotherapy
Where pain is acute, our Advanced Electrotherapy service uses Interferential Current (IFC) and TENS to modulate pain and reduce inflammation, allowing you to start exercising sooner. For patients with associated muscle weakness, we use VMS waveforms to retrain the wrist extensors and Muscle Intelligence™ technology to objectively measure muscle function.
4. Progressive Loading Programme in Our Clinical Gym
The cornerstone of long-term recovery. In our fully equipped clinical gym, we progress you through isometric holds, then heavy slow eccentric strengthening, and finally functional loading specific to your work or sport. This is what permanently changes the tendon — and it is something you cannot get from a brace or painkillers alone.
5. Activity Modification & Ergonomic Advice
We review what is loading the tendon every day — your desk setup, your tools, your grip technique — and make practical adjustments so the tendon is not constantly re-aggravated between sessions.
Should I Use a Tennis Elbow Brace?
A counterforce strap can take some load off the tendon during high-grip tasks and can be useful short-term. However, braces do not treat the underlying problem and should never be a substitute for proper rehab. We will advise you on when to use one and when to stop.
How Long Does Tennis Elbow Take to Recover?
With our combined shockwave-and-loading approach, most patients see a clear improvement within 4–6 weeks and full recovery within 8–12 weeks. Cases that have already lasted 6 months or more may take a little longer, but virtually all recover with the right protocol.
Book Tennis Elbow Treatment in Preston
Stop waiting for tennis elbow to settle on its own — it usually does not. Book an assessment at Denovo Physio & Rehab in Preston and get a clear diagnosis, a personalised treatment plan and an honest timeline for recovery. Call 01772 288065 or book online today.
