Lateral Epicondylitis (tennis elbow)
Shockwave Therapy for Tennis Elbow | Sunbury & Melton
Tennis elbow (lateral epicondylitis) is an overuse tendon condition causing pain on the outside of the elbow, often linked to repetitive gripping and wrist movements. Shockwave Therapy uses focused sound waves to deliver mechanical stimulation to affected tissues and may assist some people with persistent symptoms.
Evidence suggests Shockwave Therapy can improve pain and function in some chronic cases of tennis elbow, particularly when combined with rehabilitation exercises. However, it is not suitable for every person. An assessment helps determine whether Shockwave Therapy is appropriate based on the cause, severity and duration of symptoms.
Shockwave Therapy may help some people with persistent tennis elbow (lateral epicondylitis) by stimulating changes in the affected tendon and supporting the body’s natural repair processes. Tennis elbow is a common overuse condition involving pain and sensitivity around the outer part of the elbow, usually where the forearm muscles attach to the lateral epicondyle.
It commonly affects people who perform repetitive gripping, lifting, computer work, manual tasks, racquet sports, gardening, or activities involving repeated wrist extension. While many cases improve with activity modification, exercise and appropriate rehabilitation, some people experience ongoing symptoms despite conservative care.
At Health Wise Chiropractic, Shockwave Therapy for tennis elbow is considered as part of an individualised management plan that may also include exercise therapy, movement advice, ergonomic changes and other treatments where clinically appropriate.
Research suggests extracorporeal Shockwave Therapy may provide improvements in pain and function for some people with chronic lateral epicondylitis, although results vary between individuals. A thorough assessment is important to determine whether Shockwave Therapy is suitable and whether other approaches may be required.
Health Wise Chiropractic provides evidence-informed musculoskeletal care in Sunbury and Melton, helping patients understand their condition and develop a personalised pathway towards recovery.
Tennis elbow (lateral epicondylitis) is an overuse tendon condition causing pain on the outside of the elbow, often linked to repetitive gripping and wrist movements. Shockwave Therapy uses focused sound waves to deliver mechanical stimulation to affected tissues and may assist some people with persistent symptoms.
Evidence suggests Shockwave Therapy can improve pain and function in some chronic cases of tennis elbow, particularly when combined with rehabilitation exercises. However, it is not suitable for every person. An assessment helps determine whether Shockwave Therapy is appropriate based on the cause, severity and duration of symptoms.
What Is This Condition?
Understanding Tennis Elbow (Lateral Epicondylitis)
Tennis elbow, medically known as lateral epicondylitis or more accurately lateral elbow tendinopathy, is a condition involving pain and reduced tolerance of the tendons that attach the forearm muscles to the outside of the elbow.
Despite the name, tennis elbow is not limited to tennis players. In fact, many people who develop this condition have never played racquet sports. It is commonly seen in tradespeople, office workers, athletes, musicians, gardeners and anyone who performs repetitive gripping or wrist movements.
The main area of discomfort is usually the lateral epicondyle, which is the bony prominence on the outside of the elbow. Several forearm muscles attach through a shared tendon in this region, including the extensor carpi radialis brevis (ECRB) muscle, which helps stabilise the wrist during gripping activities.
What Happens to the Tendon?
Tendons are strong connective tissues that attach muscles to bones. They are designed to tolerate repeated loading, but problems can occur when the demands placed on a tendon exceed its ability to adapt.
In tennis elbow, repeated stress may lead to changes within the tendon structure, including:
Altered collagen organisation
Reduced tendon load tolerance
Small areas of tendon degeneration
Increased sensitivity of surrounding tissues
Changes in how the nervous system processes pain signals
Although the condition is commonly called "tendon inflammation", chronic tennis elbow is usually considered more of a tendinopathy rather than an ongoing inflammatory condition.
This distinction is important because treatment strategies are often focused on gradually improving tendon capacity rather than simply reducing inflammation.
