Tennis elbow: treatment, exercises and recovery time

By Geoff Scott, Founder & Senior Physiotherapist, Hauora

By Geoff Scott, Senior Physiotherapist and founder of Hauora. Last updated 14 November 2026.

What is tennis elbow?

Tennis elbow, known clinically as lateral elbow tendinopathy, is pain on the outside of the elbow caused by overloading the tendons that attach your forearm muscles to the bone. It hurts most when you grip, lift or twist. Despite the name, most people who get it don’t play tennis, and most recover with the right exercise programme.

At our physiotherapy clinic in Primrose Hill we see it in office workers from Camden and King’s Cross who spend all day on a keyboard and mouse, in people doing DIY and decorating, and more and more in padel and tennis players from St John’s Wood, Hampstead and Belsize Park.

Tennis elbow at a glance

  • Common: it affects up to 3% of people and is most common between the ages of 35 and 54.
  • Not just tennis: typing, using a mouse, DIY, gardening, playing an instrument and racket sports can all trigger it.
  • Usually gets better: many cases settle within weeks, but it can last more than a year without the right plan.
  • Exercise is the treatment: progressive strengthening of the forearm is the foundation of rehab.
  • Think twice about steroid injections: in a major trial they led to worse results at one year, and the pain came back far more often, than with a placebo injection.

Tennis elbow symptoms

  • Pain on the outside of the elbow, sometimes spreading down the forearm
  • Pain when gripping, lifting a kettle or shaking hands
  • Pain when twisting, such as opening a jar or turning a door handle
  • Tenderness when you press the bony point on the outside of the elbow
  • Difficulty fully straightening the arm, and pain that disturbs sleep in more severe cases

Pain on the inside of the elbow is more likely to be golfer’s elbow, which is treated in a similar way.

What causes tennis elbow?

Tennis elbow is an overload problem in the tendons on the outside of the elbow, especially the one belonging to the muscle that lifts your wrist. It usually follows a spell of more gripping and twisting than your forearm is used to. Common triggers include:

  • Long hours at a keyboard and mouse, especially with the wrist bent back
  • DIY, decorating and gardening: screwdrivers, paintbrushes, secateurs and power tools
  • Racket sports: a sudden increase in tennis, padel or squash, a new racket, or the wrong grip size
  • Lifting with your palm facing down, including carrying bags and children
  • Playing a musical instrument for long periods

How long does tennis elbow last?

The NHS says tennis elbow usually improves after a few weeks of resting the arm from the activities that aggravate it, but it can sometimes last more than a year. In our experience, people who start a structured strengthening programme early, and stop doing the things that keep flaring it up, recover fastest. Long-standing cases need patience, because tendons adapt over months rather than days.

Tennis elbow treatment: what actually works

1. Modify your activity, don’t immobilise

Cut back the gripping and twisting that aggravate it rather than resting the arm completely. Lift with your palm facing up, use a lighter grip, take regular breaks from the mouse and keyboard, and set up your desk so your wrist isn’t bent back. Padel and tennis players do well by cutting back match play for a few weeks, checking their grip size and getting a coach to look at their backhand.

2. Strengthen your forearm, gradually

Exercise is the foundation of tennis elbow treatment. Tendons respond to load, and a programme that starts gently and gets gradually heavier helps them adapt. We usually start with:

  • Isometric holds: with your forearm resting on a table, palm down, hold your wrist up against resistance for 30 to 45 seconds, 5 times
  • Slow wrist extensions: holding a light dumbbell, palm down, lift your wrist for 3 seconds and lower it for 3 seconds, 3 sets of 15
  • Grip work: squeezing a soft ball or putty, building up the resistance
  • Shoulder and upper back strength, so your forearm isn’t doing all the work

Some discomfort during the exercises is fine, as long as it’s mild and settles by the next day. We increase the load every week or two.

3. Hands-on treatment and a strap, for short-term relief

Manual therapy, such as mobilisation with movement, can ease pain in the short term and make exercise more comfortable. A forearm strap worn just below the elbow helps some people with gripping tasks. Both support the strengthening work. They don’t replace it.

