Tennis/Golfer’s Elbow Markham

Lateral and medial epicondylitis or what’s better known as tennis elbow or golfer’s elbow respectively, is a common overuse injury from repetitive movements of the wrist and arm.  This can cause significant pain on the outside/inside of the elbow that can affect not only your activity level but also your work.

What can we do to help?

• Acupuncture
• Soft tissue therapy
• Vibration therapy
• Taping
• Rehabilitation exercises to avoid recurrence
• Shockwave therapy

Understanding Tennis Elbow and Golfer's Elbow

Elbow tendon pain is a frustrating injury, partly because of how it arrives. It starts quietly, sticks around for weeks, and gets in the way of small tasks you never used to think about: pouring a kettle, shaking hands, carrying groceries, gripping the wheel on the drive down Highway 7. The names point to sport, but that is misleading. Most of the people we see at our Markham clinic developed elbow tendinopathy through ordinary daily and work activity, not from time on a court or a course. So it helps to know what is actually going on inside the tendon, and why the pain tends to hang around, before settling on a plan.

Tennis elbow (lateral epicondylitis)

Tennis elbow affects the tendons on the outside of the elbow, where the muscles that extend your wrist and fingers attach to a bony bump called the lateral epicondyle. The pain sits on the outer side of the elbow and can radiate down the forearm. It usually shows up when you grip, lift with the palm facing down, straighten the fingers against resistance, or extend the wrist. Think of lifting a coffee mug or working a computer mouse.

Golfer's elbow (medial epicondylitis)

Golfer's elbow is basically the mirror image. It affects the tendons on the inside of the elbow, where the wrist-flexor and forearm muscles attach to the medial epicondyle. Pain sits on the inner side and can travel toward the wrist. It tends to flare with gripping, twisting, and flexing the wrist, so squeezing, wringing out a cloth, or swinging a hammer or a golf club will often set it off.

In both conditions the old "-itis" label, which implies inflammation, is a bit misleading. What we understand now is that persistent cases involve tendinopathy: small-scale disorganization and breakdown in the tendon fibres, caused by repeated loading that outpaced the tissue's ability to recover. That distinction matters. It is the reason passive rest on its own usually is not enough, and the reason gradual loading ends up being central to getting better.

Who Tends to Develop It

The common thread is repetitive gripping and wrist movement, so this turns up in a wide range of people, not just athletes. In our experience, elbow tendinopathy is common among:

• Trades and manual workers such as carpenters, electricians, mechanics, and painters, along with anyone regularly using tools, torque, or a firm sustained grip.
• Desk and computer workers, where hours of mouse and keyboard use, often at a less-than-ideal workstation, load the forearm tendons in small repetitive doses.
• People who lift or carry repetitively at work or at home, including warehouse and retail staff.
• New parents, who suddenly spend the day lifting and holding a growing baby with the wrist and forearm. This one is genuinely common and often goes unrecognized.
• Cooks, hairstylists, cleaners, musicians, and gardeners whose hands and wrists work continuously.
• Racquet-sport and golf players, especially after a change in equipment, technique, or training volume.

Age matters too. These injuries are most frequent between the late 30s and mid 50s, when tendons are a little less tolerant of sudden jumps in load. A recent spike in activity is often the tipping point, whether that is a home renovation, a new job, a fitness push, or a busy season at work.

Why It Becomes Persistent

Elbow tendinopathy has a reputation for lingering, and the reasons make sense once you look at the tissue. Tendons have a fairly modest blood supply, so they remodel and recover slowly compared with muscle. The forearm tendons also work almost constantly. You can rest an ankle on crutches, but your hand and wrist keep going all day, so the tendon rarely gets a real chance to settle. On top of that, many people swing between resting when it hurts and overdoing it when it eases, which keeps the tissue stuck in a stubborn middle ground. Left alone, an occasional twinge can turn into a daily ache that eats into your work and your grip strength. The better news is that with the right mix of load management and progressive rehabilitation, many people find their symptoms improve meaningfully over time.

