Tennis Elbow: Causes, Recovery, and When to Get Help

By Nova Physical Therapy, an outpatient physical therapy clinic in North Hollywood, CA | Published October 2026

It starts as a dull ache on the outside of your elbow. Then it hurts to grip a coffee mug, turn a doorknob, shake hands, or lift a gallon of milk. You've never played tennis in your life, yet everyone keeps calling it "tennis elbow."

Tennis elbow is one of the most common causes of elbow pain, and despite the name, most people who get it don't play tennis. This article explains what it is, why it happens, how long it usually lasts, what helps, and when to see a doctor.

The short answer

Tennis elbow, also called lateral elbow tendinopathy or lateral epicondylalgia, is pain on the outside of the elbow linked with overload of the tendons that extend your wrist and fingers. It's usually caused by repeated gripping, lifting, or wrist movements at work, at home, or in sports. The APTA's 2022 guideline recommends progressive strengthening of the wrist extensor muscles, with hands-on treatment and taping as useful additions (Lucado et al., JOSPT 2022). Recovery can take a while, so a consistent plan matters. In California, you can see a physical therapist without a referral.

What is tennis elbow?

The muscles that lift your wrist and fingers attach by a shared tendon to a bony bump on the outside of your elbow, called the lateral epicondyle. When that tendon takes on more load than it can handle, over and over, it can become painful and less able to tolerate gripping and lifting.

Common symptoms include:

•          Pain or burning on the outside of the elbow

•          Pain that may spread into the forearm

•          Pain with gripping, lifting, twisting, or shaking hands

•          Weaker grip, like trouble holding a cup or carrying bags

•          Tenderness when you press on the outside of the elbow

Can you get tennis elbow without playing tennis?

Yes. In fact, most people with tennis elbow don't play tennis. Common triggers include:

•          Manual work with repeated gripping or tools, like carpentry, plumbing, painting, or assembly work

•          Computer work with a lot of mouse use

•          Household tasks like gardening, cleaning, or carrying heavy bags

•          Racquet sports, including tennis and pickleball

•          Weightlifting or a sudden increase in gym work

•          Caring for a baby, which involves a lot of lifting and carrying

It's most common in middle-aged adults, and a sudden jump in a gripping activity often comes right before symptoms start.

How long does tennis elbow last?

It varies, and it's not always quick. The 2022 guideline notes that some people recover fully and quickly, but many have pain that lingers or comes back. More than half of people who see a general medical provider still report symptoms at one year, and recurrence is common (Lucado et al., 2022).

That can sound discouraging, but it's actually a reason to start a structured plan early instead of waiting and hoping. Building the tendon's capacity gradually, while adjusting the activities that aggravate it, gives you the best chance of steady progress.

What helps tennis elbow?

The APTA's lateral elbow pain guideline supports (Lucado et al., JOSPT 2022):

•          Strengthening exercises for the wrist extensor muscles, including isometric, concentric, and eccentric exercises, for pain lasting several weeks or longer

•          Combining strengthening with hands-on treatment, such as elbow joint mobilization, for short-term pain relief and better pain-free grip

•          Shoulder and shoulder blade strengthening when weakness is found there

•          Rigid taping for short-term relief when the elbow is very irritable

•          A counterforce brace or wrist support during aggravating activity for immediate relief, though there isn't enough evidence to recommend long-term use

•          Workstation and activity changes, like adjusting grip, tool size, or mouse setup

Simple steps that help many people:

•          Lift with your palm facing up when you can, which takes some load off the painful tendon

•          Use a lighter grip on tools, bags, and steering wheels

•          Take breaks from repeated gripping or mouse use

•          Don't rest it completely. Tendons generally respond better to the right amount of load than to total rest.

Questions about injections, medication, or imaging are best directed to your physician.

How can physical therapy help?

A physical therapy evaluation may include:

•          When the pain started and which activities bring it on

•          Grip strength and pain-free grip testing

•          Wrist, elbow, shoulder, and neck motion and strength

•          How you use your hands at work, at home, and in sports

•          Screening for nerve involvement and other signs that need a physician

A typical plan may include:

•          Progressive wrist and forearm strengthening, adjusted to your pain

•          Hands-on treatment for the elbow, and for the neck or upper back if needed

•          Taping or a brace for short-term relief during aggravating tasks

•          Shoulder and upper back strengthening when it's needed

•          Changes to grip, tools, workstation, or racquet setup

•          A gradual return to work, gym, or sports

Physical therapy doesn't guarantee a specific result or timeline, and some people need further medical care.

