Tennis Elbow and Golfer's Elbow: Why Rest Alone Rarely Fixes Them

Published August 2026 · 9 min read · By the Circle Physiotherapy Clinical Team

Medically reviewed August 2026 by registered physiotherapists at Circle Physiotherapy Brampton.

Quick answer: Tennis elbow (lateral epicondylalgia) causes pain on the outside of the elbow from overloaded wrist-extensor tendons, while golfer's elbow (medial epicondylalgia) causes pain on the inside from overloaded wrist-flexor tendons — and neither requires ever having played the sport, since most cases seen at Circle Physiotherapy in Brampton come from repetitive gripping, lifting, typing, trades work, DIY projects, or carrying young children. These are genuine tendon overload injuries rather than simple inflammation, which is exactly why complete rest and anti-inflammatories alone rarely fix them. Real recovery generally comes from progressive, graded strengthening over several months, combined with load management and, where appropriate, adjuncts like bracing, shockwave therapy, or acupuncture.

If you've been told to just rest your sore elbow and it still hasn't settled down, you're not alone, and you're not doing anything wrong. Tennis elbow and golfer's elbow are two of the most common reasons people search for elbow pain relief, yet the traditional advice often falls short because it treats these conditions like a simple sprain instead of what they actually are: overloaded tendons that need a specific kind of loading to heal. This guide walks through what's really happening in the tendon, why rest alone often backfires, and what a realistic treatment timeline looks like.

What's the difference between tennis elbow and golfer's elbow?

Tennis elbow (lateral epicondylalgia) affects the tendons on the outside of the elbow where the wrist-extensor muscles attach, causing pain when gripping, lifting something with the palm facing down, or shaking hands, while golfer's elbow (medial epicondylalgia) affects the tendons on the inside of the elbow where the wrist-flexor muscles attach, causing pain when gripping and twisting with the palm facing up. Both are forms of tendinopathy — an overload injury to the tendon rather than a torn muscle or a joint problem — and they can occasionally occur together in the same arm.

• Tennis elbow: outer elbow pain, wrist-extensor tendons, worse with gripping, lifting palm-down, or straightening the wrist against resistance.
• Golfer's elbow: inner elbow pain, wrist-flexor tendons, worse with gripping, twisting, or bending the wrist against resistance.

Both conditions respond to a similar overall treatment approach, and both are managed as part of the golfer's elbow and tennis elbow programmes at Circle Physiotherapy.

Despite the names, most people who develop tennis elbow or golfer's elbow have never picked up a racquet or a golf club, since these tendon injuries are driven by repetitive gripping and wrist loading rather than by a specific sport — the names are historical, not diagnostic. In our Brampton clinic, the most common triggers are everyday and occupational: painters, plumbers, mechanics, and other tradespeople using hand tools repeatedly; hairstylists and cooks with hours of repetitive gripping; office workers with heavy mouse or keyboard use; gardeners and weekend DIYers tackling a big project all at once; and new parents whose forearms suddenly go from occasional lifting to constant carrying, feeding, and picking up a baby dozens of times a day. Anyone whose hands and forearms do repetitive, sustained, or forceful gripping is a candidate.

Why doesn't rest or anti-inflammatories fix tennis elbow pain?

Tennis elbow and golfer's elbow are usually tendinopathy — a breakdown and disorganization of the tendon's collagen structure from repeated overload — rather than classic "tendinitis," which implies active inflammation as the main problem. This is the core reason rest and anti-inflammatory medication so often disappoint: they target inflammation that, in most longer-standing cases, isn't actually the driving issue anymore.

Current physiotherapy guidelines have moved away from the old "rest it and ice it" model for chronic tendon pain. Research consistently shows that a degenerated or overloaded tendon needs progressive mechanical load to stimulate the cells that rebuild and reorganize its collagen fibres — something rest cannot provide. This is the single most important reframe in this article: a tendon overload injury is fixed by carefully rebuilding capacity, not by avoiding the tendon altogether.

Can complete rest make elbow tendon pain worse?

Yes — tendons need progressive load to remodel and stay strong, so cutting out all elbow use for weeks tends to leave the tendon, forearm muscles, and grip strength deconditioned, meaning the pain often flares up again as soon as normal activity resumes. This creates a frustrating cycle: rest, feel a little better, go back to normal tasks, and the pain returns just as sharp as before, because nothing was actually rebuilt in between.

A short period of relative rest from the most aggravating activities in the first few days can be reasonable, but the goal from early on should be finding the right amount and type of load — not eliminating it.

What treatment actually works for tennis elbow and golfer's elbow?

The most effective approach for tennis elbow and golfer's elbow is progressive loading — starting with isometric holds (pushing against resistance without moving the joint) to help settle pain, then gradually building toward slower, heavier strengthening exercises that rebuild the tendon's capacity to handle real-world grip and lifting demands. This is typically guided by a physiotherapist as part of a broader physiotherapy plan.