How We Assess Elbow Pain in Markham

Elbow pain can come from the tendon, the joint, a nerve, or the neck, so an individual assessment is important before any treatment starts. When you come in, a typical appointment includes:

1. History — a detailed conversation about how the pain started, what aggravates and eases it, your work and hobbies, and how it affects grip and daily tasks.
2. Physical examination — checking exactly where the tenderness is, along with range of motion, grip strength, and the specific movements that reproduce your pain, which helps us tell lateral involvement from medial.
3. Screening for other contributors — assessing the wrist, shoulder, and neck, since nerve irritation or referred pain can mimic or accompany elbow tendinopathy. Where the symptoms suggest nerve involvement, such as tingling into the hand, we consider conditions like carpal tunnel syndrome as part of the picture.
4. A tailored plan — using the findings to build a treatment and rehabilitation approach suited to your specific presentation, goals, and daily demands.

If anything in the assessment points to a cause outside our scope, we will talk through an appropriate referral so you get the right care.

How the Treatments Work Together

There is no single fix for elbow tendinopathy, which is why our approach combines a few complementary treatments. The idea is to calm the painful tendon in the short term and rebuild its capacity so the problem is less likely to come back. Our physiotherapy team in Markham commonly draws on the following.

Manual and soft tissue therapy

Hands-on soft tissue work aims to ease muscle tension through the forearm, improve local circulation, and settle the protective tightness that builds up around a sore elbow. That can make movement more comfortable and prepare the area for the loading exercises that drive longer-term recovery.

Shockwave therapy for stubborn tendon pain

When tendon pain has not settled with time and basic care, shockwave therapy is one option we may consider. It delivers focused acoustic pressure waves to the affected tendon, with the aim of prompting the body's natural repair response in tissue that has become slow to heal. We tend to use it as part of a broader plan rather than on its own, and whether it suits you is something we work out during your assessment.

Taping and support

Taping or a forearm support may be used to offload the irritated tendon during activities that aggravate it, giving the tissue a little relief while you stay active. Think of it as a short-term aid that works best alongside the strengthening work, not a replacement for it.

Progressive loading and strengthening — the cornerstone

For most people, the part of the plan that matters most is a graded exercise program. Carefully progressed strengthening, often starting with gentle, controlled movements and building toward heavier and more functional loading, is designed to help the tendon adapt, tolerate more, and restore grip strength. It is also the element most associated with reducing the chance of the problem coming back, which is why we lean so heavily on rehabilitation exercises you can keep doing at home. Some patients also choose acupuncture to help manage pain during the process; you can read more on our acupuncture page.

Recovery Timelines and Activity Modification

Being honest about timelines helps keep expectations realistic. Elbow tendinopathy generally improves over weeks to months rather than days, and the path varies from person to person, depending on how long the symptoms have been present, the demands of your work, and how consistently you follow the rehabilitation. Milder, recent cases often turn the corner sooner. Long-standing cases usually ask for more patience.

Activity modification is a key partner to treatment. The aim is rarely complete rest, which can actually leave the tendon weaker. It is more about adjusting how you work so the tendon is challenged without being overloaded again and again. That might mean changing your grip, taking micro-breaks during repetitive tasks, splitting a heavy job into smaller efforts, or easing off the most provocative movements for a while as you build strength. Symptoms can fluctuate along the way, and a manageable level of discomfort during rehabilitation is often acceptable. Your clinician will guide you on where that line sits for you.

Self-Care and Prevention

Alongside treatment, everyday habits make a real difference. A few practical steps worth trying:

• Set up your workstation thoughtfully. Keep the keyboard and mouse close, support the forearm, and avoid long stretches with the wrist bent or cocked.
• Warm up the forearm and wrist before demanding or repetitive tasks and sports.
• Look at your grip and technique. An oversized or overly tight grip on tools, racquets, or clubs adds load, and small adjustments can take some strain off.
• Build up activity gradually rather than in sudden jumps, whether that is a new workout, a renovation project, or a busy work stretch.
• Take regular micro-breaks so the tendons get brief recovery windows during repetitive work.
• Keep up the strengthening exercises you are given, even once you feel better, to hold onto the tendon's resilience.

If elbow pain is also affecting your shoulder, or you suspect the two are connected, our page on shoulder pain may be a helpful companion read, since the arm works as a chain.

Tennis & Golfer's Elbow FAQs