Tennis & Golfer's Elbow Treatment

Tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis) are overuse injuries affecting the tendons that attach forearm muscles to the elbow. Despite their names, these conditions are far more common in non-athletes — they frequently affect people who type, use tools, cook, garden, or perform any repetitive gripping activity.

Common symptoms include:

• Pain on the outside of the elbow (tennis elbow) — worsened by gripping, turning doorknobs, shaking hands, or lifting with the palm facing down
• Pain on the inside of the elbow (golfer’s elbow) — aggravated by gripping, carrying heavy bags, or activities involving wrist flexion
• Weak grip strength — difficulty holding a coffee mug, opening jars, or carrying groceries without pain
• Pain that extends into the forearm — aching or burning that radiates from the elbow toward the wrist during use
• Stiffness in the morning — the elbow feels tight and painful first thing in the morning or after rest periods

Both conditions result from degenerative changes in the tendon (tendinopathy) rather than acute inflammation, which is why rest alone and anti-inflammatory treatments often fail to resolve them long term. Physical therapy — particularly progressive tendon loading programs — is the most effective treatment and is supported by strong research evidence.

Modern evidence has shifted treatment away from rest and anti-inflammatories toward active rehabilitation that rebuilds the tendon’s capacity to handle load. Our approach at The Back Clinic targets the underlying tendon degeneration and the mechanical factors that contributed to the overload.

Your individualized plan may include:

• Progressive tendon loading — carefully dosed eccentric and isometric exercises that stimulate tendon healing and adaptation, the cornerstone of evidence-based tendinopathy treatment
• manual therapy — soft tissue mobilization of the forearm muscles and joint mobilization of the elbow, wrist, and cervical spine to address contributing restrictions
• Grip and wrist strengthening — rebuilding functional strength in the forearm muscles so they can handle your daily demands without overloading the tendon
• Activity modification — ergonomic adjustments for your workstation, technique changes for sports or hobbies, and strategies to reduce tendon stress during daily tasks
• Bracing guidance — proper use and positioning of counterforce bracing to reduce tendon load during aggravating activities
• Cervical spine screening — evaluating whether the neck is contributing to elbow symptoms, since nerve irritation from the cervical spine can mimic or worsen lateral elbow pain

Every session at The Back Clinic is one-on-one with a licensed physical therapist. This hands-on model ensures your loading program is progressed at the right pace, your technique is correct, and your plan is adjusted based on how your tendon responds week to week.

Your evaluation assesses grip strength, tendon sensitivity, cervical spine contribution, and the specific activities driving your symptoms. We also evaluate wrist and elbow joint mobility, forearm muscle flexibility, and shoulder mechanics to identify all contributing factors. Wear comfortable clothing that allows access to your arm from shoulder to wrist.

Tendon rehabilitation takes patience — tendons heal more slowly than muscles. Most patients begin noticing pain reduction within three to four weeks of consistent progressive loading, but full recovery typically takes eight to twelve weeks. Your therapist will explain the science behind the program and help you understand why progressive exercise is more effective than rest for tendon conditions.

The home exercise component is critical for tendon healing. We provide specific loading exercises with clear instructions on sets, repetitions, and progression criteria so you can continue building tendon capacity between visits. Many patients find that once they understand the loading approach, they are empowered to manage their condition long term.

We accept most major insurance plans, including Medicare and Medicare Advantage. In Delaware, you do not need a physician referral to begin physical therapy. Our front desk team can verify your benefits before your first appointment. Call (302) 998-7681 or use our online scheduling tool to get started.