Get to the Root of Your Elbow Pain — and Treat It Properly
Elbow pain is one of the most frustrating musculoskeletal conditions to manage. It interferes with gripping, lifting, typing, and dozens of small daily tasks that you rely on without thinking. The two most common causes—tennis elbow and golfer’s elbow—are tendon conditions that respond well to the right treatment, but often persist for months or years when managed with rest and painkillers alone.
At The Physiotherapy Centre in Waterlooville, we treat elbow pain with a structured, evidence-based approach that combines accurate diagnosis, progressive loading, and, where appropriate, adjunct treatments such as shockwave therapy, EMTT, and ultrasound-guided injections. Our team includes chartered physiotherapists, sports therapists, and a diagnostic ultrasound specialist, ensuring that your entire treatment pathway can be managed under one roof.
Patients from Widley, Purbrook, Waterlooville, Cosham, Havant, and Petersfield attend our clinic for elbow conditions that range from recent onset to problems that have lingered for over a year. Whether you are struggling with a sports-related injury or a persistent work-related strain, we provide the specialist clinical care required to restore function and get you back to your daily activities.
Understanding Elbow Pain
Tennis Elbow (Lateral Epicondylalgia)
Tennis elbow is the most common cause of elbow pain. Despite the name, it affects far more people who have never played tennis than those who have. It involves the tendons that attach to the outer (lateral) side of the elbow — the common extensor origin — and is caused by repetitive gripping, lifting, or twisting movements. It is common in office workers, manual labourers, gardeners, and recreational athletes.
Symptoms include pain on the outer elbow that worsens with gripping, lifting a kettle, turning a door handle, or shaking hands. The pain may radiate into the forearm. In the early stages it may only appear during activity, but as the condition progresses it can become constant. Tennis elbow is a degenerative tendon condition (tendinopathy), not an inflammation in the traditional sense. This is why anti-inflammatory treatments often provide only temporary relief. The tendon needs to be progressively loaded to stimulate repair — and this is where physiotherapy is most effective.
Tennis elbow is a degenerative tendon condition (tendinopathy), not an inflammation in the traditional sense. This is why anti-inflammatory treatments often provide only temporary relief. The tendon needs to be progressively loaded to stimulate repair — and this is where physiotherapy is most effective.
Golfer’s Elbow (Medial Epicondylalgia)
Golfer’s elbow affects the tendons on the inner (medial) side of the elbow — the common flexor origin. It is less common than tennis elbow but causes similar frustration. Symptoms include pain on the inner elbow with gripping, wrist flexion, and carrying. It is common in climbers, gym users, and people who perform repetitive manual tasks.
Other Causes of Elbow Pain
Not all elbow pain is tendon-related. Other causes include referred pain from the cervical spine or shoulder, ulnar nerve irritation (causing tingling in the ring and little fingers), olecranon bursitis (swelling at the point of the elbow), ligament injuries (particularly in throwing athletes), and post-fracture stiffness or post-surgical restriction. A thorough assessment is essential to determine the correct diagnosis.
How We Treat Elbow Pain
Clinical Assessment and Diagnosis
Your physiotherapist will carry out a detailed assessment that begins with palpation of the tendon insertion points and resisted muscle testing to identify exactly which tendons are involved. We also include grip strength measurement, which serves as a key objective marker for monitoring your progress throughout your recovery. To ensure the source of the pain is local, we perform cervical spine screening to rule out referred pain from the neck and neural testing to assess for ulnar nerve involvement. This comprehensive assessment determines the exact structure involved and the severity of the condition, which directly informs your bespoke treatment plan.
Progressive Tendon Loading
The most effective treatment for tennis elbow and golfer’s elbow is a graded tendon loading programme. This begins with isometric exercises—muscle contraction without movement—before progressing to isotonic loading, which involves controlled movement through a specific range. In the later stages, we advance to eccentric and heavy slow resistance exercises. Your programme is adjusted at each session based on your symptoms and objective grip strength measurements. Research consistently shows that a structured loading programme produces better long-term outcomes than cortisone injections, which may provide short-term relief but are associated with significantly higher recurrence rates.
Manual Therapy and Soft Tissue Treatment
Hands-on treatment is used to manage pain and address the contributing mechanical factors. This may include soft tissue release of the forearm muscles to ease tension and mobilisation of the elbow and wrist joints to restore fluid movement. If nerve irritation is contributing to your symptoms, we utilise neural mobilisation techniques. Furthermore, if our initial assessment identifies referred pain, we incorporate cervical and thoracic spine mobilisation to address the issue at its source.
Adjunct Treatments
For persistent elbow pain that has not responded to exercise alone, adjunct treatments can be integrated to accelerate your recovery. Shockwave therapy (ESWT) is well-supported by evidence for chronic lateral epicondylalgia and works by stimulating tendon remodelling. Additionally, EMTT can be used to address deeper tissue components and reduce pain levels. In specific cases, such as significant inflammatory bursitis or where a diagnostic scan is required to assess tendon integrity, an ultrasound-guided injection or scan with Peter Monk may be recommended.
