Musicians and Lateral Epicondylitis (“Tennis Elbow”): What You Need to Know

How do you get tennis elbow if you don’t play tennis? For many instrumentalists, long hours of practice can take a toll on the body—particularly the arms and elbows. One common overuse injury seen among musicians is lateral epicondylitis, more widely known as “tennis elbow.”

While the name may suggest this is only an athlete’s problem, musicians are actually at higher risk due to the repetitive, precise, and often awkward movements required by their instruments.

What Is Lateral Epicondylitis?

Lateral epicondylitis is an overuse injury affecting the tendons that attach to the lateral epicondyle, the bony bump on the outer part of the elbow. These tendons, especially the extensor carpi radialis brevis, are responsible for stabilizing and extending the wrist.

When they are stressed repeatedly without adequate recovery, tiny tears and inflammation can develop, leading to pain and weakness.

Symptoms and Presentation in Musicians

* Pain or burning on the outside of the elbow.
* Weak grip strength (trouble holding bows, sticks, or frets).
* Pain when lifting, gripping, or twisting (like turning a doorknob or opening a jar).
* Symptoms worsened by practice sessions but may linger during everyday activities.
* Gradual onset often starting as mild discomfort and progressing if ignored.

Why Musicians Are Vulnerable

Certain instruments and playing postures put unique strain on the forearm and elbow:

* String players (violin, viola, guitar, bass): Repeated finger flexion and wrist extension for fretting and bowing.
* Pianists: Continuous wrist extension and finger flexion across wide ranges of motion.
* Drummers and percussionists: High repetition and shock forces with sticks, mallets, or hand percussion.
* Wind players: Supporting the instrument’s weight with one arm while adjusting fine finger movements with the other.

Combine this with long practice hours, limited breaks, and sometimes poor ergonomic setup, and it creates the perfect storm for overuse injury.

Other Contributing Causes (Outside of Music)

Musicians may unknowingly aggravate their condition with activities beyond the practice room:

* Typing or computer mouse use with extended wrists
* Heavy lifting or repetitive gripping (gym workouts, carrying groceries, yardwork)
* Smartphone or tablet overuse
* Recreational activities like tennis, golf, or racquetball
* DIY work: painting, carpentry, home repairs

These repetitive strain activities can **slow recovery and prolong symptoms** if not addressed.

 Prevention for Musicians

* **Ergonomics and posture:** Ensure instruments, chairs, and stands are set up to reduce strain.
* **Warm-ups:** Gentle stretches and mobility drills for the forearm, wrist, and shoulders before practice.
* **Scheduled breaks:** Short, frequent breaks reduce cumulative tendon stress.
* **Strengthening:** Targeted exercises for the forearm extensors, rotator cuff, and postural muscles.
* **Technique review:** Small changes in hand position, bow hold, or grip can reduce overloading.

 Chiropractic and Physiotherapy Solutions

When injury does occur, care from a doctor of chiropractic astute in physiotherapy can make a significant difference – without the use of drugs, injections or surgery.

* Manual therapy: Adjustments and mobilizations can restore joint alignment and improve nerve and blood flow.
* Soft tissue techniques: Myofascial release, Graston/IASTM, and trigger point therapy reduce tension in forearm muscles.
* Rehabilitation exercises: Eccentric loading programs for the wrist extensors are evidence-based and effective.
* Neuromuscular re-education: Helping musicians relearn healthier playing movements.
* Modalities: Ultrasound, laser therapy, and electrical stimulation may help reduce inflammation and pain.
* Education: Guidance on ergonomics, instrument setup, and self-care strategies.

The Musician’s Path to Recovery

Musicians are often tempted to “push through” pain to keep practicing or performing. Unfortunately, ignoring the early warning signs of lateral epicondylitis often makes the injury worse—and recovery longer.

By learning to listen to the body’s signals, addressing contributing lifestyle factors, and seeking care through chiropractic and physical therapy, musicians can not only heal from tennis elbow, but also develop better habits to prevent recurrence.

 

Music demands discipline, repetition, and passion—but your body needs balance, recovery, and smart care. If you’re experiencing pain on the outside of your elbow that worsens with playing or daily tasks, don’t ignore it. With the right approach, you can protect your game and continue playing for years to come—free of the limitations of injury.

 

Dr. Lou Jacobs, Chiropractor and acupuncturist in Portland, Maine, has been working with and specializing in the health and performance of musicians of all types, for over 23 years. His work has been highlighted in Guitar Player Magazine, and his client list is extensive. Dr. Lou is always accepting new patients and offers tele-consulting for musicians outside of Southern Maine. Dr. Lou also works with families and is board certified in chiropractic care for children and  pregnant moms. Dr. Lou may be reached by calling (207) 774-6251 or by messaging his office manager, Sandra Escobar, at Sandra@DrLouJacobs.com.

***Note: Dr. Lou did not work with Benjamin Tod & The Lost Dog Street Band. This picture was taken at the pre-show as their appointment to work together fell through due to lack of time on the day of the concert. The band was kind enough to do a meet and greet that included Dr. Lou.

……………

All information, content, and material of this video or website is for informational and demonstration purposes only. It is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.

Don’t use this content as a replacement for treatment and advice given by your doctor or health care provider. Consult with your doctor or healthcare professional before doing anything contained in this content.

By watching this video, or using any of Dr. Lou’s content, you agree to indemnify and hold harmless Jacobs Chiropractic Acupuncture (and its representatives), Dr. Lou Jacobs for any and all losses, injuries, or damages resulting from any and all claims that arise from your use or misuse of this content. Jacobs Chiropractic Acupuncture and Dr. Lou Jacobs make no representations about the accuracy or suitability of this content.

USE OF THIS CONTENT IS AT YOUR OWN RISK.

With regard to supplements:

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.