That nagging ache on the outside of your elbow has been there for months. You’ve tried resting it, stretching it, maybe even found a few exercises on YouTube. And yet, it’s still there. Sound familiar?
Tennis elbow is one of the most common — and most mismanaged — soft tissue conditions we see in people in their 40s, 50s, and 60s. The frustrating truth is that it rarely goes away on its own, and many of the things people try to fix it actually make it worse or simply delay proper recovery.
In this post, we’re going to explain exactly what tennis elbow is, why it tends to drag on far longer than it should, the common mistakes that keep people stuck, and — most importantly — what a proper, structured approach to treatment actually looks like.
What Is Tennis Elbow?
Tennis elbow — or lateral elbow tendinopathy to use the correct clinical term — is a condition affecting the tendons that attach the forearm muscles to the bony prominence on the outside of the elbow. These tendons, particularly the one connected to the extensor carpi radialis brevis muscle, become overloaded and undergo degenerative changes at a cellular level.
Despite the name, you don’t need to have picked up a racquet in your life to develop it. It’s extremely common in people who use their hands and forearms repetitively — gardeners, DIY enthusiasts, office workers, tradespeople, and anyone carrying heavy loads. The condition is driven by cumulative load and inadequate recovery, not a single dramatic injury.
Pain is typically felt on the outside of the elbow, and can radiate down the forearm. Gripping, lifting, typing, and even something as simple as lifting a kettle can become genuinely difficult.
Why Does It Last So Long?
Here’s the thing that surprises many people: tendons have a poor blood supply, which means they heal slowly compared to muscles. When a tendon becomes overloaded and starts to break down, it needs very specific stimulus — the right type and amount of load — to regenerate properly.
Without that stimulus, the tendon stays in a state of disrepair. It doesn’t fully heal, but it doesn’t fully give up either. It just sits in a frustrating middle ground — uncomfortable, reactive, and limiting.
This is why lateral elbow tendinopathy can persist for months, or even years, if it isn’t addressed correctly. And the longer it goes on, the more complex and layered it becomes to treat.
The Mistakes That Keep People Stuck
If you’ve been struggling with elbow pain for a while, there’s a good chance you’ve tried at least one of the following. We’re not here to judge — these are incredibly common responses — but understanding why they fall short is an important step forward.
“I’ll just wait and see if it goes away” Rest feels logical. But complete rest actually deprives the tendon of the loading stimulus it needs to heal. After a brief period of activity modification, tendons need progressive, structured loading — not prolonged inactivity.
YouTube exercises. Generic exercise videos aren’t designed for your specific presentation. Tendons can be highly reactive, and the wrong exercise, done at the wrong intensity or at the wrong stage, can flare symptoms significantly. What works for one person can set another back weeks.
Advice from well-meaning friends and family. “Just rub some ibuprofen gel on it” or “I had that — I just wore a brace and it sorted itself out” — advice like this is offered with kindness, but it’s rarely based on an accurate understanding of tendon biology.
Steroid injections. Corticosteroid injections are widely used and can reduce pain in the short term. However, research suggests that whilst they may provide temporary relief, they can have a detrimental effect on tendon tissue over time and are associated with higher recurrence rates in the longer term. They are not a solution — and can sometimes mask the problem long enough for it to worsen.
Pushing through the pain. Tendons don’t respond well to being bullied. Continuing to load a reactive tendon without a structured plan is one of the most reliable ways to keep it irritated and slow recovery to a crawl.
Why Getting This Right — and Getting It Right Soon — Matters
Lateral elbow tendinopathy is one of those conditions where early, accurate intervention genuinely changes outcomes. Left unmanaged, the tendon undergoes structural changes that become progressively harder to reverse. The nervous system also adapts over time, sometimes making pain more persistent and more widespread than the original injury would suggest.
The bottom line is this: the longer this goes on, the more complicated treatment becomes. If you’ve had elbow pain for more than a few weeks, this is the time to take it seriously — not in six more months.
