7 min
Most people with "tennis elbow" have never stepped on a court with a tennis racket in hand.
But for those of you who have experienced a nagging ache on the outside of your elbow after a weekend of gardening, assembling an IKEA cabinet, or one too many biceps curls in the gym, you may already be dealing with lateral epicondylitis — better known as "tennis elbow."
Despite the sports-themed nicknames, most people who develop this condition don’t develop this problem because of too much time playing sports. What is more common is the repetitive strain of daily activities (think typing and texting) on the tendons that attach the forearm muscles to the elbow.
If you want to solve this specific problem, you need to understand what exactly is going on and what science says is the best way to treat it.
It's Not "Inflammation" in the Way You'd Think
For decades, these diagnoses were treated as an inflammatory process, hence the "-itis." But research over the past twenty years has shown that chronically painful tendons typically show degeneration of the collagen fibers in the tendon rather than red-hot inflammation. That's why clinicians now use the term “tendinopathy”.
This matters more than you would assume. Treatments aimed purely at reducing inflammation, like long-term anti-inflammatory use, are often less effective compared to treatments that support the tendon's actual healing. If you're treating the wrong problem, you get the wrong result.
What Causes It
The tendons at the elbow take a beating from repetitive gripping, wrist extension, or forearm rotation — think keyboard use, manual labor, weightlifting, racquet sports, or even repetitive phone scrolling. Over time, these small cumulative stresses can overwhelm the tendon's ability to repair itself, leading to microscopic tears in the tissue.
In other words, it's rarely one dramatic injury. It's the slow accumulation of load your tendon couldn't keep up with.
What Actually Works
Relative rest — not total rest
Complete immobilization can actually weaken tendon tissue further. The current consensus favors modifying the activities that aggravate your elbow rather than eliminating movement altogether. The tendon needs some load to heal — just not the load that's overwhelming it.
Eccentric and isometric loading exercises
This is where the real healing happens. Eccentric exercises — where the muscle lengthens under tension, like slowly lowering a light weight — stimulate tendon remodeling. Isometric holds (pushing against a fixed resistance without movement) are often used early on for pain relief before progressing to eccentric work.
A graded program done consistently over 8–12 weeks has been shown to produce measurable improvement in most studies. The key words are graded and consistent — the right load, at the right stage, progressed over time. Too much too soon flares it; too little does nothing. Getting that progression right is a large part of what we do.
Looking upstream and downstream
The most common ways of treating tennis elbow often miss the contribution of the cervical spine (neck) and shoulder to this problem. Our daily lives involve a mountain of screen time and computer work, which can lead to poor posture and muscle imbalances that place more strain on the neck and shoulder. An unstable shoulder or neck demands more from the tissues of neighboring joints, and ignoring a problem in either of these areas leaves you at higher risk for the problem coming right back.
Soft tissue techniques
There are a number of affordable tools that can help desensitize irritable tissue, improve mobility around the joint, and support a healing environment — often with immediate pain relief. A few of our favorites: a lacrosse ball, floss bands, and even a common kitchen spoon.
A word of caution, though: these tools work when they're applied to the right tissue, with the right pressure, at the right stage of healing. In untrained hands, they just as easily irritate the tendon further or get used in a way that does nothing at all. This is one of the areas where we coach you directly — what to use, where, how much, and when — so you're helping the tendon instead of aggravating it.
Counterforce bracing
A forearm strap-style brace worn just below the elbow can reduce strain on the tendon during activity. The evidence is mixed when it comes to using braces for long-term healing, but many people find it useful for symptom control in the early stages of rehab while working through a progressive exercise program. Placement matters with these braces, and we coach our clients how and when to use these braces in the most effective way.
6. Addressing your form
If you carry anything in your hands during the day, you're gripping — and that doesn't just mean dumbbells. An oversized water bottle, your phone, a toddler on your hip, a backpack. How you manage these challenges for the upper body contributes to or counteracts your body’s ability to heal from tennis elbow. These are the small mechanical details that add up, and they're exactly the kind of thing our team coaches you through.
Medical and Adjunct Options
Ice: Helpful for symptom relief, not for "curing" anything. It can ease pain, especially after activity, but won't resolve the underlying tendon changes on its own.
NSAIDs: Over-the-counter anti-inflammatories can help with short-term pain, but since the underlying problem isn't primarily inflammatory, they're a symptom-management tool rather than a treatment for the tendon itself. Extended daily use should be discussed with a physician.
Corticosteroid injections: These often provide fast relief, which makes them tempting. However, several studies have found worse outcomes at the 6–12 month mark compared to physical therapy alone, possibly because steroids can further weaken tendon tissue. Based on the current evidence, we believe this option is fine in the short term but not a great long-term solution.
PRP and shockwave therapy: Platelet-rich plasma (PRP) injections and shockwave therapy have both been studied for chronic, stubborn cases that haven't responded to several months of conservative treatment. Again, the evidence on these treatments is mixed as a long-term or lasting solution.
When to See a Professional
Most mild cases of tennis elbow improve with consistent conservative management over a period of months; tendon healing is a slow process, ranging from 6 weeks up to a year in severe cases. That said, it's worth scheduling an evaluation with a physical therapist, athletic trainer, or sports medicine physician if:
Pain persists beyond 6–8 weeks despite rest and activity modification
You notice weakness in your grip strength
Pain is severe enough to limit basic daily tasks
Symptoms keep recurring despite treatment
The Bottom Line
Elbow tendinopathy responds best to a combination of smart activity modification and progressive loading exercises — not to waiting it out passively or chasing quick fixes. It often takes three to six months of consistent work, but the research is genuinely encouraging: most people get back to full function without surgery.
If elbow pain is sticking around, the best first step isn't a Google rabbit hole — it's a conversation with a physical therapist who can assess your specific movement patterns and build a plan around them.
Dealing with elbow pain that won't quit? Schedule a free 15-minute phone consultation with Restore Thrive — we'll talk through what you're dealing with and whether we're the right fit.
Book a free 15-minute phone call →
Frequently Asked Questions
Is tennis elbow actually caused by inflammation?
Not in the way the name suggests. Despite the "-itis" ending, research over the past two decades shows that chronically painful elbow tendons usually show degeneration of the collagen fibers in the tendon rather than classic inflammation. That's why clinicians now call it tendinopathy — and why treatments aimed only at reducing inflammation often fall short compared to progressive loading that supports the tendon's structural healing.
Should I rest my elbow completely until it stops hurting?
No. Complete rest can actually weaken the tendon further. The better approach is "relative rest" — modifying the activities that aggravate your elbow while keeping the tendon gently loaded, because it needs some load to heal. The goal is to reduce the overload in the tendon, not eliminating all of the stress on the tendon
How long does tennis elbow take to heal?
Tendon healing is slow. Mild cases often improve over 6 weeks, but a full recovery can take anywhere from three to six months of consistent work, and sometimes up to a year. The encouraging news is that most people return to full function without surgery when they follow a graded loading program.
Do cortisone shots work for tennis elbow?
They can provide fast, short-term relief, but the long-term picture is mixed. Several studies have found worse outcomes at the 6–12 month mark compared to physical therapy alone, possibly because corticosteroids can further weaken tendon tissue. They're sometimes reasonable for managing a severe flare, but they generally aren't a first-line, long-term solution.
Do I need a referral to see a physical therapist for elbow pain in Kansas?
No. Kansas is a direct-access state, so you can be evaluated and treated by a licensed physical therapist without a physician's referral. You can book directly with us.
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