Article Text

Original research
Lived experience of people with lateral elbow tendinopathy: a qualitative study from the OPTimisE pilot and feasibility trial
  1. Marcus Bateman1,
  2. Jonathan C Hill2,
  3. Karin Cooper3,
  4. Chris Littlewood4,
  5. Benjamin Saunders2
  1. 1Derby Shoulder Unit, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
  2. 2School of Medicine, Keele University, Keele, UK
  3. 3Patient Representative, Derby, UK
  4. 4Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
  1. Correspondence to Mr Marcus Bateman; marcus.bateman{at}


Objectives To explore the lived experience of people with lateral elbow tendinopathy (LET) and its impact on everyday life.

Design Qualitative semi-structured interviews, analysed using thematic analysis.

Setting Conducted as part of the mixed-methods OPTimisE pilot and feasibility randomised controlled trial of outpatient physiotherapy patients in the UK.

Participants 17 participants with LET, purposively sampled from the trial to provide representativeness based on age, sex, ethnicity, deprivation index and treatment allocation.

Results Four themes were identified from the participants’ responses: (1) cause of onset—typically symptoms were attributed to: sudden changes in activity, repetitive work or compensating for other musculoskeletal conditions; (2) impact on everyday life—which included substantial impacts on quality-of-life, particularly due to pain disturbing sleep and difficulties performing daily tasks (related to work and hobbies) due to pain, although most reported being able to persevere with work; (3) self-help and understanding of the condition—with uncertainty about the appropriateness and potential harm of online advice and confusion from the diagnostic term ‘Tennis Elbow’ that non-sporting individuals struggled to relate to; (4) healthcare experiences—the treatments received were highly variable and often perceived as ineffectual.

Conclusions For the first time, the lived experience of people from a range of backgrounds suffering from LET has been explored. Findings suggest that people frequently related the cause to a specific activity. They reported substantial impacts on daily tasks, sleep, work and hobbies. People also reported hesitancy to trust online information without formal healthcare advice, were confused by the common label of ‘Tennis Elbow’, and perceived the wide array of healthcare treatment options they had received to offer false hope and be largely ineffective. This study provides stimulus for clinicians to consider the advice and treatment provided, and whether the messages conveyed reflect the favourable natural history of the condition.

Trial registration number ISRCTN64444585

  • Elbow & shoulder
  • Musculoskeletal disorders
  • Tennis Elbow
  • Elbow Tendinopathy

Data availability statement

Data are available upon reasonable request. A copy of the codebook is available on written request.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

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Data availability statement

Data are available upon reasonable request. A copy of the codebook is available on written request.

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  • Twitter @MarcusBatemanPT, @BSaunders30

  • Contributors MB conducted the interviews and the transcript coding, with mentorship from BS. MB produced the initial codebook before MB, BS, KC and JCH collectively finalised the codebook and interpreted the themes. MB, BS, KC, CL and JCH contributed to this final written report. MB was responsible for the overall content as the guarantor.

  • Funding Marcus Bateman is funded by a National Institute for Health Research (NIHR) Chartered Society of Physiotherapy Charitable Trust Doctoral Fellowship (reference NIHR300704).

  • Disclaimer This paper presents independent research funded by the National Institute for Health Research (NIHR) and Chartered Society of Physiotherapy Charitable Trust. The views expressed are those of the author(s) and not necessarily those of Chartered Society of Physiotherapy Charitable Trust, the NHS, the NIHR or the Department of Health and Social Care.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.