Your elbow is essential for countless daily activities—from lifting your morning coffee to typing at work, from playing sports to simply getting dressed. When elbow pain strikes, these routine tasks become painful reminders of how much you depend on this joint. Whether you’re dealing with the nagging ache of tennis elbow, the sharp pain of golfer’s elbow, or discomfort following an injury, elbow problems can significantly impact your work, hobbies, and quality of life. At Midas Physiotherapy in Oakville, we provide comprehensive assessment and evidence-based treatment to help you overcome elbow pain and return to full, pain-free function.
Elbow pain is remarkably common—lateral epicondylitis (tennis elbow) alone affects 1–3% of the adult population at any given time, making it one of the most frequent upper limb conditions. Despite the names “tennis elbow” and “golfer’s elbow,” most people with these conditions have never picked up a racquet or club. These problems typically develop from repetitive activities at work, in hobbies, or during everyday tasks—and they respond very well to physiotherapy when treated appropriately.
The good news about elbow tendinopathy is that conservative treatment is highly effective. Research consistently shows that structured exercise programs produce excellent long-term outcomes—often better than injections or surgery. The key is understanding that these conditions involve tendon degeneration rather than inflammation, which means the treatment approach focuses on progressive loading to stimulate healing rather than just rest and anti-inflammatories.
For Oakville residents struggling with elbow pain—whether it’s affecting your golf game at Glen Abbey, your work at the computer, or your ability to pick up your grandchildren—our Cornwall Road clinic offers thorough evaluation and personalized treatment to get you moving comfortably again.
Common Elbow Pain Conditions We Treat
Elbow pain can arise from various structures. Here are the most common conditions we see:
Lateral Epicondylitis (Tennis Elbow)
Lateral epicondylitis—commonly called “tennis elbow”—is the most common cause of elbow pain. It affects the tendons that attach to the lateral (outer) epicondyle, particularly the extensor carpi radialis brevis (ECRB). Despite the name, fewer than 10% of people with tennis elbow actually play tennis—it’s much more commonly caused by work activities, computer use, or other repetitive tasks involving gripping and wrist extension.
Despite being called “epicondylitis” (implying inflammation), research shows the condition actually involves tendon degeneration (tendinosis) rather than inflammation. This is why anti-inflammatory treatments often provide only temporary relief, while progressive loading exercises that stimulate tendon repair produce lasting improvement.
Medial Epicondylitis (Golfer’s Elbow)
Medial epicondylitis—commonly called “golfer’s elbow”—affects the tendons attaching to the medial (inner) epicondyle, particularly the flexor-pronator mass. Like tennis elbow, most people with this condition aren’t golfers—it’s commonly caused by activities involving gripping, throwing, or repetitive wrist flexion. The condition is less common than lateral epicondylitis but responds to similar treatment principles: progressive loading rather than rest.
Cubital Tunnel Syndrome
Cubital tunnel syndrome is compression or irritation of the ulnar nerve as it passes behind the medial epicondyle—the “funny bone” area. Symptoms include numbness and tingling in the ring and little fingers, aching along the inner forearm, and weakness of grip in advanced cases. Symptoms are often worse at night or with prolonged elbow bending (like holding a phone). Treatment focuses on nerve gliding, activity modification, and addressing contributing factors.
Radial Tunnel Syndrome
Radial tunnel syndrome involves compression of the radial nerve or its posterior interosseous branch as it passes through the forearm muscles just below the elbow. It can cause deep, aching pain on the outer forearm that may be mistaken for lateral epicondylitis. The key difference is that pain is typically located slightly more toward the forearm and may be aggravated by resisted supination (turning palm up). Treatment addresses nerve mobility and muscle factors.
Elbow Bursitis (Olecranon Bursitis)
Olecranon bursitis is inflammation of the bursa over the point of the elbow (olecranon). It causes visible swelling at the tip of the elbow, which may be painful or simply cosmetically concerning. It often results from direct pressure (leaning on elbows), trauma, or can occur without obvious cause. Non-infected bursitis often resolves with protection and avoiding pressure; infected bursitis requires medical treatment.
