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Tennis Elbow and Golfer's Elbow Physiotherapy

Tennis elbow and golfer's elbow are among the most common causes of elbow pain and despite their names, most people who develop them have never played either sport. Both are tendon overload conditions that respond well to physiotherapy, particularly when addressed before the tendon becomes significantly degenerated.

At InHealth Physiotherapy in Etobicoke, elbow conditions including lateral and medial epicondylalgia are assessed and treated by an experienced physiotherapy team.

Understanding Tennis Elbow and Golfer's Elbow

Both conditions involve overload of the tendons that attach at the elbow, but they affect different sides:

Tennis elbow (lateral epicondylalgia) affects the outer side of the elbow. It involves the tendons of the forearm muscles that extend the wrist and fingers, most commonly the extensor carpi radialis brevis (ECRB). It is aggravated by gripping, lifting, and repetitive wrist extension movements.

Golfer's elbow (medial epicondylalgia) affects the inner side of the elbow. It involves the tendons of the forearm muscles that flex the wrist and fingers. It is aggravated by gripping, wrist flexion, and throwing or swinging movements.

Common causes include:

  • Repetitive manual tasks at work, particularly gripping, lifting, or tool use

  • Racket sports, golf, climbing, and throwing sports

  • Keyboard and mouse overuse in desk workers

  • Sudden increase in activity load or a change in technique or equipment

The underlying problem in both conditions is tendinopathy- a breakdown in the normal structure and capacity of the tendon rather than simple inflammation, which is why rest alone often provides only temporary relief.

How InHealth Treats Tennis and Golfer's Elbow

Treatment at InHealth begins with a thorough assessment of the elbow, wrist, forearm, and shoulder because the load on the elbow is often influenced by what is happening above and below it. Your physiotherapist will evaluate tendon integrity, grip strength, range of motion, and the specific tasks and movements driving your symptoms.

Treatment may include:

  • Tendon loading exercises (eccentric and isometric loading) : the most evidence-supported approach for tendinopathy; structured loading programs that stimulate the tendon to rebuild its capacity

  • Manual therapy: soft tissue work and joint mobilization of the elbow, wrist, and cervical spine where contributing factors are identified

  • Shockwave Therapy: an effective option for persistent or treatment-resistant lateral and medial epicondylalgia; a course of shockwave can significantly reduce pain and support tendon recovery

  • Acupuncture: to support pain relief and reduce local tissue irritation

  • Interferential Current (IFC) and TENS: for symptom management in the acute phase

  • Bracing and activity modification guidance: counterforce bracing and specific load management strategies to reduce pain during daily tasks while rehabilitation progresses

  • Ergonomic and technique review: identifying and correcting the contributing factors in your work or sport

Tendinopathy responds to load, not rest. Your physiotherapist will guide you on what to avoid versus what to keep doing — and how to progress the loading program safely over time.

Shockwave Therapy for Stubborn Elbow Pain

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If you have been dealing with tennis elbow or golfer's elbow for more than three months and standard stretching, bracing, or prior physiotherapy has not resolved it - Shockwave Therapy is worth discussing. Shockwave delivers focused acoustic energy to the tendon, supporting a healing response in chronically overloaded tissue. It is one of the better-evidenced options for persistent elbow tendinopathy and is available at InHealth.

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