Conditions
Elbow pain and injuries
Most elbow pain is a tendon that has been asked to do more than it was ready for — and most of it has nothing to do with tennis or golf. It is common, it is slow, and the things people reach for first (rest, braces, an injection) tend to help less than the thing that works: gradually asking the tendon to do more.
See a doctor first
Elbow pain with any of the following needs a physician or an emergency department before a therapy visit:
- Obvious deformity, or an elbow that will not straighten or bend after a fall
- A hot, red, swollen joint with fever
- Numbness or weakness in the hand that is getting worse
- Pain after a fall onto an outstretched arm that has not improved in a few days — some elbow fractures are easy to miss
- In a child: an elbow they will not move after a pull or a fall
What we see most
Elbow conditions we treat, and what therapy does for each.
Tennis elbow (lateral epicondylalgia)
Pain on the outside of the elbow that spreads down the forearm, worse gripping, lifting a kettle, or turning a door handle. Most common between 35 and 55, and far more often from work or hobbies than from tennis.
What therapy does: The evidence favors progressive loading of the wrist extensors — strengthening, not rest — combined with manual therapy and, where useful, a counterforce brace. Corticosteroid injections relieve pain for a few weeks but are associated with worse outcomes at one year than doing nothing, so we do not recommend them as a first step. Expect three to six months; it is slow, but it resolves.
Golfer's elbow (medial epicondylalgia)
The same problem on the inside of the elbow, affecting the tendons that flex the wrist and turn the palm down. Less common than tennis elbow and seen in throwers, climbers and manual workers.
What therapy does: Treated on the same principles: progressive loading of the wrist flexors and forearm, adjustment of the activity that provoked it, and a graded return. The ulnar nerve runs close by, so we check it at the first visit — tingling in the ring and little fingers changes the plan.
Elbow stiffness after fracture or surgery
The elbow stiffens faster than almost any other joint after injury or immobilization, and lost extension is hard to win back once it has settled in.
What therapy does: Early, frequent range-of-motion work within your surgeon's limits is what preserves movement, and it is the reason to start therapy as soon as you are cleared rather than waiting for the cast to come off. We restore movement first, then strength, then the specific demands of your work or sport.
Cubital tunnel syndrome (ulnar nerve)
Tingling and numbness in the ring and little fingers, worse with the elbow bent — on the phone, sleeping curled up — from the ulnar nerve being compressed at the elbow.
What therapy does: Mild cases often settle with activity modification, night positioning to keep the elbow straighter, and nerve-gliding exercises. Weakness in the hand or persistent numbness means the nerve is under more pressure than therapy can relieve, and we refer for a surgical opinion rather than treating on.
Youth throwing injuries
Inner-elbow pain in young baseball and softball players, from the growth plate or the ligament being overloaded by throwing volume.
What therapy does: In a growing athlete this is a load problem first, so the plan starts with pitch counts and rest, then shoulder and hip strength, throwing mechanics and a graded throwing program. Pain that persists despite rest needs imaging, and we say so early.
Do you need a scan first?
For tennis and golfer's elbow, no. The diagnosis is made by examination, and imaging does not change the initial plan. An X-ray is needed after a fall, and ultrasound or MRI only when a proper course of treatment has not moved things or the picture does not fit.
What treatment looks like
The first visit confirms which tendon or structure is involved, checks the nerves that pass the elbow, and looks upstream at the shoulder and neck — elbow pain that is really a neck problem is common enough to rule out every time.
Treatment for tendon pain is built around progressive loading: exercises that start below the level that provokes symptoms and build over weeks. Manual therapy, bracing and taping support that; they do not replace it. We also change the way you are doing the thing that caused it — grip size, tool weight, how you lift.
Tendon problems are measured in months. Most people are seen once a week for six to twelve weeks and continue the program at home well beyond that.
How we treat it
The services that apply.
Physical Therapy
Pain and movement problems treated without drugs or surgery. Offered at every clinic.
Learn moreHand Therapy
A separate specialty with its own certification, for the part of you that does the fine work.
Learn moreDry Needling
A thin-needle technique for tight muscle, used inside a wider plan — never on its own.
Learn more
FAQ
Common questions
- Should I get a cortisone injection for tennis elbow?
- Usually not as a first step. Injections relieve pain for a few weeks, but randomized trials show worse outcomes and more recurrences at one year compared with physical therapy or even doing nothing. Progressive loading is slower to work and more reliable.
- How long does tennis elbow take to heal?
- Typically three to six months with a consistent loading program, and most cases resolve within a year. Rest alone tends to bring the pain back as soon as activity resumes.
- Does a tennis elbow brace help?
- A counterforce brace worn just below the elbow can reduce pain during activity and is a reasonable addition to a strengthening program. On its own it does not fix the tendon.
- Which SportsCare clinics treat elbow pain?
- Orthopedic physical therapy for the elbow is offered at every SportsCare clinic. Hand therapy with a Certified Hand Therapist, which covers the elbow and forearm, is available at select clinics.
Sources
- Tennis Elbow (Lateral Epicondylitis) — OrthoInfo, American Academy of Orthopaedic Surgeons
- Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial — JAMA, 2013
- Golfer's elbow (medial epicondylitis) — symptoms and causes — Mayo Clinic
- Ulnar Nerve Entrapment at the Elbow (Cubital Tunnel Syndrome) — OrthoInfo, American Academy of Orthopaedic Surgeons
- Tennis elbow — NHS
This page is general information, not a diagnosis. A physical therapist at any SportsCare clinic can evaluate your specific situation.