Common Symptoms of Tennis Elbow
Symptoms can vary depending on the severity and duration of the condition. Common signs include:
Pain on the outside of the elbow
Tenderness over the lateral epicondyle
Discomfort when gripping objects
Pain when lifting a kettle, cup or tools
Difficulty opening jars or turning door handles
Weakness in grip strength
Pain during wrist extension movements
Symptoms that worsen after repetitive activity
Some people notice pain only during specific activities, while others experience ongoing discomfort even during rest.
Different Types of Elbow Pain
Not all outer elbow pain is caused by tennis elbow. A thorough assessment helps distinguish between different sources of symptoms.
Muscular Pain
Muscle-related pain may occur due to overuse, fatigue or increased tension in the forearm muscles. This type of discomfort often improves with rest, massage, stretching and gradual strengthening.
Tendon Pain
Tendon-related pain is commonly associated with gripping, lifting and repeated wrist movements. Tennis elbow usually involves reduced tendon tolerance and sensitivity around the tendon attachment.
Joint Pain
Pain originating from the elbow joint may involve conditions such as arthritis, joint irritation or previous injury. Joint pain may present differently from tendon-related symptoms.
Nerve-Related Pain
Irritation of nerves around the elbow or neck can sometimes produce symptoms that feel similar to tennis elbow. Signs that may suggest nerve involvement include:
Tingling or numbness
Burning sensations
Symptoms extending into the forearm or hand
Changes in sensation or strength
An accurate diagnosis is important because Shockwave Therapy is generally aimed at musculoskeletal tendon conditions rather than nerve-related disorders.
Acute vs Chronic Tennis Elbow
Acute Tennis Elbow
Early symptoms may develop after a sudden increase in activity, such as:
Starting a new exercise program
Increased workplace demands
Heavy lifting
Repetitive weekend activities
Symptoms may settle with appropriate load modification and rehabilitation.
Chronic Tennis Elbow
Persistent tennis elbow is generally considered when symptoms continue for several months despite appropriate management.
Chronic cases may involve:
Longer-lasting tendon changes
Reduced grip strength
Increased sensitivity
Difficulty performing normal activities
Greater impact on work and lifestyle
Persistent symptoms do not necessarily mean permanent damage. Tendons can adapt and improve with appropriate progressive loading and management.
Common Causes and Risk Factors
Tennis elbow usually develops from repeated stress rather than one single injury.
Common contributing factors include:
Repetitive Wrist and Forearm Movements
Activities involving repeated gripping, lifting or wrist extension can increase tendon load, including:
Computer mouse use
Plumbing
Carpentry
Construction work
Cooking
Gardening
Racquet sports
Sudden Increase in Activity
A rapid increase in workload without enough adaptation time can overload the tendon.
Examples include:
Increasing gym training volume
Returning to sport after a break
Taking on extra physical work
Age-Related Changes
Tendons naturally undergo changes with ageing. Lateral elbow tendinopathy is more common in adults between approximately 35 and 60 years of age.
Reduced Strength or Movement Control
Weakness in the forearm, shoulder or upper limb may influence how load is distributed through the arm during activities.
Prognosis and Recovery
The outlook for tennis elbow is generally positive, although recovery time varies.
Many people improve with:
Activity modification
Progressive strengthening exercises
Education about tendon loading
Manual therapy where appropriate
Targeted treatments such as Shockwave Therapy in selected cases
Some persistent cases can take several months to improve because tendon adaptation occurs gradually.
Factors that may influence recovery include:
How long symptoms have been present
Severity of tendon changes
Work demands
General health
Sleep quality
Stress levels
Ability to modify aggravating activities
Consistency with rehabilitation
A personalised approach is important because the best treatment plan depends on the individual presentation rather than the diagnosis alone
Who May Benefit From Shockwave Therapy?
Shockwave Therapy may be considered for people who have:
Persistent tennis elbow symptoms lasting several months
Pain that limits work, sport or daily activities
A diagnosis consistent with lateral elbow tendinopathy
Not achieved enough improvement with exercise and load modification alone
A preference for non-surgical treatment options
People who often respond well are those who understand that tendon recovery requires gradual rehabilitation and consistent participation.
Who May Not Be Suitable for Shockwave Therapy?
Shockwave Therapy is not appropriate for everyone.
