Refuah Physical & Occupational Therapy Book an appointment

Tennis Elbow (Lateral Elbow Pain): Physical Therapy in Brooklyn

By Dr. Jack Engelberg, PT, DPT · · 4 min read

Despite its name, most people with tennis elbow have never picked up a racket. It's just as likely to affect a carpenter, a busy parent lifting a toddler, a hairstylist, or someone typing all day in an office in downtown Brooklyn. If gripping a coffee mug, turning a doorknob or shaking hands sends pain to the outside of your elbow, physical therapy can help.

What Is Tennis Elbow?

Tennis elbow, or lateral epicondylalgia (also called lateral epicondylitis), is pain at the outside of the elbow where the tendons of the forearm muscles attach to a bony bump called the lateral epicondyle. These muscles extend the wrist and fingers and stabilize the wrist when you grip.

Although the name includes "-itis," the condition is usually not mainly inflammatory. It's better understood as tendinopathy: the tendon has been overloaded and hasn't adapted well, leading to pain and reduced tolerance to gripping.

Common Symptoms

  • Pain or burning on the outside of the elbow
  • Pain that may spread down the forearm
  • Pain with gripping, lifting, or twisting (like opening a jar)
  • Weak grip
  • Pain when lifting objects with the palm facing down
  • Tenderness over the bony bump on the outside of the elbow

What Causes Tennis Elbow?

  • Repetitive gripping and wrist extension — tools, keyboards and mice, racquet sports, cooking, carrying bags
  • Sudden change in activity — a new job, a home renovation project, or a burst of yard work
  • Poor equipment fit — grips that are too small or too large, heavy tools
  • Age — most common between about 35 and 55

Tennis elbow often develops gradually. Symptoms can last for months, which is why getting on a good plan early is helpful.

How Physical Therapy Helps Tennis Elbow

Exercise-based treatment is a cornerstone of care for lateral elbow pain. The aim is to calm the irritated tendon, then gradually rebuild its capacity to handle the loads of your daily life.

Evaluation

Your therapist will confirm the source of your pain and check the neck and shoulder, since nerve irritation from the neck can mimic elbow pain. They'll assess grip strength and which activities provoke symptoms.

Treatment May Include

  • Load management — modifying aggravating tasks without stopping all activity
  • Progressive tendon loading — isometric, then slow strengthening exercises for the wrist extensors, gradually increasing difficulty
  • Grip and forearm strengthening — including the whole arm and shoulder
  • Manual therapy — soft tissue work and elbow or wrist mobilization when helpful
  • Counterforce bracing — a strap just below the elbow can reduce pain during activity for some people
  • Ergonomic and technique advice — tool handles, mouse position, lifting with palms up, sport technique

What You Can Do at Home

  • Lift with your palm facing up when possible, which uses the arm differently.
  • Use your whole arm rather than just the wrist when carrying or lifting.
  • Take breaks from repetitive gripping every 20 to 30 minutes.
  • Try an isometric hold. Rest your forearm on a table, palm down, and gently press the back of your hand up against your other hand without moving. Hold 30 to 45 seconds, a few repetitions, at a level that doesn't increase pain afterward.
  • Use ice or heat for comfort.
  • Check your setup. A mouse that fits your hand and a keyboard at elbow height can reduce strain.

When to See a Physical Therapist

Consider an evaluation if:

  • Elbow pain has lasted more than a couple of weeks
  • It interferes with work, sleep or daily tasks
  • Grip feels weak
  • You've tried rest and the pain returns as soon as you go back to activity

See a physician if elbow pain follows a fall or injury with swelling or deformity, if you can't bend or straighten your elbow, or if the area is red, hot and swollen.

Frequently Asked Questions

How long does tennis elbow last?

Many cases resolve within several months to a year, but symptoms can linger without the right approach. A structured exercise program helps many people improve sooner.

Are cortisone injections a good idea?

Injections may relieve pain in the short term, but research suggests they may not help, and could hinder, long-term outcomes for tennis elbow. Discuss the pros and cons with your physician.

Is it the same as golfer's elbow?

No. Golfer's elbow affects the inside of the elbow, though the treatment approach is similar. Numbness and tingling in the hand may point to a nerve issue instead, like carpal tunnel syndrome.

Ready to get started? Call the Refuah office nearest you

Schedule an evaluation by phone, or book online at refuahpt.com.

Book at refuahpt.com

About the author. Dr. Jack Engelberg, PT, DPT is a Doctor of Physical Therapy and owner of Refuah Physical & Occupational Therapy, with offices in Midwood and Boro Park, Brooklyn, and on Staten Island.

Medical disclaimer: This article is for general education only and is not medical advice, diagnosis or treatment. Everyone’s situation is different. Talk with your physician or a licensed physical therapist about your symptoms. If you think you have a medical emergency, call 911.

Call a clinic

Which clinic?

Book