Physiotherapist tips: treatment of tennis elbow/golfer's elbow

Pain on the outside or inside of the elbow is common with repetitive movements and strenuous gripping. Tennis elbow and golfer's elbow are two common overuse injuries that often arise during work, training, or sports where the forearm muscles are heavily used.

These conditions can be long-lasting, but with proper loading, training, and offloading, many gradually improve. In this blog post, we'll go through what you can do yourself to alleviate the symptoms and create better conditions for recovery.

In our Injury Guide, you can read more about tennis elbow, golfer's elbow, and other arm and elbow conditions, common symptoms, and what you can do yourself in various situations.

What are tennis elbow and golfer's elbow?

Tennis elbow involves pain on the outside of the elbow, while golfer's elbow is on the inside. The conditions often arise when the tendon attachments around the elbow are overloaded for a prolonged period. It's common for the pain to come on gradually and worsen with activities such as:

• Lifting and carrying
• Gripping movements
• Working with a computer or tools
• Training with rackets or weights
• Repetitive hand and forearm movements

Many also experience stiffness, weakness, or tenderness when pressing over the area.

Self-care for tennis elbow and golfer's elbow

For overuse injuries, treatment often involves finding the right balance between activity and recovery. Complete rest for a long time is rarely the best solution, but the load may need to be adjusted temporarily.

Adjust the load

Try to identify which activities provoke the most pain. This could be heavy lifting, repetitive movements, or strenuous training. You often don't need to stop the activity completely, but it can help to:

• Reduce intensity for a period
• Take more breaks
• Vary work tasks
• Avoid activities that significantly worsen the pain

The goal is to stay as active as possible without the symptoms clearly increasing afterwards.

Train the forearm muscles

Lighter strength training is often an important part of rehabilitation for both tennis and golfer's elbow. Gradually increasing the load can help the tendons tolerate more over time. Since the conditions are on different sides of the elbow and affect different muscle groups, the exercises can be adapted accordingly.

Static exercise with a dumbbell

Here's how to do it:

• Rest your forearm on a table or your leg with your hand off the edge. Your wrist should be still and slightly extended 20-30 degrees, with the back of your hand facing up (for tennis elbow rehab). Your palm should face up and your wrist in a neutral position or another suitable angle for you (for golfer's elbow rehab).
• Hold a light weight in your hand, about 1-2 kg
• Hold the position for 30-60 seconds and repeat 4-6 times
• The exercise can be progressed by increasing the weight of the dumbbell or extending the holding time to 90 seconds.

Dynamic exercise with a dumbbell

Here's how to do it:

• Rest your forearm on a table or your leg with your hand off the edge. The back of your hand should be facing up (for tennis elbow rehab). Your palm should be facing up (for golfer's elbow rehab).
• Hold a light weight in your hand, about 1-2 kg
• Lower your hand downwards for 3 seconds, then lift it up again at the same slow pace
• Do 15 repetitions and repeat 3 times
• Gradually increase the resistance as you get stronger and more resilient.

Forearm rotation exercise

Here's how to do it:

• Hold a light hammer or weight in your hand
• Bend your elbow about 90 degrees
• Slowly rotate your palm up and down
• Perform the movement in a controlled manner
• Start with low load and few repetitions

Grip training (especially for golfer's elbow)

Here's how to do it:

• Squeeze a soft ball
• Hold for a few seconds and then slowly relax
• Start gently and gradually increase the load

The above exercises can be performed daily. When the load becomes heavier, you can space them out to every other or every third day.

Review ergonomics and technique

For recurrent problems, it can be beneficial to review how you load your arm and wrist in daily life.

Small changes can sometimes make a big difference, for example:

• Adapted working posture for computer work
• Variation between different tasks
• Correct grip size on racket or tool
• Technique adjustment for training and sports

Can heat or cold help?

Some experience relief from heat before activity to warm up the area, while cold can feel pleasant after exertion if the area feels irritated.

The effect varies between individuals but can be a simple way to temporarily alleviate symptoms.

The physiotherapist recommends - products that can help with tennis or golfer's elbow

An elbow brace or strap can help relieve the overloaded tendon attachment at the elbow. For chronic problems, a combination of an elbow brace and wrist support may be optimal. Here, our physiotherapist recommends five products in our range that can help with tennis or golfer's elbow.

1. The Dynamics Plus elbow support provides compression around the elbow and has two integrated pads to simultaneously relieve both tennis and golfer's elbow and to fit both the right and left arm. The movable Velcro strap allows the relief to be further adjusted as needed. The elbow crease has a zone with extra soft fabric, which reduces the risk of chafing.
2. The BOA elbow band has two detachable pads, allowing both tennis and golfer's elbow to be relieved simultaneously. The degree of support and relief can be easily adjusted with the practical BOA dial.
3. The NRX Epi elbow support provides compression around the elbow and has a movable pad for extra compression and relief. The elbow support is made of a material with slightly warming properties, which can have a pain-relieving effect.
4. Wrist support SRX provides light support to the wrist without affecting grip. It is therefore a suitable model for more extensive problems where both the wrist and elbow need relief, but where the support must not hinder grip ability.
5. Sometimes massage of the forearm muscles can alleviate the symptoms of tennis or golfer's elbow. Our trigger ball is a compact, lightweight massage ball that can be used for massage of superficial and deep muscles and is easy to carry in your gym bag.

How long does it take to get better?

Recovery varies from person to person. For some, the problems resolve within a few weeks, while others may have symptoms for a longer time.

Often, rehabilitation involves patience and a gradual increase in load. It is common for symptoms to fluctuate during this period.

When should you seek help?

If the pain does not improve despite self-care, or if you experience clear weakness or significant difficulties in daily life, you should contact a physiotherapist or other healthcare provider for a thorough assessment of your symptoms and to ensure they are not due to something else.

With load adaptation, training, and support, many can gradually return to work, training, and activity despite issues with tennis elbow or golfer's elbow.