🔔 Not Sure Whether Your Elbow Pain Is Tennis Elbow?
That’s actually one of the most important questions to ask. Not all pain on the outside of the elbow is lateral elbow tendinopathy. Radial nerve entrapment, posterior interosseous nerve compression, referred pain from the neck, joint irritation, and other conditions can all present with similar symptoms — and they each require a completely different approach to treatment. Getting this wrong at the diagnostic stage is one of the core reasons people end up going in circles.
This is why an accurate, thorough assessment comes first — before any treatment decision is made.
👉 Book Your Free Discovery Visit Here
If you’ve been struggling and you’re not sure where to turn, a free Discovery Visit is the ideal starting point. No pressure, no obligation — just clarity.
How Thorpes Physiotherapy Approaches Tennis Elbow Differently
At Thorpes Physiotherapy, we don’t hand you a leaflet and send you on your way. Our approach is built on two foundations: accurate diagnosis and a personalised treatment plan that reflects where you are in your recovery right now.
Here’s what that looks like in practice:
1. A Thorough Assessment First
Before we do anything else, we take time to understand your full picture — when it started, what aggravates it, your work demands, your lifestyle, your history. We conduct a detailed clinical examination to confirm whether this is genuinely lateral elbow tendinopathy or something else presenting in a similar way.
This diagnostic clarity changes everything. It means you’re not guessing — and neither are we.
2. A Treatment Plan Built Around You
No two people’s elbows are the same, and no two treatment plans should be either. Your plan will be tailored to your specific tendon presentation, your daily demands, and your goals.
This will typically include:
- Personalised exercise prescription — graded, progressive loading that meets your tendon where it currently is and moves it forward safely. Not a generic printout, but exercises selected and progressed specifically for you.
- Practical advice and load management — clear guidance on what to modify at work or at home, and how to gradually reintroduce activities without flaring symptoms.
- Hands-on physiotherapy treatment — manual therapy techniques to address stiffness, improve tissue quality, and support recovery.
3. Advanced Technology Where Appropriate
For cases that need more than exercise and manual therapy alone, we have access to a range of specialist tools:
- Shockwave Therapy — a clinically supported treatment that uses acoustic energy to stimulate tendon healing, reduce pain, and promote tissue repair. Particularly effective in stubborn, long-standing cases.
- Stimpod Therapy — a nerve stimulation technology that can be highly effective where nerve involvement is contributing to pain and dysfunction.
4. Acupuncture and Taping
Where clinically appropriate, we may also incorporate acupuncture to help manage pain and support tissue recovery, alongside therapeutic taping to offload the tendon and reduce irritation during daily activity.
These are tools used thoughtfully — not routinely applied to everyone, but available when they’re the right fit for you.
The Bottom Line
Tennis elbow is not something you simply have to put up with. But it also won’t resolve itself reliably without the right approach — and the longer it’s left, the harder it becomes to turn around.
At Thorpes Physiotherapy, we offer something far more valuable than a generic exercise sheet or a temporary pain-relieving injection: a clear diagnosis, a personalised plan, and the clinical expertise to guide you through it properly.
Whether your elbow pain started three weeks ago or three years ago, there is very likely a clear path forward. You just need the right guidance to find it.
Take the First Step Today
If you’re tired of managing elbow pain day to day, wondering whether it will ever fully resolve, the best thing you can do right now is get a proper assessment.
Book your free Discovery Visit at Thorpes Physiotherapy — a no-obligation conversation where we can help you understand exactly what’s going on and what your options are. There’s no pressure, no sales pitch — just honest, expert guidance.
You deserve more than waiting and hoping. Let’s get this sorted.
If you are ready to take action to fix the problem, you can call 01276 37670 to book an appointment (or book online through the button below).
I hope this has been interesting and of value to you.
Warm regards
Jonathan Smith (MSc BSc FSOMM MCSP SRP)
Director of Thorpes Physiotherapy