Common symptoms
- Pain on the outer elbow (inner for golfer’s elbow)
- Pain when gripping, lifting or twisting
- Weaker grip with jars, kettles or door handles
- Tenderness over the bony point of the elbow
- Ache spreading into the forearm
- Stiffness in the elbow first thing in the morning
Tennis elbow causes pain on the outside of the elbow that flares whenever you grip, lift or twist, from carrying a full kettle to turning a door handle. Despite the name, most people who get it have never picked up a racket. Golfer’s elbow is its mirror image, affecting the inside of the elbow.
Both are tendon problems that tend to settle with time, but they can linger for months if the tendon keeps being overloaded. At Tylurs com, our physiotherapists help you ease the pain, change the habits that feed it and rebuild the strength your tendon needs to cope with work, hobbies and sport.
Tennis elbow and golfer’s elbow: what is the difference?
Both conditions affect the tendons that anchor your forearm muscles to the bony points on either side of the elbow. They are forms of tendinopathy, meaning a tendon that has been asked to do more than it can currently tolerate.
| Tennis elbow | Golfer’s elbow | |
|---|---|---|
| Medical name | Lateral elbow tendinopathy (lateral epicondylitis) | Medial elbow tendinopathy (medial epicondylitis) |
| Where it hurts | Outer elbow, sometimes down the back of the forearm | Inner elbow, sometimes down the inner forearm |
| Muscles involved | Those that pull the wrist and fingers back | Those that bend the wrist and fingers and turn the palm down |
| Typical triggers | Gripping with the palm down, lifting with the wrist cocked back, using a mouse or screwdriver | Forceful gripping and wrist bending, throwing, golf swings |
Older names end in “-itis”, suggesting inflammation, but the main issue is usually a tendon that has become less able to tolerate load. That is why treatment focuses on rebuilding tendon strength rather than only calming inflammation. Tennis elbow is the more common of the two.
What causes tennis elbow?
The NHS describes tennis elbow as developing from activities that involve gripping and repeatedly twisting the wrist and forearm. It is more common between the ages of about 35 and 54. Typical triggers include:
- long hours with a mouse and keyboard, especially with the wrist bent back
- manual trades such as plastering, carpentry, painting and electrical work
- gardening, pruning, DIY and heavy lifting at home
- racket sports, particularly with a one-handed backhand or the wrong grip size
- playing an instrument, or repeatedly carrying heavy bags
Often it is not one activity but a sudden change, such as a busy week decorating, a new job or extra matches, on top of your usual load. Golfer’s elbow follows the same pattern with gripping and wrist-bending tasks, including throwing sports and weight training.
Symptoms of tennis elbow and golfer’s elbow
The main symptom is pain and tenderness on the bony point on the outside of the elbow (or the inside, for golfer’s elbow). You may also notice:
- pain when gripping, shaking hands, lifting a cup or turning a key
- an ache spreading into the forearm, sometimes worse at night
- a weaker grip, making jars and heavy pans harder to manage
- stiffness in the morning, or difficulty fully straightening the arm
Tingling or numbness in the fingers is not typical of tendon pain. It can point to an irritated nerve at the elbow or in the neck, so tell your physiotherapist or GP about it. Arm pain can also come from the neck, and pain higher up around the shoulder may suggest a different problem such as frozen shoulder.
How we assess your elbow
Diagnosis is usually made from your history and a clinical examination, so most people do not need a scan. At your first appointment, we ask about your work, hobbies, sport and any recent changes in how much you use your arm. We then:
- press gently on the tendon attachment to find the exact sore spot
- test gripping and resisted wrist and finger movements, which typically reproduce the pain
- measure grip strength on both sides, giving us a baseline to track progress
- check your neck, shoulder and wrist to rule out other sources of arm pain
- look at how you perform the tasks that bother you most
This tells us how irritable the tendon is, and that decides where your exercise programme starts.
How long does it take to recover?
Most cases improve, but patience is needed. The NHS notes that tennis elbow may take a few weeks to settle but can sometimes last more than a year. Arthritis UK says both conditions can last between six months and two years, with most people better within a year, and that they can come back.
The NHS suggests seeing a GP if pain continues after at least two weeks of rest and self-care, and physiotherapy may be recommended if home treatment has not helped after about six weeks. Because tendons adapt slowly, it is worth starting a structured plan rather than waiting to see whether the pain fades on its own.