Elbow Osteoarthritis
Elbow osteoarthritis is less common than hip or knee arthritis but can occur, particularly following previous injury or in people who have used their arms extensively for heavy work. Symptoms include pain, stiffness, and sometimes catching or locking due to loose bodies. Conservative treatment—strengthening, mobility work, and activity modification—can significantly improve function.
Distal Biceps Tendinopathy and Tears
Distal biceps problems affect the biceps tendon at its attachment to the radius. Tendinopathy causes anterior elbow pain with lifting. Complete tears (rupture) cause sudden pain with a “pop,” bruising, and weakness of elbow flexion and supination. Partial tears and tendinopathy respond to conservative treatment; complete tears in active individuals often require surgical repair.
Triceps Tendinopathy
Triceps tendinopathy affects the triceps tendon at the back of the elbow. It causes pain at the olecranon with pushing activities and resisted elbow extension. It’s less common than lateral or medial epicondylitis but responds to similar progressive loading principles.
Throwing Injuries
Throwing athletes (baseball, softball, javelin, cricket) can develop specific elbow problems including ulnar collateral ligament (UCL) injuries, valgus extension overload, and flexor-pronator injuries. These conditions require sport-specific assessment and rehabilitation, often including throwing mechanics analysis and gradual return-to-throwing programs.
Elbow Fractures and Post-Traumatic Stiffness
The elbow is prone to stiffness after injury or surgery. Post-traumatic elbow stiffness can significantly limit function—the elbow needs approximately 100 degrees of flexion and 100 degrees of pronation/supination for most daily activities. Rehabilitation focuses on restoring range of motion through progressive mobilization and strengthening while respecting healing timelines.
Common Symptoms of Elbow Pain
Elbow problems present with various symptoms depending on the underlying condition:
- Pain location: Outer elbow (lateral epicondylitis), inner elbow (medial epicondylitis), back of elbow (olecranon bursitis, triceps), front of elbow (biceps)
- Pain with gripping: Difficulty holding objects, shaking hands, turning doorknobs—classic for tennis elbow
- Pain with lifting: Difficulty picking up objects, especially with palm down (tennis elbow) or palm up (golfer’s elbow)
- Weakness: Reduced grip strength, difficulty with daily tasks
- Stiffness: Difficulty fully bending or straightening the elbow
- Numbness or tingling: In the ring and little fingers (cubital tunnel) or back of forearm (radial tunnel)
- Swelling: Visible swelling at the tip of the elbow (bursitis) or general joint swelling (arthritis)
- Clicking or catching: May indicate loose bodies or joint pathology
- Night symptoms: Numbness or tingling that wakes you, or elbow aching at rest
Causes and Contributing Factors
Elbow pain typically develops from a combination of factors rather than a single cause. Understanding these guides comprehensive treatment and prevention.
Repetitive Strain
Repetitive activities are the most common cause of elbow tendinopathy. Computer mouse use, typing, assembly line work, cooking, gardening, DIY projects—any activity involving repeated gripping, lifting, or wrist movements can overload the elbow tendons. The problem isn’t that these activities are harmful, but that load exceeds the tendon’s capacity to adapt—either through excessive volume, insufficient recovery, or sudden increases in activity.
Poor Load Management
Doing too much, too soon is a common pattern. Starting a new activity (new job, new hobby, home renovation project), suddenly increasing an existing activity, or returning too quickly after a break can all trigger symptoms. Tendons adapt to load, but they need time—weeks to months—to strengthen in response to new demands.
Workplace Ergonomics
Workstation setup can contribute to elbow problems. Mouse use with the wrist extended, keyboard height that requires wrist deviation, and sustained awkward positions increase load on the forearm muscles and their tendon attachments. Addressing ergonomics is an important part of treatment and prevention for work-related elbow pain.
Technique Issues
Sports technique can contribute to elbow problems—hence “tennis elbow” and “golfer’s elbow.” Poor backhand technique, inappropriate grip size, and hitting off-center increase elbow strain. Similarly, improper lifting technique in the gym or poor tool use in trades can overload the elbow. Addressing technique is important for athletes and workers whose activities contributed to their symptoms.
Age and Tissue Changes
Age-related changes affect tendon capacity. Lateral epicondylitis peaks between ages 35–55—a time when tendon quality may be declining while activity demands remain high. This doesn’t mean elbow pain is inevitable with aging, but it does mean tendons may need more attention to recovery and gradual progression.
