Tennis or Golfer’s Elbow: Physical Therapy, Grip and Daily Activity

How are tennis elbow and golfer’s elbow different?

Both names describe problems near the attachment of forearm muscles to the upper-arm bone at the elbow. A tendon is the tissue that connects muscle to bone. These muscles also act on the wrist and hand, so gripping, twisting or lifting transmits force through the tendon attachment and may provoke elbow pain. You do not have to play the named sport to develop either condition.

The AAOS tennis-elbow guide describes tendon degeneration or small tears associated with repeated use. The APTA golfer’s-elbow guide explains the medial muscle group. A search for “elbow tendonitis” does not tell you which of these structures, if either, is causing your symptoms.

What should an assessment clarify?

Describe where you feel pain, how it began and which task brings it on. Include work, household activity, exercise and any recent increase in force or repetition. Explain whether carrying a shopping bag, opening a jar or using a tool is the main difficulty. Mention an injury, neck symptoms, numbness or changing hand strength.

The examination considers elbow and wrist movement, strength, tenderness and the demands of the task. Nerve compression and neck problems can produce overlapping arm symptoms, as AAOS explains. Imaging or other tests may be considered when the findings call for them; they are not required simply because an elbow hurts. Do not repeatedly perform a painful resistance test on yourself to confirm a diagnosis.

Start by changing an aggravating demand

A temporary reduction in repeated gripping or forceful wrist use can make room for rehabilitation. This is different from deciding never to use the arm again. Identify the difficult part of a task: the weight, length of time, number of repetitions or position of the wrist. A plan can change one of those demands and review the response.

For example, repeated lifting of a loaded pan is different from moving an empty one. Discuss dividing a task, using support or changing its frequency while preserving useful activity. These are examples for planning, not instructions to continue a movement that repeatedly worsens symptoms. A sports-related plan can also examine technique and equipment rather than treating soreness as the only issue.

Which exercises might be selected?

Exercise can address forearm strength, movement and tolerance for repeated work. The starting resistance, range and amount should fit the examination. The APTA tennis-elbow guide describes progressing from appropriate movement toward strengthening as symptoms and capacity allow.

The goals differ from simply stretching a sore spot. Mobility work addresses a restricted movement; strengthening and endurance work develops the capacity to manage force and repeated use. The task changes give that work a manageable starting point. As control and tolerance improve, the plan can increase one demand and check the same task and later symptoms again.

For a lateral problem, a therapist may select wrist-extension work; for a medial problem, wrist-flexion or forearm-rotation work may be relevant. The AAOS program distinguishes these directions. Raising and slowly lowering a selected resistance can be parts of an exercise, but a useful version also specifies forearm support and elbow position. Copying the same weight with a different arm position may change the demand.

For a selected wrist-extension exercise, the AAOS handout shows an initial position with the elbow bent and the forearm supported on a table, wrist at the edge. With the palm down, lift the back of the hand and then lower slowly through the chosen range. If the therapist selects lowering-only work, the other hand can help lift it first. The support, assistance and selected resistance are part of the exercise, not optional details.

Both conditions may share rehabilitation principles but involve different muscles and clinical research. Tennis-elbow guidance does not establish equal benefit for every golfer’s-elbow program. Each selected movement has a purpose, an assessment-based starting level and response-guided progression; hands-on care fits within that plan.

For a selected wrist-flexion exercise, the starting forearm support is similar but the palm faces up. Curl the hand toward the forearm and then lower it slowly. The AAOS handout also shows forearm turning as a separate exercise direction. The therapist chooses which direction, range and amount fit the affected group. Do not copy the printed weight or progress to an unsupported straight arm without checking the intended stage.

How do you use the plan at home?

Have the exercise demonstrated, then show it back. Record the position, movement, resistance and amount actually selected for you. Agree on the symptom response that is acceptable in your case and what should make you pause or contact the therapist. Do not increase weight, repetitions and your work demands together simply because one session felt easier.

Bring a practical obstacle to review: a movement you cannot manage, equipment you do not have or instructions you do not understand. Our home exercise guide explains how to keep the details usable. A clear, manageable plan is more useful than collecting several unrelated routines.

Is there a tennis-elbow exercise PDF?

AAOS provides a downloadable exercise handout for tennis and golfer’s elbow. It includes separate wrist-extension and wrist-flexion strengthening examples and says the program should be performed under a doctor’s supervision, with exercise selection discussed with a doctor or physical therapist.

Use it as a resource to discuss, rather than a personal prescription. The printed repetitions, weights and program length do not establish what is appropriate for your diagnosis, sensitivity or other restrictions. Bring the handout to your therapist if you want help identifying which parts fit your plan.

How do you know whether rehabilitation is helping?

Track a repeatable task, such as using a familiar tool or handling a permitted load. Compare the same weight and duration rather than testing a heavier object each time. Record pain, grip confidence, later symptoms and what you could actually do. Less discomfort at rest and tolerating a demanding workday are different outcomes.

The plan includes a review and next decision. Improving function guides the next workload increase. Persistent symptoms, declining strength or repeated aggravation call for reassessing diagnosis and programming. A fixed visit count cannot guarantee recovery.

When does elbow pain need a different assessment?

New numbness, tingling or marked weakness should not automatically be called tendon pain. Report these changes, particularly when they spread into the hand or accompany neck symptoms. A new injury with substantial loss of movement or function needs medical assessment before exercise. Persistent symptoms despite an appropriate plan can also justify further evaluation; repeating an unchanged routine is not the only next step.

Planning an assessment

Explore physical therapy at Wongs Acupuncture & Angel Alliance Physical Therapy in Manhattan, Forest Hills and Great Neck. Bring your reports and one activity you want to regain. Allow approximately 75–90 minutes for an initial PT visit and confirm insurance requirements with the office. An acupuncture consultation may be discussed separately for an assessed pain concern; it does not establish that needling repairs the tendon.