At Nova Physical Therapy in North Hollywood, sports injury rehab and work injury physical therapy are core services, and every plan starts with an evaluation so treatment fits what we find.

When should I see a doctor?

Get medical care right away if you have:

•          Elbow pain after a fall or injury, especially with swelling, deformity, or trouble moving your elbow

•          An elbow that's hot, red, and swollen, or pain with a fever

•          Sudden arm pain with chest pain, shortness of breath, or sweating

See a physician promptly if you have:

•          Numbness or tingling in your hand or fingers

•          Weakness in your hand or fingers that's getting worse

•          Neck pain with pain spreading down your arm

•          Pain that's constant, including at rest or at night

•          Pain that isn't improving despite several weeks of consistent care

We screen for these signs during every evaluation and refer you to a physician when findings call for medical assessment.

Do I need a referral for physical therapy in California?

Not to get started. California allows direct access to physical therapy. A physical therapist can evaluate and treat you without a referral for up to 45 calendar days or 12 visits, whichever comes first. After that, a physician or podiatrist needs to sign the plan of care for treatment to continue. Your insurance plan may have its own referral rules, so check your coverage.

Frequently asked questions

Should I wear a tennis elbow brace?
A counterforce brace may ease pain during activities that aggravate your elbow. The research doesn't support relying on one long term, so it works best alongside a strengthening program.

Should I rest my elbow completely?
Usually not. Tendons tend to respond better to the right amount of load. Cut back on the activities that clearly flare it, and follow a gradual strengthening plan.

What exercises help tennis elbow?
Strengthening exercises for the muscles that lift the wrist have the best support, including holds, slow lowering, and lifting movements. A physical therapist can set the right starting level and progress it.

Can I keep working out with tennis elbow?
Often, yes, with changes. Lighter grips, different hand positions, and avoiding the most painful lifts for a while can help you keep training.

Does tennis elbow need surgery?
Most people never need surgery. Surgery or injections are decisions made with your physician, usually only after long-lasting symptoms that haven't responded to consistent care.

Is tennis elbow the same as golfer's elbow?
No. Tennis elbow affects the outside of the elbow. Golfer's elbow affects the inside, where the tendons that bend the wrist attach.

Do I need a referral to see a physical therapist?
No, not to start. California allows direct access within the limits described above.

About Nova Physical Therapy

Nova Physical Therapy is an outpatient physical therapy clinic in North Hollywood, California, led by a Doctor of Physical Therapy. We help people recover from sports injuries, back and neck pain, work injuries, auto accident injuries, knee pain, and shoulder problems, and we also work with balance problems and rehab after surgery. Patients come to us from North Hollywood, Burbank, Studio City, Toluca Lake, Valley Village, and across the San Fernando Valley. Learn more about Nova or see our services.

Schedule an evaluation

If elbow pain is making it hard to grip, lift, work, or play, an evaluation can help sort out what is driving it and which next steps fit you.

Nova Physical Therapy
4795 Vineland Ave #E, North Hollywood, CA 91602
Call (818) 639-3402 | Book an appointment online

Disclaimer

This article is for general education only. It is not medical advice, a diagnosis, or a treatment recommendation for any individual. Elbow pain has many causes, and only an in-person evaluation can determine what is right for you. No treatment guarantees symptom resolution, and results vary. Physical therapists evaluate movement and function within their scope of practice and refer to physicians when findings warrant. Physical therapy in California is regulated by the Physical Therapy Board of California.

References

1.        Lucado AM, Day JM, Vincent JI, et al. Lateral Elbow Pain and Muscle Function Impairments: Clinical Practice Guidelines. J Orthop Sports Phys Ther. 2022;52(12):CPG1–CPG111. Link

2.        Physical Therapy for People with Lateral Elbow Tendinopathy: Using the Evidence to Guide Musculoskeletal Rehabilitation Clinical Practice. J Orthop Sports Phys Ther. 2023. Link