Elbow Pain

What Causes Elbow Pain?

Elbow pain is almost always about tendons. Your forearm muscles attach to your elbow via tendons, and when you overload those tendons through repetitive gripping, lifting, or typing, they break down faster than they can adapt.

It’s common in gym-goers who’ve ramped up pulling volume too quickly — pull-ups, deadlifts, rows, curls. Also desk workers across Liverpool and Chester who spend hours gripping a mouse or typing. Tradespeople using hand tools all day. Climbers. Anyone whose job or hobby involves sustained or repetitive grip.

The onset is usually gradual. You don’t wake up one day with elbow pain — it builds over weeks or months as the tendon’s capacity to handle load gets overwhelmed. Sometimes there’s a specific incident that tips it over the edge, like a heavy session at the gym or a day of unusually intense manual work, but the underlying issue has been brewing for a while.

Common Elbow Problems I Treat

Here’s what typically brings people through the door across Liverpool, Chester, Queensferry, and the wider Merseyside and Cheshire areas.

Tennis Elbow (Lateral Epicondylitis/Tendinopathy)

Pain on the outside of the elbow with gripping, lifting, and turning movements, common in desk workers and gym-goers despite the misleading name. Progressive loading rehabilitation over 6-12 weeks is effective, though chronic cases may require 3-6 months of consistent work.

Read more about Tennis Elbow →

Golfer’s Elbow (Medial Epicondylitis/Tendinopathy)

Pain on the inside of the elbow from overload of the forearm muscles that flex the wrist and fingers, common in climbers and gym-goers doing heavy pulling. Progressive loading rehab similar to tennis elbow, typically taking 6-12 weeks for acute cases or longer for chronic presentations.

Read more about Golfer’s Elbow →

Triceps Tendinopathy

Pain at the back of the elbow, less common but seen in gym-goers who do a lot of overhead pressing, dips, or heavy triceps work.

The triceps tendon attaches at the back of the elbow, and if you ramp up pressing volume or intensity too quickly without adequate recovery, you can overload it.

Symptoms: Pain at the back of the elbow during or after pressing movements, sometimes tender to touch.

Rehab involves progressive loading of the triceps, modifying pressing volume temporarily, and addressing any technique issues contributing to the problem.

Recovery: 4-8 weeks for acute cases, longer if it’s been there for months.

What You Can Expect in Your Assessment

I’ll take a detailed history — how the pain started, what makes it worse, what you’ve tried, and what your goals are. Then I’ll assess your elbow: range of movement, strength testing, palpation to identify exactly where the pain is, and specific clinical tests to confirm whether it’s lateral, medial, or triceps tendinopathy.

Often I’ll watch you grip, lift, or perform movements relevant to your problem — typing posture for desk workers, pulling mechanics for gym-goers, work-specific movements for tradespeople.

By the end of the session, you’ll have:

Do I Need a Scan?

Probably not. Elbow tendinopathy is a clinical diagnosis — I can usually tell what’s wrong based on your history and examination without imaging.

Ultrasound can confirm tendinopathy and show the extent of tendon changes if needed, but it doesn’t change the treatment approach. We can start rehab straight away without waiting for a scan.

You might need imaging if:

• Symptoms aren’t responding to rehab as expected and we need to rule out other issues
• There’s been significant trauma and I suspect a ligament injury or fracture
• You’re being considered for more invasive treatment and the clinician needs imaging to plan it

If imaging is needed, I’ll guide you on the best route — NHS referral via your GP (free but slower), or private ultrasound if you want results quickly.

Why Rest Alone Doesn’t Work

People rest their elbow, pain settles a bit, they go back to the gym or work, and it flares up again within days. Sound familiar?

Here’s why that happens: rest reduces pain by removing the aggravating load, but it doesn’t fix the underlying problem — the tendon’s capacity to handle load is still insufficient.

When you return to activity at the same level you were at before, you’re asking a deconditioned tendon to handle loads it couldn’t manage when it was stronger. No surprise it breaks down again.

What Does Elbow Rehab Involve?

Depends on the specific diagnosis, but here’s what most elbow rehab programmes include:

Isometric loading initially: Holding positions under load without moving the joint. This builds tendon tolerance and reduces pain without aggravating symptoms. Think: gripping exercises, wrist extension holds, static positions.

Progressive eccentric and heavy slow resistance training: Once symptoms settle with isometrics, we progress to slow, controlled lowering movements and heavier loading. This is what actually builds tendon capacity long-term. The research is clear — tendons respond to heavy, slow loading.

Grip strengthening: Whether it’s tennis elbow or golfer’s elbow, grip strength is usually involved. We’ll work on building overall forearm and grip capacity.

Load management: Modifying training volume, adjusting grip width on pulling exercises, swapping out aggravating movements temporarily, managing work activities if they’re contributing. The goal is to keep doing what you need to do while staying within tolerable symptom levels.

Modifying aggravating activities: If certain exercises or work tasks consistently flare symptoms, we modify them. That might mean changing grip position, using different tools or equipment, adjusting technique, or temporarily reducing volume on specific movements.

How Long Does Recovery Take?

Realistic timescales for common elbow problems:

Tennis elbow: 6-12 weeks of progressive loading for recent cases. Chronic tennis elbow that’s been there for 6+ months can take 3-6 months to settle. You won’t be out completely — most people can modify training or work activities and keep doing some version of what they need to do.

Golfer’s elbow: Similar timeline to tennis elbow — 6-12 weeks for acute cases, longer if it’s chronic.

Triceps tendinopathy: 4-8 weeks depending on severity. Less common and usually responds a bit faster than lateral or medial tendinopathy.

These are broad ranges. Your specific timeline depends on how long you’ve had it, how severe it is, and how well you stick to the progressive loading programme.

Tendons are slow to adapt. Anyone promising to fix your elbow tendinopathy in three sessions is talking rubbish. But with the right approach, most people see significant improvement by 12 weeks.

When to Book an Assessment

Location and Booking

I run a clinic in Chester, with appointments available Monday, Wednesday, Thursday, and Friday.

Whether you’re a gym-goer across Cheshire dealing with tennis elbow from high-volume pulling, a desk worker from Chester with pain from gripping a mouse all day, or a tradesperson from North Wales whose elbow is struggling with the demands of manual work, I can help.

Book online to see available slots, or get in touch if you’ve got questions before booking.

No hard sell. No obligation. Just honest physio focused on getting you back to doing what you want to do, pain-free.