Golfer’s and Tennis Elbow

When rest, braces, and anti-inflammatories help temporarily but gripping, typing, or lifting keeps triggering the same elbow pain pattern.
person holding tennis racket

The Clinical Reality

Golfer’s elbow (medial elbow pain) and tennis elbow (lateral elbow pain) are commonly load tolerance problems at the tendon-bone junction and along the forearm muscle-tendon units. Despite the “-itis” names, the clinical picture often behaves like tendinopathy and protective neuromuscular guarding rather than an ongoing inflammatory injury.

Symptoms tend to flare when forearm flexors and pronators (often medial pain) or forearm extensors and supinators (often lateral pain) are asked to do more than their current capacity. That overload can come from sudden training volume changes, repetitive gripping, prolonged mouse and keyboard use, heavy carries, climbing, or racquet and bat sports. Pain can also be amplified by sensitized local tissues and compensatory tone in the forearm, shoulder, and neck, which makes normal loading feel threatening to the nervous system.

Our clinical goal is not to “chase inflammation.” It is to improve your tolerance for the specific loads that currently provoke symptoms, and to make gripping, lifting, typing, and sport movements more predictable again.

Why Standard Care Fails

Standard care often focuses on symptom suppression or structural explanations. Anti-inflammatories may reduce soreness but do not reliably improve tendon and grip load tolerance. Bracing can offload temporarily but may not address the motor strategy and strength endurance deficits that re-trigger pain when the brace comes off. Imaging can show tendon changes that do not correlate cleanly with symptoms, and “normal” imaging does not rule out a significant functional pain pattern.

Surgery and injections may be appropriate in select cases managed by sports medicine or orthopedics, but they do not automatically resolve the functional drivers that keep overloading the region: forearm muscle over-recruitment, grip asymmetry, shoulder and thoracic mechanics, cervical contribution, and rapid volume changes. The gap in care is often the lack of hands-on mapping of sensitive tissues and neural structures, paired with a plan to downshift protective tone so progressive loading becomes possible.

Signs & Symptoms

Do any of these sound familiar?

Medial elbow pain with gripping or wrist flexion

A sharp or pulling pain near the inner elbow that flares with heavy carries, pull-ups, throwing, golf swings, or forceful gripping, often worse with resisted wrist flexion or forearm pronation.

Lateral elbow pain with typing, mouse use, or lifting

Outer elbow pain that spikes with resisted wrist extension, lifting with the palm down, shaking hands, or prolonged mouse clicking, sometimes felt more in the forearm than at the elbow itself.

Grip weakness and rapid fatigue

Not a true loss of strength in every context, but a drop-off in endurance where the forearm burns quickly, grip feels unreliable, or you avoid certain handles, bars, or racquet grips.

Morning stiffness or “start-up” pain

The elbow and forearm feel stiff at first use, then warm up, then flare later with volume, suggesting a capacity mismatch rather than a single traumatic event.

Referred ache into forearm with specific wrist angles

Pain travels along the extensor or flexor mass with certain wrist positions or sustained gripping, sometimes accompanied by a protective clench that is hard to relax.

Root Cause Contributors

The mechanical drivers behind your symptoms

Forearm flexor-pronator or extensor-supinator over-recruitment

A persistent high-tone strategy where local tissues do too much of the work during gripping, lifting, or swing mechanics, increasing sensitivity and reducing endurance.

Grip strength imbalance and wrist loading intolerance

Mismatch between finger flexor strength, wrist stabilization, and forearm endurance that makes common tasks feel disproportionately irritating, especially with repeated eccentric loading.

Shoulder and scapular control deficits

When shoulder rotation and scapular stability do not contribute efficiently, the forearm and elbow compensate during racquet sports, climbing, pressing, pulling, and desk posture.

Cervical and radial or median nerve mechanosensitivity

Neural sensitivity can amplify pain at the elbow and forearm, especially when symptoms are diffuse, variable, or provoked by neck position, prolonged sitting, or sustained gripping.

Rapid training volume changes and repetitive micro-load

A sudden increase in climbing sessions, racquet time, heavy lifting, or even a new workstation setup can outpace tissue adaptation and trigger a flare cycle.

What to Expect

Your roadmap to recovery
Weeks 1 to 2
Symptoms become more predictable with daily tasks. You may notice reduced sensitivity with light gripping and less reactive soreness after typing or workouts, even if heavier loads still flare.
Weeks 3 to 6
Improved grip and wrist loading tolerance with a clearer understanding of which positions and volumes are safe to train. Many patients can reintroduce modified lifting, climbing holds, or racquet volume with fewer spikes.
Weeks 6 to 10+
Capacity-focused gains: longer workdays with less cumulative irritation, more confidence with carries and pulling, and a more durable return to sport-specific training when paired with appropriate progressive loading.

Frequently Asked Questions

Get answers to common questions

It can be irritable, but many cases behave more like tendinopathy and load intolerance than a purely inflammatory injury. Rest can calm a flare, but long-term improvement usually requires restoring tolerance to gripping and wrist loading through progressive strengthening and better mechanics.

They are used as supportive medical care to reduce local tissue sensitivity and protective tone in the forearm, elbow region, and related shoulder musculature. This can make gripping and progressive loading more tolerable, which is often the limiting factor when rehab stalls.

Both, when indicated. Medial and lateral elbow pain commonly involves regional contribution from the shoulder, scapula, thoracic spine, and sometimes cervical or peripheral nerve sensitivity. We treat what reproduces and sustains your pattern, not just the painful dot.

It depends on chronicity, how reactive the tissue is, and how much gripping volume you need to maintain. Many patients start with a short initial course to reduce sensitivity and improve tolerance, then transition to less frequent visits while building capacity with a loading plan.

Not always, but a structured tendon loading program is often helpful, especially for athletes and climbers. We can collaborate with your PT or sports medicine clinician, or help you identify when a referral makes sense based on your presentation and goals.

Seek prompt medical evaluation for significant swelling, redness, fever, acute trauma with inability to use the arm, rapidly progressive weakness, numbness that is worsening, or unexplained night pain. If you have already seen an orthopedist or sports medicine clinician, we can coordinate care around their findings.

Ready to Find Real Answers?

Schedule a free 15-minute discovery call to discuss your case and determine if our approach is right for you.

Related Conditions We Treat

118 W. 72nd, Rear Lobby, Upper West Side, NY 10023 Evidence-based acupuncture and dry needling on the Upper West Side, NYC. From chronic pain, headaches, and pelvic floor dysfunction, Dr. Jordan Barber integrates the highest level of training with compassionate care to help you thrive. Disclaimer: This site does not provide medical advice. Always consult a qualified healthcare professional before making changes to your health. Read our full disclaimer

Got Questions?

Limited spots available each week book now to reserve yours
Free Discovery Call
Got Questions Before You Book?
Schedule an Apointment

Phone

Email Us

support@drbarberclinic.com
COPYRIGHT ©ELEMENT ONE ACUPUNCTURE PLLC | ALL RIGHTS RESERVED