4. Be wary of steroid injections

Steroid injections often bring quick relief, but the long-term picture is poor. In a trial of 165 people published in JAMA in 2013, people given a steroid injection were less likely to have recovered at one year than those given a placebo injection (83% compared with 96%), and far more likely to have the pain come back (54% compared with 12%). People who had physiotherapy without a steroid injection had the lowest recurrence of any group. An earlier trial in the BMJ also found that most people who improved after an injection relapsed within a year, while very few did after physiotherapy.

5. Other options for stubborn cases

For tennis elbow that hasn’t improved after several months of good rehab, options include shockwave therapy, other types of injection such as platelet-rich plasma and, rarely, surgery. The NHS says surgery may be an option if symptoms persist after 6 to 12 months. We’ll talk you through the evidence and refer you if it’s needed.

When to see a physio about elbow pain

The NHS suggests seeing a GP if elbow pain continues after at least two weeks of rest and self-care, and recommends physiotherapy if symptoms haven’t improved after six weeks. Book an assessment sooner if the pain is affecting your work, sleep or sport, or keeps coming back. Get it checked promptly if the elbow is very swollen, hot or red, if you’ve had a fall or heard a crack, or if you have numbness or tingling in your hand. You can read more on our sports injuries page.

How we treat tennis elbow at Hauora

Your 45-minute assessment (£155) confirms it’s tennis elbow and not pain referred from your neck, a trapped nerve or a joint problem. We test your grip and forearm strength, look at your work set-up and, for racket players, your technique and equipment. You leave with a load plan, a progressive strengthening programme and practical changes for work and sport. Hands-on treatment eases pain while the strength work does its job, and our strength and movement coaching can take you back to full training. You’ll be seen by Geoff Scott or Jason Oliveira, both senior physiotherapists with elite-sport backgrounds.

Frequently asked questions

How long does tennis elbow take to heal?

Many cases settle within a few weeks of easing off aggravating activities, but the NHS notes it can last more than a year. Starting a progressive strengthening programme early gives you the best chance of a faster recovery.

What is the best exercise for tennis elbow?

Progressive strengthening of the muscles that lift your wrist is the core of rehab. Most people start with isometric holds, then move on to slow wrist extensions with a light dumbbell, increasing the weight as the tendon adapts.

Should I get a steroid injection for tennis elbow?

Think carefully. Steroid injections often help in the first few weeks, but a major trial found that people who had one were less likely to have recovered at one year, and much more likely to have the pain return, than people given a placebo injection.

Can I play padel or tennis with tennis elbow?

Often, yes, at a reduced level, as long as the pain stays mild and settles by the next day. Cutting back match play, checking your grip size and working on your backhand while you strengthen usually works better than stopping completely.

Does a tennis elbow strap work?

A forearm strap worn just below the elbow eases pain during gripping for some people. It’s a useful short-term aid, but it won’t fix the problem without strengthening exercises.

Can using a computer cause tennis elbow?

Yes. Long hours with a mouse and keyboard, especially with your wrist bent back, are a common trigger. Adjusting your set-up, taking regular breaks and strengthening your forearm usually help.

Related reading: shoulder injury rehab, lower back pain from sitting at a desk and strength training after 40.

Tennis elbow physio in Primrose Hill, St John’s Wood and Belsize Park

If elbow pain is affecting your work or your game, book an assessment at Hauora, an independent physiotherapy clinic at 44 Gloucester Avenue, Primrose Hill, London NW1 8JD. We’re close to Chalk Farm and Camden Town stations and easy to reach from St John’s Wood, Belsize Park, Swiss Cottage, Hampstead, Regent’s Park, Marylebone, Kentish Town and Maida Vale. Book online at hauora.com/book or call 020 4541 8924.

Finding us: Hauora is based inside the At The Core building, but we’re a separate business from At The Core. We share the building and the phone number, so when you call, please ask for Hauora.

This article is general information, not a diagnosis. If you’re injured or unwell, see a doctor or physiotherapist.

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