Tennis elbow is a common over use injury of upper limbs that leads to acute or chronic inflammation of lateral epicondyle . The usual complain is pain in gripping and in moving heavy objects and exacerbated with wrist extension and on examination there are tenderness and pain is increased with wrist extension against resistance .Nonoperative treatment is successful in over 90% of patients; heat or ice is helpful in relieving tennis elbow pain. Once acute symptoms have subsided, heat treatment is used to increase blood circulation and promote healing ,in the form of ultrasound ,elbow strap ,stretching exercises ,NSAIDs and corticosteroid injection . Resisted tennis elbow to non operative treatment is indicated to operative treatment .