Neck and Shoulder Contributions
The neck and shoulder can contribute to elbow pain. Cervical nerve irritation can refer pain to the lateral elbow and mimic tennis elbow. Shoulder weakness or dysfunction can alter arm mechanics and increase elbow loading. This is why comprehensive assessment includes the entire upper limb and neck.
Grip Strength Deficits
Weak grip strength is both a consequence and contributor to elbow tendinopathy. When grip is weak, you may use more forearm muscle effort for everyday tasks, increasing tendon load. Grip strengthening is often a key component of rehabilitation.
How We Treat Elbow Pain at Midas Physiotherapy
Our approach combines thorough assessment with evidence-based treatment targeting the specific factors contributing to your elbow pain.
Comprehensive Assessment
Effective treatment begins with accurate diagnosis. We assess your elbow, but also your wrist, shoulder, and neck—all of which can contribute to elbow symptoms. We evaluate strength, flexibility, movement patterns, and the specific activities that aggravate your symptoms. Understanding what you need your arm to do guides our treatment approach.
Education
Understanding your condition is essential. We explain that tennis elbow and golfer’s elbow are tendon degeneration problems, not inflammation—which is why rest and anti-inflammatories often don’t provide lasting relief, while progressive loading does. Understanding the healing process helps you commit to the exercise program and have realistic expectations for recovery timelines.
Progressive Loading Exercise
Progressive loading is the cornerstone of tendinopathy treatment. Exercises are prescribed to load the tendon appropriately—enough to stimulate healing and strengthening, but not so much as to aggravate symptoms. Programs typically start with isometric exercises (holding positions), progress to eccentric exercises (controlling lowering), and advance to heavier resistance exercises as the tendon adapts. This progression occurs over weeks to months.
Manual Therapy
Hands-on treatment can provide pain relief and address contributing factors. This may include soft tissue techniques for the forearm muscles, elbow joint mobilization, and treatment of the wrist, shoulder, or neck when they’re contributing. Manual therapy can reduce symptoms in the short term, creating a window for exercise to be more effective.
Dry Needling
Dry needling can be effective for elbow tendinopathy and forearm muscle trigger points. It may reduce pain and improve muscle function, supporting your exercise program. Some patients find dry needling provides significant short-term relief while working on longer-term strengthening.
Shockwave Therapy
For chronic tennis elbow that hasn’t responded to initial exercise treatment, shockwave therapy can be an effective addition. Research supports its use for recalcitrant lateral epicondylitis, with success rates of 60–80% in cases that haven’t improved with other treatments.
Bracing and Taping
Counterforce braces (tennis elbow straps worn below the elbow) can reduce tendon loading during activities and provide symptom relief. They’re useful as an adjunct during rehabilitation and for high-demand activities, but they shouldn’t replace strengthening. Wrist splints may help by reducing wrist extensor activity, particularly at night.
Activity Modification and Ergonomics
Modifying aggravating activities—rather than stopping them completely—allows symptoms to settle while you continue to function. We provide guidance on workstation setup, tool use, and technique modifications to reduce elbow strain. The goal is keeping you active while managing load appropriately.
Neural Mobilization
For nerve-related elbow pain (cubital tunnel, radial tunnel), neural mobilization techniques help restore normal nerve movement and reduce sensitivity. Combined with addressing contributing positions and activities, these techniques often produce significant improvement.
Frequently Asked Questions
- I’ve never played tennis—why do I have tennis elbow?
Tennis elbow (lateral epicondylitis) has very little to do with tennis—fewer than 10% of people with this condition actually play tennis. The name comes from the fact that backhand strokes can contribute to the problem. Much more commonly, it develops from occupational activities (computer work, manual trades), hobbies (gardening, DIY), or simply repetitive daily tasks. Any activity involving gripping and wrist extension can overload these tendons.
- Should I rest my elbow completely?
Complete rest is generally not recommended and can actually delay healing. Tendons need appropriate loading to heal and strengthen. “Relative rest”—modifying activities to reduce aggravating loads while continuing gentle use and beginning a loading program—produces better outcomes than complete rest. The key is finding the right balance: enough load to stimulate healing, not so much that symptoms flare.
- Should I get a cortisone injection?
