Why tennis elbow keeps showing up

Read Time: 3 minutes
Time to Perform Exercises: 5 minutes

Hey there!

Ever wonder why tennis elbow keeps showing up, even after you rest it, stretch it, or try to be careful?

Tennis elbow usually isn’t just about the elbow itself, and it doesn’t just happen to tennis players.

It’s about where stress is landing and what’s not doing its job upstream.

Let’s break that down.

What’s not doing its job

When tennis elbow shows up, I’m usually looking at two things.

1. The elbow tendon
The tendon on the outside of the elbow anchors the wrist extensor muscles (this is where the pain is coming from).

These muscles are responsible for:

• Lifting the wrist

• Stabilizing your grip

• Controlling the fingers during lifting, typing, and gripping

When these tendons take on more load than they can handle, they become irritated and sensitive.

This is the part most people treat and it does matter, but it’s not the only thing to pay attention to.

2. A common missing piece: shoulder stability 
The shoulder plays a major role in how force moves through your arm.

When the shoulder isn't strong or stable enough, the forearm has to work harder to control the hand.

That extra demand often shows up at the elbow.

This is one of the most common compensation patterns I see in practice.
Not everyone compensates in the exact same way, but this is a frequent one.

This pattern is one of the main reasons tennis elbow keeps coming back.

Two places I often start

These aren’t a complete solution.
They’re two pieces that often help calm symptoms and reduce the compensation that keeps this going.

Remember, a full plan also builds mobility, stability, and tissue quality in the elbow and nearby joints, while progressing them over time.

But this is a good starting point for most and can bring some immediate relief.

1. Wrist extension isometrics (to calm the tendon)

This is a simple way to help the irritated tendon handle load again.

How to do it:

• Pull your fingers and wrist back as far as you comfortably can using the extensor muscles

• Hold that position without letting the wrist move

• Aim for 3 sets of 30 seconds

• If that feels like too much at first, work up to it over time

• Keep pain at 3 out of 10 or less

I also like to use a quick before-and-after test (for example, gripping or lifting something light) to see how the tendon responds.

Done consistently, this helps the tendon tolerate more load over time without aggravating symptoms.

2. Shoulder external rotation (to reduce repeat stress)

This exercise restores shoulder stability so the elbow doesn’t keep compensating.

How to do it:

• Sit or stand tall with elbows at your sides

• Hold a light band and rotate your forearms outward

• Pause, then return slowly

This strengthens the rotator cuff and reduces stress on the elbow.

Here’s a video of me demonstrating these exercises:

One important reminder

Sometimes the elbow tendon is the main issue. It’s irritated and needs the right kind of loading to calm down.

But if it keeps coming back, something else is likely adding stress.

If that sounds familiar, I’d love to help you figure it out together.
When you’re ready, we can hop on a short Clarity Call. It's a video call where we’ll:

• Talk through what’s been going on with your elbow

• Find what’s not doing its job

• Build a simple 2-week plan to help you start feeling better

No pressure. Just clarity and a clear next step when it feels right for you.

You can learn more or book your call here:

👉 Learn More About Clarity Calls

Talk soon,

Dr. Matt Moreno, D.C., C.C.S.P.®
The Move More Minute

Disclaimer: The information provided in this newsletter is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, chiropractor, or other qualified healthcare provider with any questions you may have regarding a medical condition or before starting any new exercise program.

The exercises and suggestions provided are general recommendations and may not be suitable for everyone. If you experience pain, discomfort, or any concerning symptoms while performing these exercises (such as numbness, dizziness, or increased pain), stop immediately and consult a qualified healthcare professional.

Do not disregard professional medical advice or delay seeking it because of something you have read in this newsletter. The author, Move More Minute, and its affiliates assume no responsibility for injuries or issues that may arise from following the recommendations provided. By engaging with this content, you agree to do so at your own risk.

For personalized care or specific advice, please schedule an appointment with a qualified professional.