While exactly what causes tennis elbow is unclear, there are a number of risk factors, including: Repetitive motion – Overuse of the elbow is a major contributing factor in the development of tennis elbow; Age – Most people who develop tennis elbow are between the ages of 30 and 50; Activities – Anyone who vigorously uses her or his forearm muscle on a regular basis is at greater risk for developing tennis elbow; Technique and equipment – Those who use improper tennis technique, or whose equipment is not appropriately sized for his or her body are at greater risk for tennis elbow.