1. Early stage: isometric (static) holds against resistance to reduce pain and maintain some tendon loading without aggravating symptoms.
2. Building stage: slow, controlled strengthening exercises for the wrist and forearm, gradually increasing resistance as symptoms allow.
3. Load management: identifying and temporarily reducing the specific tasks that are overloading the tendon fastest.
4. Technique and tool review: adjusting grip, posture, or equipment so the tendon isn't repeatedly loaded the same aggravating way.

Some mild-to-moderate discomfort during exercise is expected and generally acceptable; sharp, worsening pain that lingers well after you stop is the signal to back off and adjust the programme.

How long does tennis elbow take to heal?

Most cases of tennis elbow and golfer's elbow take several months, not several weeks, to substantially improve, and that's worth saying plainly because it's the honest answer, not the convenient one. Mild, recently-started cases may respond within six to eight weeks of consistent loading, but many people come in after symptoms have built up gradually over months, and those cases often need three to six months of progressive strengthening — sometimes longer — before the elbow feels reliably strong again.

Consistency matters more than intensity here. A tendon that is loaded appropriately a few times a week, every week, for months will generally do better than one pushed hard for two weeks and then abandoned when progress feels slow.

Do elbow braces, taping, shockwave therapy, or acupuncture help?

Braces, taping, shockwave therapy, and acupuncture or dry needling can all play a useful supporting role in tennis elbow and golfer's elbow recovery, but they work best as adjuncts alongside a progressive loading programme rather than as replacements for it. Used well, they can reduce pain enough to let you tolerate the exercises that actually rebuild the tendon.

• A counterforce brace or strap can offload the tendon during aggravating tasks like gripping tools.
• Kinesio taping and cupping may reduce pain and support movement in the short term.
• Manual therapy at the elbow, wrist, and neck can help with movement quality and general symptom relief, and our approach to manual therapy is informed by a physiotherapist with FCAMPT designation.
• Shockwave therapy is often considered for stubborn cases that haven't responded well to loading alone — see our guide to how shockwave therapy works for more detail.
• Acupuncture or dry needling may help calm pain and muscle tension around the forearm.

Should you get a cortisone injection for tennis elbow or golfer's elbow?

Cortisone injections can reduce tennis elbow or golfer's elbow pain in the short term, but they are not a durable answer for an overloaded tendon and, in some people, symptoms return or worsen once the injection wears off. Because a cortisone injection can temporarily mask pain without addressing the underlying loss of tendon capacity, it's a decision best made together with a physician who knows your full medical history and can weigh it against a structured loading programme.

If you and your doctor do decide an injection is appropriate, it works best paired with, not instead of, ongoing physiotherapy once the acute pain has settled enough to begin loading again.

How can you reduce elbow strain at work, in the trades, or with a new baby?

Small, practical changes to how you grip, lift, and repeat tasks can meaningfully reduce the strain going through an already-irritated tendon, often faster than any passive treatment. The goal is spreading the load, not avoiding it entirely.

• Trades and manual work: use a larger grip diameter on tools where possible, let power tools do the twisting instead of your wrist, and alternate hands or tasks through the day rather than repeating the same motion for hours.
• Office and desk work: reduce grip force on your mouse, take short breaks every 30–45 minutes to move your wrists and forearms, and check that your keyboard and mouse height aren't forcing your wrist into extension all day.
• New parents: lift and carry your baby with two hands when possible, alternate which arm you use for feeding and carrying, and try carrying with the palm facing up rather than down to reduce strain on an irritated outer-elbow tendon.
• Everyone: break up repetitive chores like vacuuming, gardening, or DIY projects into shorter blocks with rest in between rather than doing it all in one long session.

What are the red flags that mean it's not simple tennis elbow?

Most elbow pain from gripping and lifting is straightforward tendon overload, but certain signs point to something else and deserve prompt assessment rather than a home exercise programme. See a clinician promptly, or seek urgent care, if any of the following apply.

How does Circle Physiotherapy treat tennis elbow and golfer's elbow in Brampton?

Circle Physiotherapy in Brampton treats tennis elbow and golfer's elbow with a thorough hands-on assessment to confirm the diagnosis, identify the tasks driving the overload, and rule out red-flag causes before building a personalized, progressive loading programme. Because physiotherapists in Ontario are direct-access providers, you can book an assessment without a doctor's referral.

Depending on your presentation, your plan may combine graded exercise with manual therapy, taping, bracing, acupuncture, or shockwave therapy, and — because chiropractic care is also available on-site — some patients benefit from seeing Dr. Thessa Prashad, DC, who is certified in Contemporary Medical Acupuncture through McMaster University. We offer direct billing to most major insurers and a genuine free initial consultation, so you can get a clear picture of what's going on before committing to a full plan. The clinic is located at 10725 McLaughlin Rd, Unit #5, Brampton, near McLaughlin and Bovaird/Sandalwood, with free on-site parking and hours seven days a week.

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