Cortisone injections provide short-term pain relief (weeks), but research shows significantly worse long-term outcomes compared to exercise—including higher recurrence rates and poorer function at 12 months. Injections essentially trade short-term relief for longer-term problems. We typically recommend exercise-based treatment first, reserving injections for specific circumstances. If you’ve already had an injection, rehabilitation is still the key to lasting recovery.
- Why is it taking so long to heal?
Tendon healing is inherently slow—tendons have poor blood supply and low metabolic activity. Elbow tendinopathy typically takes 3–6 months for full recovery, though improvement often begins earlier. Think of it like remodeling a house rather than painting a wall—it’s a gradual process of breaking down damaged tissue and building new, stronger tissue. Patience and consistent loading are key.
- Will I need surgery?
Very unlikely. Over 90–95% of people with tennis elbow recover with conservative treatment. Surgery is only considered when symptoms persist despite 6–12 months of comprehensive rehabilitation. Even then, surgery isn’t guaranteed to help and has a recovery period of its own. Most people who commit to an exercise program recover without needing surgery.
- Does a tennis elbow strap help?
Counterforce braces (tennis elbow straps worn just below the elbow) can provide symptom relief during activities by reducing load on the tendon attachment. They’re a useful adjunct during rehabilitation and for high-demand activities. However, they shouldn’t replace strengthening exercises—think of them as a helpful tool during recovery, not a solution on their own.
- Is it okay to work through the pain?
Some discomfort during loading is often acceptable—and even necessary for tendon adaptation. However, pain that significantly worsens during activity and doesn’t settle quickly afterward suggests you’re overloading. We often use a “traffic light” system: mild discomfort (green) is acceptable, moderate worsening (yellow) means back off a bit, and significant flare-ups (red) indicate too much load. Finding the right level is part of the rehabilitation process.
- Can my neck cause elbow pain?
Yes. Cervical nerve irritation can refer pain to the lateral elbow and mimic tennis elbow. This is one reason why comprehensive assessment is important—if your neck is contributing (or is the primary cause), treating only the elbow won’t fully resolve symptoms. We assess your neck as part of our standard elbow evaluation.
- I have numbness in my fingers—is that related to my elbow?
Possibly. Numbness in the ring and little fingers often comes from the ulnar nerve at the elbow (cubital tunnel syndrome). Numbness in the thumb, index, and middle fingers may be carpal tunnel syndrome at the wrist—but can also originate from the neck. Numbness in the back of the forearm may involve the radial nerve. We can help determine the source and appropriate treatment.
- Can I still play tennis/golf with elbow pain?
Often yes, with modifications. Reducing playing frequency, warming up properly, using appropriate equipment, and focusing on technique can allow continued play while recovering. Sometimes a brief break is helpful, but complete cessation isn’t always necessary. We can help you modify your activity appropriately and guide a gradual return to full play.
- Should I ice or heat my elbow?
Either can provide temporary pain relief—use what feels best. Since tennis elbow and golfer’s elbow involve degeneration rather than inflammation, anti-inflammatory approaches (ice, NSAIDs) don’t address the underlying problem. They may provide symptomatic relief, which can be helpful, but the real treatment is progressive loading. Heat before activity and ice after can be a reasonable approach for some people.
- Do I need a referral to see a physiotherapist for my elbow?
No. In Ontario, you can access physiotherapy directly without a doctor’s referral. If we believe you need imaging, medical evaluation, or specialist referral, we’ll let you know. For workplace injuries (WSIB), we work directly with your insurer—no referral required.
Get Relief from Your Elbow Pain
If elbow pain is affecting your work, sports, or daily activities, don’t wait for it to become a chronic problem. Evidence-based physiotherapy—particularly progressive loading exercise—produces excellent long-term outcomes for elbow tendinopathy and other elbow conditions. Let us help you understand what’s causing your pain and develop a plan to restore full, pain-free function.
Midas Physiotherapy
2061 Cornwall Road, Unit 3
Oakville, Ontario
Website: midasphysiotherapy.ca
Direct billing available for most major insurance providers. WSIB claims accepted.
Related Services
- Tennis Elbow & Golfer’s Elbow Treatment
- Shockwave Therapy
- Hand & Wrist Pain Treatment
- Shoulder Pain Treatment
- Sports Physiotherapy
