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What Causes Tennis Elbow To Flare Up?

Tennis elbow[1] occurs when the forearm muscles are overused. Tennis elbow affects men and women equally and the annual incidence in United States is about 1 to 3%.
Lateral epicondylitis is the medical term for tennis elbow. This is a degenerative condition in which there will be tears developing in the tendon of the muscle due to chronic over usage, strenuous activity and irritation, which causes inflammation near the bony lump (lateral epicondyle) on the outside of your elbow. This causes the pain and other symptoms associated with tennis elbow. The muscle extensor carpi radialis brevis is a forearm muscle extending from the elbow to the wrist.

What Causes Tennis Elbow To Flare Up?

What Causes Tennis Elbow To Flare Up?[2]

Some of the patients with tennis elbow complains that their elbow pain returns even after wearing braces, splints, pain killers, physiotherapy and sometimes even after surgical treatment. Even with the new techniques of treating tennis elbow, some patients still experience pain.

The best way to heal the tendons is to increase the blood supply to the irritating areas. This will heal the tears in the tendons. It is important to reduce the use of the tendon and muscle until it heals.

Therefore, we need to identify the triggering factors that caused tennis elbow to avoid it. Activities causing repeated twisting of the wrist and usage of forearm muscles for at least two hours daily and lifting weights >20 kg are the causes for triggering tennis elbow.

Examples Of Such Activities:[3]

Playing racquet sports – tennis, squash, badminton. Playing racquet sports increase the risk of getting tennis elbow, especially when you play for the first time. Studies have shown experienced players has less risk of developing tennis elbow. Even though this condition is referred as tennis elbow only about 10% of patients with tennis elbow are tennis players. Half of the tennis players present with pain in the elbow, of which only 75% have true tennis elbow.

Sports like – basketball. In basketball it’s the shooting, passing or dribbling the ball that causes strenuous activity in the forearm.

Throwing sports – discus throw, javelin.

Manual work – plumbing, bricklaying.

Activities that require fine, repetitive hand and wrist movements – typing, sewing, painting.

Activities that require repeatedly bending the elbow– violin playing, using screwdrivers, hammers and pliers

Other activities – engaging in arm wrestling, fishing, weaving and raking

If you are older than 40 years, a smoker and obese, with any of the above triggering factors then the risk of developing tennis elbow increases.

When the tendon is not healed completely and if you engage in any of the above mentioned triggering factors this will flare up the symptoms of tennis elbow.


Tennis elbow which is scientifically called lateral epicondylitis is a degenerative condition that is caused by the inflammation of the extensor carpi radialis brevis tendon due to over usage of the elbow muscle. Any activity involved in repetitive wrist and forearm movement for at least 2 hours daily, lifting weights >20 kg causes tear of this tendon leading to the inflammation. The triggering factors include playing racquet sports (tennis, squash, and badminton), sports like basketball, discus throw, javelin, and engaging in wrestling. Then plumbing, bricklaying, painting, fishing, weaving and raking, also using screwdrivers, hammers and pliers can trigger flare up of tennis elbow.

Any of these triggering factors can also flare up the tennis elbow as well if you engage in the above mentioned activities before the complete healing of the tendon. On top of the triggering factors if you are older than 40 years, a smoker and obese, this increases the risk even more of getting a flare up. Therefore, in order to prevent the disease flaring up, the activity that triggered tennis elbow flare up should be stopped temporarily until the tendon has completely healed. Usually tennis elbow spontaneously recovers within 1 to 2 years in 80 to 90% of patients.[4]


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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:December 15, 2020

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