It may not be recommended for people with:
Suspected fracture or significant trauma
Active infection in the treatment area
Certain bleeding disorders
Certain medications that affect bleeding risk
Tumour or serious unexplained symptoms in the treatment region
Symptoms caused by conditions unrelated to tendon problems
A clinician assessment is important before treatment.
Why Do Results Differ Between Patients?
Every person responds differently to treatment.
Factors that may influence outcomes include:
Duration of Symptoms
Long-standing tennis elbow may require more time and a more structured rehabilitation approach.
Activity Demands
A person performing heavy manual work may require different management compared with someone with mild symptoms from recreational activity.
Tendon Capacity
The ability of the tendon to tolerate load varies between individuals.
Rehabilitation Participation
Exercise is an important component of tendon recovery. Shockwave Therapy is generally most effective when combined with appropriate strengthening and movement strategies.
Overall Health Factors
Recovery may also be influenced by:
Sleep quality
Stress levels
General activity levels
Nutrition
Smoking status
Other health conditions
What Happens During Your Appointment?
Initial Consultation and Assessment
Your first appointment at Health Wise Chiropractic begins with a detailed discussion about your symptoms, lifestyle and goals.
Your practitioner may ask about:
When the elbow pain started
Activities that aggravate or relieve symptoms
Work and sporting demands
Previous injuries
Previous treatments
Your recovery goals
Understanding the cause and contributing factors helps determine whether Shockwave Therapy is appropriate.
Physical Examination
A physical assessment may include:
Checking elbow movement
Assessing grip strength
Testing wrist and forearm movements
Palpating the tendon and surrounding tissues
Identifying painful movements
Assessing related areas such as the wrist, shoulder and neck where appropriate
The aim is to determine whether symptoms are consistent with tennis elbow and whether other conditions may be contributing.
Treatment Session
If Shockwave Therapy is considered appropriate, your practitioner will:
Explain the treatment process
Position the elbow comfortably
Apply gel to improve contact
Deliver controlled acoustic waves to the targeted area
Adjust settings according to comfort and clinical requirements
Treatment duration is commonly around 5–15 minutes depending on the individual plan.
Some patients feel pressure or discomfort during treatment, but intensity can be adjusted.
Aftercare Advice
Following Shockwave Therapy, patients may be advised to:
Continue gentle movement
Follow prescribed exercises
Avoid excessive aggravating activities temporarily
Gradually increase loading as symptoms allow
Recovery usually depends on combining treatment with appropriate rehabilitation.
Home Care & Exercises
Exercises for Tennis Elbow Recovery
Exercise is one of the most important components of managing lateral epicondylitis (tennis elbow). While Shockwave Therapy may assist some people with persistent tendon pain, improving the strength and capacity of the forearm muscles and tendon is essential for long-term recovery.
Exercises should generally be progressed gradually. Mild discomfort during exercise can be acceptable for many people, but sharp pain or a significant increase in symptoms afterwards may indicate that the load needs to be reduced.
The following beginner-friendly exercises may be useful for many people with tennis elbow. However, exercise selection should be individualised based on your assessment.
1. Wrist Extensor Stretch
Purpose:
Helps reduce tension through the forearm extensor muscles, which attach near the painful area in tennis elbow.
Instructions:
Extend your affected arm in front of you with your palm facing down.
Use your opposite hand to gently pull the fingers and wrist downward.
Feel a stretch along the top of your forearm.
Hold without forcing the movement.
Repetitions:
Hold for 20–30 seconds
Repeat 2–3 times
Frequency:
Daily, especially after activities that involve gripping or computer work
Progression:
Gradually increase the duration of the stretch if it remains comfortable.
2. Isometric Wrist Extension Hold
Purpose:
Builds tolerance of the wrist extensor muscles without excessive movement through the tendon.
Instructions:
Rest your forearm on a table with your hand hanging slightly over the edge.
Place your opposite hand on top of your affected hand.
Attempt to lift your affected wrist upwards while resisting with your other hand.
Hold the contraction without moving the wrist.