Physiotherapy for tennis elbow
Treatment has two goals: settle the pain enough for you to function, then build a tendon that can handle your daily demands again. Most programmes combine the elements below.
Load management
We start by identifying the tasks that load the sore tendon most and finding ways to reduce them without stopping everything. Practical examples include lifting with your palm facing up, using two hands for heavy items, switching hands for repetitive jobs and spreading tough tasks across the week. A simple rule helps: activity that causes mild discomfort which settles by the next morning is usually fine, while pain that builds day by day means the load needs adjusting.
Progressive loading exercises
Exercise is the core of tendon rehabilitation, and it is progressed in stages:
- Isometric holds. You hold the wrist still while pressing gently against resistance, often for 30 to 45 seconds. For some people these ease pain in the short term and are a comfortable starting point.
- Slow, heavy strengthening. Using a light dumbbell or resistance band, you slowly lift and lower the wrist, with extra emphasis on the lowering (eccentric) phase. Heavy slow resistance training means gradually increasing the weight while keeping each movement slow and controlled.
- Grip and rotation. Squeezing exercises and turning the forearm with a light hammer or weighted bar build strength for real tasks.
- Function and sport. Finally, we add movements that mimic your job, hobby or sport at full speed.
We also strengthen the shoulder and upper back, because a stronger chain above the elbow reduces the demand on the forearm.
Physio tip: Tendons adapt slowly. Expect to do your exercises for at least 12 weeks, and judge progress over weeks rather than individual days.
Grip, technique and workstation changes
Small adjustments often make a large difference. Tools with thicker handles reduce grip effort, and a coach can check your racket grip size, string tension and backhand technique. At a desk, keep your mouse close and your forearm supported. Our guide to posture-related pain and our desk stretches for office workers cover the wider set-up.
Straps and hands-on treatment
A counterforce strap worn just below the elbow can reduce pain during aggravating tasks in the short term. Manual therapy, such as soft tissue techniques and elbow or wrist mobilisation, may also ease pain so you can exercise more comfortably. Neither replaces strengthening. Ice or heat can ease flare-ups; our article on ice or heat for injury explains which to choose.
Injections and other treatments for tennis elbow
If symptoms persist despite a good programme, your GP or a specialist may discuss other options:
- Steroid injections can reduce pain for a few weeks, but they are generally not recommended because of evidence that results can be worse in the longer term, with a higher chance of the pain returning. Arthritis UK advises against them for tennis and golfer’s elbow.
- Platelet-rich plasma (PRP) injections use a concentrate made from your own blood. The evidence is still developing and the treatment is not available at every hospital, so it is not a routine option.
- Shockwave therapy is sometimes offered for stubborn cases alongside exercise, although the evidence for it is mixed.
- Surgery is only needed for a small number of people. The NHS notes it may be considered if symptoms have not improved after 6 to 12 months.
If you play sport and want to return quickly, our sports injury rehabilitation service builds your programme around training and fixtures.
When to seek urgent medical help
Most elbow tendon pain can be managed with physiotherapy, but seek medical help if you notice:
- Sudden swelling, bruising or deformity after a fall or injury, or you cannot bend or straighten the elbow. Get urgent medical care, as this may be a fracture, a dislocation or a ruptured tendon.
- A pop at the front of the elbow when lifting, followed by bruising and weakness turning the palm up. This can be a torn biceps tendon, which needs prompt assessment.
- A hot, red, swollen elbow, or a high temperature and feeling unwell. This can be a sign of infection and needs same-day medical advice.
- Numbness, tingling or weakness in your hand or fingers. See your GP, as a nerve may be involved. If it comes on suddenly with facial drooping, speech problems or weakness on one side, call your local emergency number, as these are signs of a stroke.
- Loss of movement or locking of the elbow that does not settle.
Book tennis elbow physiotherapy at Tylurs com
You do not have to put up with a painful grip for months. At Tylurs com, we pinpoint what is overloading your tendon, adapt your work and hobbies to give it breathing space, and progress your exercises step by step until your arm feels strong and reliable again.
Book your elbow assessment and get a clear plan to settle your pain.
This page is for general information and does not replace a personal assessment. If you have severe, sudden or worsening symptoms, seek medical advice promptly.