Elbow pain has a way of disrupting almost everything: your grip at the gym, your swing on the golf course at Emirates Golf Club, your serve on the padel court, even typing at a desk. As a physiotherapist, I see lateral and medial elbow tendinopathy, commonly called tennis elbow and golfer's elbow respectively, affecting people across a wide range of occupations and activities here in Dubai. What surprises many people is that you do not need to play tennis or golf to develop either condition.

What Is Tennis Elbow?

Tennis elbow, or lateral epicondylalgia, involves irritation and degeneration of the tendons that attach to the lateral epicondyle, the bony prominence on the outer side of the elbow. These tendons belong to the muscles that extend the wrist and fingers. The condition typically causes pain and tenderness on the outer elbow, which can radiate down the forearm, and weakness of grip.

Despite its name, lateral epicondylalgia is common among office workers, construction workers, musicians, and anyone who performs repetitive gripping or wrist extension movements. I regularly see it in people who have recently increased their training load at the gym or taken up a racket sport.

What Is Golfer's Elbow?

Golfer's elbow, or medial epicondylalgia, affects the tendons on the inner side of the elbow, those that belong to the wrist flexors and forearm pronators. The pain is located on the medial epicondyle (inner bony prominence) and can extend into the forearm. Some people also notice tingling in the ring and little fingers due to the proximity of the ulnar nerve.

This condition is seen in golfers, baseball players, and climbers, but also in people who perform heavy lifting with a palm-up grip or repetitive throwing movements.

Tendinopathy responds remarkably well to the right loading programme, but it is unforgiving when ignored or mismanaged. Understanding the biology of the tendon helps people commit to the graduated loading approach that actually produces lasting change.

Why These Conditions Develop

Modern research has shown that chronic tennis elbow and golfer's elbow are not primarily inflammatory conditions, despite the traditional use of the suffix -itis. They involve a degenerative change in tendon structure, often driven by repetitive loading that exceeds the tendon's capacity to recover. This understanding has significantly changed how physiotherapy approaches treatment.

How Physiotherapy Addresses Elbow Tendinopathy

The most evidence-supported approach to both conditions involves progressive tendon loading, which means gradually exposing the tendon to controlled stress in a way that stimulates tissue remodelling and adaptation.

  • Isometric exercises: Sustained muscle contractions without joint movement are often used in the early phase for pain relief and initial tendon loading.
  • Isotonic strengthening: Controlled eccentric and concentric loading through the wrist extensors or flexors, progressed according to pain and capacity.
  • Load management: Modifying aggravating activities during rehabilitation without complete rest, which is now understood to delay recovery.
  • Grip and upper limb kinetic chain assessment: Addressing any weakness or movement dysfunction in the shoulder, scapula, or wrist that may be contributing to excessive elbow loading.

What About Braces and Straps?

Counterforce braces are commonly used and can provide short-term pain relief by reducing the force transmitted through the affected tendon during activity. They are a useful adjunct but are not a substitute for a structured rehabilitation programme addressing the underlying tendon capacity deficit.

If elbow pain is interfering with your training or daily life, please book a consultation with Dr. Smruti Rathod for a thorough assessment.