Repetitions:
Hold for 10–30 seconds
Repeat 5 times
Frequency:
Once daily initially
Progression:
Increase the hold duration or resistance gradually as symptoms improve.
3. Eccentric Wrist Extension Exercise
Purpose:
Improves tendon strength and load tolerance.
Instructions:
Hold a light weight such as a small dumbbell or water bottle.
Support your forearm on a table with your palm facing down.
Use your other hand to lift the wrist upwards.
Slowly lower the affected wrist back down over 3–5 seconds.
Repetitions:
2–3 sets of 10–15 repetitions
Frequency:
3–4 times per week
Progression:
Gradually increase resistance as strength improves.
4. Grip Strength Exercise
Purpose:
Improves tolerance for everyday activities involving gripping.
Instructions:
Hold a soft ball, rolled towel or therapy putty.
Squeeze gently and hold.
Release slowly.
Repetitions:
10–15 repetitions
2–3 sets
Frequency:
3–5 times per week
Progression:
Increase resistance gradually.
5. Forearm Rotation Exercise
Purpose:
Improves movement capacity of the forearm, which may assist with lifting and functional activities.
Instructions:
Hold a lightweight object such as a hammer or small bottle.
Bend your elbow to 90 degrees.
Slowly rotate your palm upwards and downwards.
Move through a comfortable range.
Repetitions:
10 repetitions each direction
Frequency:
Daily or every second day
Progression:
Increase weight gradually when comfortable.
Prevention Tips
Reducing the Risk of Tennis Elbow Returning
Preventing tennis elbow often involves managing how much load is placed on the tendon and allowing enough time for adaptation.
Improve Workstation Setup
For people who experience elbow symptoms from computer use:
Keep your keyboard and mouse positioned comfortably close
Avoid prolonged gripping of the mouse
Keep wrists in a neutral position rather than constantly extended
Take regular movement breaks
Alternate tasks where possible
Small ergonomic changes can reduce repeated strain.
Manage Repetitive Activities
If your work or hobbies involve repetitive gripping:
Avoid sudden increases in workload
Take short breaks during repetitive tasks
Use appropriate tools and equipment
Rotate activities when possible
Build strength gradually
Tendons respond well to progressive loading but may struggle with sudden changes.
Improve Lifting Technique
When lifting objects:
Keep loads close to your body
Avoid lifting heavy objects with the wrist bent backwards
Use both hands where possible
Avoid repeated gripping with excessive force
Exercise Regularly
Maintaining strength through the:
Forearm
Wrist
Shoulder
Upper back
may help improve overall upper limb function.
A balanced exercise program should include:
Strength training
Mobility exercises
Cardiovascular activity
Recovery periods
Sleep and Recovery
Adequate recovery supports tissue adaptation.
Helpful strategies include:
Maintaining consistent sleep routines
Managing stress levels
Avoiding excessive training without recovery
Maintaining general physical activity
Stretching and Mobility
Stretching may help some people manage muscle tightness, although strengthening is usually more important for long-term tendon health.
Regular movement breaks can help reduce stiffness associated with prolonged desk work or repetitive tasks.
Australian Statistics
How Common Is Tennis Elbow in Australia?
Reliable Australian-specific population data for lateral epicondylitis is limited, but international research suggests tennis elbow affects approximately 1–3% of adults each year.
The condition is most common in adults between approximately 35 and 60 years of age and is associated with occupations and activities involving repetitive gripping, wrist movements and manual loading.
Australian workers in industries such as construction, manufacturing, trades, healthcare, hospitality and office-based occupations may experience increased exposure to repetitive upper limb demands.
Musculoskeletal conditions represent a significant health burden in Australia. According to the Australian Institute of Health and Welfare (AIHW), musculoskeletal disorders are among the leading contributors to disability and healthcare use nationally.
Common impacts of tennis elbow include:
Reduced ability to work comfortably
Difficulty performing household tasks
Reduced participation in sport and hobbies
Lost productivity
Early assessment and appropriate management may help prevent symptoms from becoming persistent.
Evidence & Clinical Guidelines
What Does Research Say About Shockwave Therapy for Tennis Elbow?
