Tennis Elbow & Office Work: How Taping, Ergonomics, and Rehabilitation Help

What Is Tennis Elbow?

Tennis elbow, medically known as lateral epicondylalgia or lateral elbow tendinopathy, involves pain and tenderness on the outside of the elbow, mainly from degenerative changes—not inflammation—in the extensor tendon (commonly, the Extensor Carpi Radialis Brevis).

It affects about 1–3% of adults, especially those aged 35–54, and is the most common cause of persistent elbow pain.

Why Are Office Workers Prone to Tennis Elbow?

While “tennis elbow” (lateral epicondylalgia) is often associated with racquet sports, research shows that office workers are also highly susceptible. This comes down to the way computer-based tasks load the Extensor Carpi Radialis Brevis (ECRB) tendon.

• Repetitive mouse and keyboard use: Prolonged wrist extension and gripping movements when typing or using a mouse repeatedly activate the wrist extensor muscles. Over time, this can cause microtears and tendon overload at the lateral epicondyle (Coombes et al., 2015).

• Poor ergonomics: A workstation that is too high, low, or poorly set up increases stress on the wrist and elbow. Constant reaching or awkward hand positions amplify the load on the extensor tendons (Shiri & Viikari-Juntura, 2011).

• Static postures: Holding the wrist in extension for hours without variation leads to reduced blood flow and tendon fatigue, making tendons more vulnerable to injury.

• Lack of strength and conditioning: Unlike athletes, office workers rarely strengthen their forearms, leaving the tendons less resilient to repetitive strain.

In fact, one large-scale study found that computer workers who use a mouse for more than 20 hours per week are at significantly higher risk of developing lateral epicondylalgia compared to those who use it less (Thomsen et al., 2008).

Takeaway: Office workers are prone to tennis elbow not because of high-intensity forces, but because of low-level, repetitive strain applied for long periods without adequate rest, strength, or ergonomic support.

Evidence-Based Management Strategy

1. Load Management and Activity Modification

The first step is to identify and reduce aggravating activities. This doesn’t mean complete rest, but rather adjusting how much or how often certain tasks are performed.

• Ergonomic adjustments at work (e.g., keyboard and mouse height, wrist support).

• Modifying grip techniques for tools or sports equipment.

• Avoiding prolonged static wrist extension.

👉 Evidence: Systematic reviews show that load management, rather than complete immobilisation, leads to better tendon recovery (Coombes et al., 2015).

2. Exercise Therapy (The Cornerstone of Treatment)

Progressive strengthening exercises are the most effective long-term solution.

• Isometric exercises: Helpful for short-term pain relief.

• Eccentric loading: Gradually lowering a weight with wrist extension has strong evidence for tendon remodelling.

• Heavy slow resistance (HSR) training: Combining concentric and eccentric work with progressive overload has been shown to improve pain and tendon structure.

👉 Evidence: Strengthening is the most supported intervention, with multiple trials confirming superior outcomes compared to passive treatments (Cullinane et al., 2014; Coombes et al., 2015).

3. Manual Therapy and Massage

Hands-on techniques such as soft tissue massage, joint mobilisation, and trigger point release can help reduce pain and improve mobility, particularly in the short term.

👉 Evidence: A Cochrane review (Bisset et al., 2005) found that manual therapy combined with exercise provides greater short-term relief compared to exercise alone.

4. Education and Self-Management

Patients need to understand that recovery can take 6–12 months, but active rehabilitation is more effective than passive treatments alone.

• Setting expectations around tendon healing.

• Encouraging self-directed exercise programs.

• Reinforcing the importance of gradual progression.

5. Adjunct Therapies

• Shockwave therapy: May help in chronic cases where exercise alone is insufficient.

• Corticosteroid injections: Provide short-term pain relief but are associated with poorer long-term outcomes compared to physiotherapy (Coombes et al., 2010).

• Platelet-Rich Plasma (PRP): Evidence remains mixed; some studies show modest improvements, while others find little benefit over placebo.

6. Surgery (Only in Severe Cases)

Less than 5% of patients require surgery. It is reserved for persistent cases that do not respond to 6–12 months of structured physiotherapy.

Key Takeaway

The best evidence supports a combination approach:

✅ Load management

✅ Progressive strengthening

✅ Manual therapy

✅ Short-term support with taping/bracing

✅ Education for long-term self-management

This multi-faceted strategy addresses both pain and tendon resilience, giving patients the best chance of returning to pain-free function.