What to Expect at Your First Appointment
At The Physiotherapy Centre, we understand that when you are in pain, you want answers as much as you want relief. Your initial 45 to 60-minute consultation is designed to provide both.
Your First Appointment: What to Expect
Practicalities for your visit:
- What to wear: Please wear comfortable, loose-fitting clothing that allows your physiotherapist to see your spine in motion. A vest top, sports bra, or loose t-shirt is ideal for neck and back assessments.
- Clinical Clarity: You won’t leave wondering what is wrong. By the end of the session, your therapist will provide a clear explanation of the likely cause of your pain and a bespoke roadmap for your recovery.
- Immediate Progress: You will receive your first round of treatment and a small selection of specific home exercises to begin your rehabilitation the very same day.
Honesty in Recovery
We believe in realistic expectations. While many patients experience a significant reduction in pain within the first two to three sessions, every spine is different. Your physiotherapist will provide an honest assessment of your prognosis, outlining how many sessions you are likely to need and what milestones we are aiming for.
Whether your goal is to get through a workday without stiffness, return to the golf course, or simply get a full night’s sleep, we are here to help you achieve it.
Pricing and Appointments
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Initial Assessment £79 (45 minutes) or £89 (60 minutes)
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Follow-Up Session £72 (30 minutes)
We are recognised providers for Bupa, AXA PPP, Aviva, WPA, and Cigna.
Conveniently Located in Waterlooville
- The Physiotherapy Centre 96 London Road, Widley, Waterlooville, Hampshire, PO7 5AB
- Opening Hours: Mon: 8.00–7.00 | Tue: 8.00–7.30 | Wed: 8.00–8.00 | Thu: 8.00–7.00 | Fri: 8.00–5.00 | Sat: 8.30–1.00
- We serve patients from Widley, Purbrook, Waterlooville, Cosham, Havant, and Petersfield. The clinic is on the old A3 / London Road, just north of Portsdown Hill, near the Hampshire Rose pub. The No. 8 bus (Bushy Mead) stops just up the road.
Frequently Asked Questions
How long does tennis elbow take to get better?
Most cases improve within three to six months with a structured loading programme. Some chronic cases take longer. The condition often persists because people rest it (which does not stimulate tendon repair) or rely on cortisone injections (which provide short-term relief but do not address the underlying tendon degeneration). A progressive exercise-based approach produces the most durable results.
Should I wear an elbow brace?
An epicondylar clasp (a strap worn just below the elbow) can reduce symptoms during activity by offloading the tendon insertion. It can be a useful short-term adjunct, but it does not treat the underlying condition. Your physiotherapist can advise on whether a brace would be helpful for you and ensure it is fitted correctly.
Is a cortisone injection a good idea for tennis elbow?
Cortisone injections provide effective short-term pain relief (typically four to eight weeks), but research shows that outcomes at 12 months are worse for patients who received injections compared to those who followed an exercise programme alone. Cortisone can weaken tendon tissue with repeated use. We recommend trying a structured loading programme first, and reserving injection for cases where pain is preventing engagement with rehabilitation.
Can I still work with tennis elbow?
Usually, yes — though you may need to modify how you perform certain tasks. Your physiotherapist will advise on ergonomic adjustments, activity modification, and pacing strategies to manage your symptoms while continuing to work.
Is tennis elbow caused by my computer use?
Repetitive mouse and keyboard use can contribute to tennis elbow, particularly if your workstation is poorly set up. However, it is rarely the sole cause. Weakness of the forearm muscles, sudden increases in manual activity, and gripping-intensive hobbies are all common contributing factors. Your physiotherapist will assess the full picture and advise on ergonomic changes where relevant.
What if my elbow pain is not getting better?
If your symptoms have not responded to a well-structured loading programme after eight to twelve weeks, your physiotherapist may recommend shockwave therapy, EMTT, or a diagnostic ultrasound scan to assess the tendon structure. In rare cases, referral to a consultant for consideration of surgery may be appropriate — but this is a last resort.
Can elbow pain come from my neck?
Yes. The cervical spine can refer pain to the elbow region, and it is not uncommon for neck-related elbow pain to be misdiagnosed as tennis or golfer’s elbow. Your physiotherapist will screen your cervical spine during the assessment to check for this, and treat both areas if needed.
Is golfer’s elbow treated the same way as tennis elbow?
The treatment principles are the same — progressive tendon loading, manual therapy, and activity modification — but the specific exercises target the flexor tendons on the inner side of the elbow rather than the extensors on the outer side. The distinction matters because the tendons respond differently to loading, and the exercises need to be specific.
Can I still go to the gym with elbow pain?
Yes, with modifications. Your physiotherapist will advise on which exercises to continue, which to adapt (for example, using a neutral grip instead of a pronated grip), and which to avoid temporarily. Staying active is important, and most gym programmes can be adjusted to work around elbow pain.
Do I need a referral?
No. You can self-refer directly by contacting the clinic. If imaging is needed, diagnostic ultrasound is available on-site without an external referral.
Team