Current evidence suggests Shockwave Therapy may provide meaningful improvements for some people with chronic lateral epicondylitis, particularly when symptoms have persisted despite other conservative approaches.
A systematic review and meta-analysis published in the Journal of Orthopaedic Surgery and Research found that Extracorporeal Shockwave Therapy was associated with improvements in pain and function compared with some control treatments in patients with lateral epicondylitis.
Evidence has shown improvements in outcomes such as:
Pain scores measured using Visual Analogue Scale (VAS)
Functional scores
Grip strength
However, researchers have noted variation between studies regarding treatment protocols and patient populations.
Example evidence:
Systematic reviews have reported statistically significant reductions in pain scores following ESWT compared with placebo or other conservative treatments in selected patients with chronic tennis elbow.
Functional improvements are commonly reported after multiple treatment sessions combined with rehabilitation.
A review by Dedes et al. (2019) reported that ESWT may be effective for improving pain and function in patients with lateral epicondylitis, although treatment protocols varied between studies.
A systematic review by Staples et al. (2008) found evidence supporting extracorporeal shockwave therapy as a treatment option for some patients with chronic lateral epicondylitis, although benefits were not consistent across all trials.
Sources:
Frequently Asked Questions
1. Can Shockwave Therapy help tennis elbow?
Shockwave Therapy may help some people with tennis elbow (lateral epicondylitis), particularly those with persistent symptoms that have not improved with exercise, activity modification or other conservative approaches.
Research suggests Shockwave Therapy may reduce pain and improve function in some patients with chronic tennis elbow. However, results vary, and it is not effective for everyone.
A clinical assessment is recommended to determine whether Shockwave Therapy is appropriate for your specific condition.
2. What is tennis elbow?
Tennis elbow is a common condition involving pain and reduced tolerance of the tendons that attach the forearm muscles to the outside of the elbow.
Despite its name, it does not only affect tennis players. It commonly occurs in people who perform repetitive gripping, lifting, typing, manual work or sporting activities.
The medical term is lateral epicondylitis, although many clinicians now use the term lateral elbow tendinopathy because chronic cases usually involve tendon changes rather than traditional inflammation.
3. How does Shockwave Therapy work for tennis elbow?
Shockwave Therapy uses acoustic pressure waves to deliver mechanical stimulation to the affected area.
The treatment may help by:
Supporting tendon remodelling
Influencing pain sensitivity
Encouraging local tissue responses
Improving tolerance to rehabilitation exercises
The exact mechanisms are still being studied, and improvement depends on the individual.
4. Is Shockwave Therapy painful?
Some people feel pressure, tapping or discomfort during Shockwave Therapy.
Treatment intensity can usually be adjusted depending on your comfort level and the condition being treated.
Mild soreness or sensitivity after treatment can occur and often settles within a short period.
5. How many Shockwave Therapy sessions are needed for tennis elbow?
The number of sessions varies depending on:
How long symptoms have been present
Severity of symptoms
Response to treatment
Rehabilitation progress
Many treatment programs involve several sessions spaced over a number of weeks.
Your practitioner will discuss a suitable treatment approach after assessing your elbow.
6. Can Shockwave Therapy fix tennis elbow permanently?
No treatment can guarantee a permanent cure for every person.
Shockwave Therapy may assist some people by reducing pain and improving function, but long-term recovery usually depends on improving tendon capacity through:
Strengthening exercises
Appropriate activity progression
Managing aggravating factors
Addressing contributing movement patterns
7. Should I rest my arm if I have tennis elbow?
Complete rest is usually not recommended for most cases of tennis elbow.
While reducing aggravating activities can help settle symptoms, tendons generally respond well to gradual and appropriate loading.
A rehabilitation program aims to restore strength and confidence rather than avoiding movement permanently.
8. Is Shockwave Therapy suitable for acute tennis elbow?
Shockwave Therapy is more commonly considered for persistent or chronic tendon conditions rather than very early symptoms.
For recent-onset elbow pain, initial management may include:
Activity modification
Education
Exercise therapy
Monitoring symptoms
An assessment helps determine the most appropriate approach.
