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Elbow Tendon Pain

  • Method Health
  • Mar 3
  • 4 min read

Previously known as Tennis and Golfers elbow.

Clues or common symptoms? Pain only around the tendons on the inside or/and outside of the elbow where they attach to the elbow when gripping or lifting tasks or when the tendon is poked. Pain can spread around the elbow for those with persistent tendon pain. Other conditions with similar presenting symptoms, such as elbow osteoarthritis, a fracture, or ligament sprain, should be ruled out. Imaging is unnecessary for diagnosing tendon pain or helpful for reassurance unless imaging results are likely to change management, such as if we think it is not tendon pain but something that will need surgery. 



  • How common are both? Both affect about 1-3% of the population, and 40% will experience them throughout their lives. Both tendons on each side of the elbow can be sore at the same time. 

  • What is wrong? Simple: The tendons of your hand gripping and elbow bending muscles are sore, like a persistent headache for the elbow tendons. Structural changes that could be seen on imaging, such as “tears,” “degeneration,” swelling, or inflammation within the tendon, have never been consistently linked to pain or explain why someone's pain improves if reversed. We don’t have strong evidence for a known cause of tendon pain or what can explain why symptoms improve over time. 

  • Why me? Most of the time, this occurs either randomly or after sudden increased use of the elbow muscles (sometimes after prolonged underuse). Periods of life, that everyone can go through, can reduce your ability to tolerate tendon strain or recover from increased use, such as periods of high mental stress, worsening sleep, or increased weight gain. Both tennis and golf can cause pain on either side of the elbow, which is why we no longer call each tennis or golfer's elbow. 


  • What can I do about it? Sometimes, you don’t have to do anything. 70% of people have improved within 12 months without doing anything. Some people might benefit from adding upper body and elbow strength exercises to improve tolerance to the activities that are impacted by elbow pain. Pain during arm use is safe with tendon pain, especially if tolerable. Educate yourself on the condition by asking us for validated, up-to-date information (lots of unhelpful physio fluff is out there). Sometimes an elbow brace or taping (that puts tolerable pressure over the sore tendon) can be helpful while you are improving tolerance to gripping tasks again, but should be weaned off over time. Surgery is hardly ever suggested or more helpful than an exercise program or even a sham/fake surgery. Injections should be becoming less recommended for tendon pain based on recent research updates. Movement optimism and patience are the best management strategies for elbow tendon pain.



  • Busting Myths?

    • Strength, weakness, or muscle flexibility does not predict tendon pain onset. However, strengthening and movement exercises can still be helpful.

    • Avoiding pain while managing tendon pain is not helpful, especially if you have had the pain for many weeks. Avoiding pain is not the goal of management; rather, it is to modify your valued activities so that you can tolerate continuing them while the body's immune and nervous systems do their thing, reducing pain around the elbow over time. 

  • How long will it take? If you are optimistic, have clear expectations and education about what tendon pain means (more tendon pain does not equal more tendon damage), and follow realistic, up-to-date advice, many can feel much better before or after three months. Sometimes, it takes more than 12 months to feel better. Don’t be too concerned; just having symptoms for longer does not mean you will not improve when following good advice. Just keep doing the things that are helpful for your tendon health, like improving your general health (sleep, physical activity, stress coping). You can live well with tendon pain. 

  • What can Physiotherapy or Exercise Physiology at MH offer? 

    • We can offer individual advice to help you modify your active activities to tolerate keeping up with life with tendon pain. Tendon pain should not stop you from doing the things you love. This might involve adding some strength exercises for your elbow and upper body to your weekly routine or supporting ways to get back to the activities you enjoy and might have reduced or avoided. 

    • We can be your support crew to encourage lifestyle changes that can improve your general health, like coaching around sleep and guiding you through ways to reduce stress or adding things to your life to better cope with stress. 

    • If you have had persistent tendon pain and are very confused about why you still have it, we can help you make sense of the pain, highlight areas of management to prioritize or be more optimistic about, and give you individual guidance to assist in managing and resolving it. 

    • Physiotherapy can suggest a confident diagnosis, while both Exercise physiology and physiotherapy can offer high-quality exercise-based management. 



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