Treatment for Golfers and Tennis Elbow

Tennis elbow, medically known as lateral epicondylitis, is an overuse injury from repetitive activities. This condition primarily causes pain where the forearm muscles' tendons attach to the bony bump outside the elbow.

A similar condition affecting the inner side of the elbow is called medial epicondylitis, commonly known as a golfer’s elbow. Tennis elbow and golfer’s elbow are the leading causes of elbow pain, affecting up to 3% of adults annually. These conditions are more prevalent in the dominant arm.

While athletes are commonly associated with these conditions, many people who engage in work or recreational activities involving repetitive and vigorous use of the forearm muscles or repetitive wrist and hand extension can also develop tennis or golfer’s elbow. These conditions are prevalent in both men and women aged 35-50, particularly those involved in tasks requiring repetitive gripping or lifting.

Common Causes of Tennis Elbow:

Repeated hand motions in various occupations (e.g., butchers, musicians, dentists, auto workers, and carpenters)
Frequent use of hand tools
Extensive use of a computer mouse
Painting with a brush
Driving screws

Common Symptoms Include Pain and Weakness When:

Shaking hands or gripping an object
Turning a doorknob
Holding a coffee cup

How is tennis elbow diagnosed?

Diagnosis is made clinically with tenderness over the lateral epicondyle, which is worse with resisted wrist extension and hand clenching.

Do I need a scan:

Not every patient will need a diagnostic ultrasound before starting treatment. Your physiotherapist will take a detailed history and perform a thorough physical examination to decide the best course of action and whether imaging is necessary.

If you would like to book an appointment including an ultrasound scan, please ensure you inform us when booking.

Treatment for Tennis and Golfer’s Elbow:

For individuals dealing with tennis or golfer's elbow, the initial treatment typically involves a combination of relative rest from activities that trigger symptoms, the use of an offloading strap during repetitive movements, and a course of physiotherapy. The primary objective of physiotherapy is to encourage the tendon to heal naturally, without causing additional harm.

Physiotherapy for tennis and golfer’s elbow focuses on soft tissue mobilization and targeted exercises. Key exercises include controlled stretches and progressive loading through eccentric movements, which are designed to strengthen the affected tendon and support recovery.

For more information on tendon and soft tissue healing, please refer to the following resources:

Advanced Treatment for Tennis Elbow: Shockwave Therapy

If you do not see improvement with initial treatments, the next step may be a course of shockwave therapy. Evidence supports our clinical experience that shockwave therapy, combined with a structured rehabilitation program, is the most effective approach for treating chronic tennis and golfer’s elbow.

Steroid injection for Tennis and Golfer’s Elbow

Very occasionally for persistent symptoms which are not improving, you may be offered a low-dose steroid injection into the painful area. This is sometimes referred to as a cortisone injection. The purpose of this injection is to settle down any inflammation in your tendon.

To achieve the best results and ensure accuracy the injection procedure should be done under the guidance of a real-time ultrasound scan. Research has shown that guided injections are more effective at reducing pain than non-guided injections.

You must start physiotherapy straight away after an injection.

Injection should not be performed at an early, acute stage (up to 12 weeks) due to the risk of symptoms recurrence and chronicity.