9. When should I see a doctor for elbow pain?
You should seek medical advice if elbow pain:
Occurs after significant trauma
Is severe or rapidly worsening
Is associated with swelling, redness or fever
Causes significant weakness
Includes numbness or tingling
Does not improve with appropriate management
A GP or specialist assessment may be recommended if symptoms suggest a condition other than tennis elbow.
10. Can Health Wise Chiropractic help with tennis elbow in Sunbury and Melton?
Health Wise Chiropractic provides evidence-informed musculoskeletal care for conditions such as tennis elbow.
Your appointment may include assessment, education, treatment recommendations and rehabilitation strategies based on your individual presentation.
Shockwave Therapy may be considered alongside other appropriate approaches where clinically suitable.
Why Choose Health Wise Chiropractic?
At Health Wise Chiropractic, tennis elbow management focuses on understanding the cause of your symptoms and creating an individualised plan based on your goals.
Our experienced practitioners provide evidence-informed care that considers:
Your symptoms and history
Work and lifestyle demands
Movement patterns
Rehabilitation needs
Long-term recovery goals
Shockwave Therapy may be included as part of a broader treatment approach where appropriate, alongside exercise advice, rehabilitation strategies and other clinically suitable treatments.
Health Wise Chiropractic supports patients through their recovery journey with clinics conveniently located in Sunbury and Melton.
Patients can access personalised musculoskeletal care and online bookings to arrange an assessment and discuss whether Shockwave Therapy may be suitable for their tennis elbow.
If tennis elbow is affecting your work, exercise, hobbies or daily activities, an individual assessment can help determine the most appropriate treatment approach.
At Health Wise Chiropractic, our practitioners assess your symptoms, identify contributing factors and develop a personalised plan based on your goals. Shockwave Therapy may be suitable for some people with persistent lateral epicondylitis, particularly when combined with appropriate rehabilitation and exercise strategies.
Whether you are located in Sunbury, Melton or surrounding areas, our team can help you understand your condition and explore evidence-informed options for recovery.
Book an appointment online with Health Wise Chiropractic today to discuss your tennis elbow symptoms and whether Shockwave Therapy may be appropriate for you.
Recovery Timeline
How Long Does Tennis Elbow Take to Recover?
Recovery from lateral epicondylitis varies significantly between individuals. The timeline depends on factors such as symptom duration, tendon health, activity demands and consistency with rehabilitation.
Mild Cases
People with mild symptoms may improve within:
Several weeks to a few months
Recovery may occur with:
Activity modification
Exercise
Load management
Education
Moderate Cases
Moderate cases may require:
Several months of structured rehabilitation
Treatment may include:
Progressive strengthening
Manual therapy where appropriate
Shockwave Therapy if clinically suitable
Workplace or sporting modifications
Persistent or Chronic Cases
Long-standing tennis elbow may take:
6–12 months or longer
This does not mean improvement is unlikely. Tendons often adapt slowly, and persistent cases may require a more comprehensive management approach.
Tennis elbow (lateral epicondylitis) is an overuse tendon condition causing pain on the outside of the elbow, often linked to repetitive gripping and wrist movements. Shockwave Therapy uses focused sound waves to deliver mechanical stimulation to affected tissues and may assist some people with persistent symptoms.
Evidence suggests Shockwave Therapy can improve pain and function in some chronic cases of tennis elbow, particularly when combined with rehabilitation exercises. However, it is not suitable for every person. An assessment helps determine whether Shockwave Therapy is appropriate based on the cause, severity and duration of symptoms.
Tennis elbow (lateral epicondylitis) is an overuse tendon condition causing pain on the outside of the elbow, often linked to repetitive gripping and wrist movements. Shockwave Therapy uses focused sound waves to deliver mechanical stimulation to affected tissues and may assist some people with persistent symptoms.
Evidence suggests Shockwave Therapy can improve pain and function in some chronic cases of tennis elbow, particularly when combined with rehabilitation exercises. However, it is not suitable for every person. An assessment helps determine whether Shockwave Therapy is appropriate based on the cause, severity and duration of symptoms.