Ask a doctor: Can I get tennis elbow without picking up a racket?

So, the doctor diagnosed you with tennis elbow, but you’ve never picked up a racket. You’re probably thinking, “How is that possible?”

Unfortunately, nearly 3 percent of Americans are diagnosed each year with lateral elbow tendinosis, commonly referred to as tennis elbow, regardless of time spent on the court.

And even more surprising: The injury has very little to do with your elbow.

Our experts detail what you should know about tennis elbow and how to keep yourself safe — on and off the court.

The quick answer

Tennis elbow actually begins in the wrist.

The tendon responsible for wrist extension (extensor carpi radialis brevis) extends up from your wrist, spreads into a sheet-like shape and attaches to the outside bony bump of your elbow. When injured, that sheet of tendons pulls away from the elbow, allowing degenerative tissue to build up in the gap.

Injury can occur when the wrist faces resistance. Think movements where your wrist bends up, such as a backhand tennis swing, or — more commonly — repeated movements like heavy lifting, painting, carpentry, computer mouse usage, gardening or playing the drums.

Symptoms can range from mild to severe, including tenderness or pain in the elbow, increased pain with wrist use or debilitating pain while at rest. With proper observation and care, including bracing and physical therapy, 90 percent of cases will resolve on their own within a year.

Take a deeper look

Rather than putting tennis elbow in the sports injury category, think of it as wrist overuse.

The good news for young people: Diagnosis is rare. Some people may experience a traumatic injury that causes a pull or tear in the tendon, but the majority of cases build up over time.

Most tennis elbow diagnoses occur between the ages of 45 to 65. As you age and activity levels decrease, you lose muscle mass and mobility. In turn, this can increase the risk of overexertion of the wrist during a quick movement.

Additionally, some conditions may present with similar symptoms as tennis elbow, including elbow instability, arthritis or radial tunnel syndrome (a compression of the nerves in the forearm). Take note of when and how your pain or discomfort presents and review those symptoms with your doctor or other health care provider.

When to seek care

The key to treating tennis elbow is patience.

If you haven’t experienced a traumatic injury and aren’t concerned about other potential injuries, doctors recommend starting with over-the-counter pain relievers, a wrist brace and heat/ice for at least six weeks.

If after six weeks you’re seeing little improvement, schedule an appointment with your primary care provider for an evaluation. Your provider may recommend a different brace, such a counterforce brace, which wraps around the arm just below the elbow. Physical therapy may also be recommended.

Be cautious of quick-fix treatments. Steroid shots may provide immediate, short-term improvement for pain, but studies show the pain is often worse when it does return. Soft-tissue atrophy could also interfere with the healing process.

While some cases require surgery to repair, experts recommend trying bracing and therapy for at least one year. If symptoms persist, then surgery can be explored.

Medical review provided by Benjamin Welling, MD, orthopedic and hand surgeon, MultiCare Integrated Sports Medicine. Note: This information does not qualify as individualized medical advice. Please schedule an appointment with your care team to ensure the most appropriate care.