Elbow tendonitis is damage to the tendons that attach your forearm muscles to the bony bumps on either side of your elbow. It causes pain at the inner or outer elbow that typically worsens with gripping, lifting, or twisting motions. Most cases take 6 to 12 months to fully heal, though you’ll likely feel improvement within a few weeks of starting treatment.
The condition comes in two forms depending on which side of the elbow is affected, and despite its common nicknames, it strikes people in all kinds of jobs and activities far more often than it strikes athletes.
Tennis Elbow vs. Golfer’s Elbow
Your elbow has two bony points where forearm muscles anchor via tendons. Tendonitis can develop at either one, and the location determines the type.
Lateral epicondylitis (tennis elbow) affects the outside of the elbow. The tendons involved connect to the muscles that extend your wrist and fingers, pulling them backward. The primary site of damage is in the tendon of a muscle called the extensor carpi radialis brevis, which runs along the outer forearm. Pain shows up when you grip something, turn a doorknob, or lift with your palm facing down.
Medial epicondylitis (golfer’s elbow) affects the inside of the elbow. Here, the tendons connect to the muscles that flex your wrist and rotate your forearm inward. Pain tends to flare when you squeeze objects, swing a tool, or pull something toward you. Tennis elbow is significantly more common of the two.
What Actually Happens Inside the Tendon
The word “tendonitis” implies inflammation, and in the early stages that’s accurate. You get a swollen, painful tendon without structural damage. Symptoms at this point include swelling or tightness, a dull ache that worsens with movement, and tenderness when you press on the area.
If the injury doesn’t heal, it can progress to something called tendinosis, which is a different problem. In tendinosis, the collagen fibers that give the tendon its flexibility begin to break down and degenerate. The tendon becomes hard, thick, and scarred. Some of this damage is only visible under a microscope. Signs of tendinosis include a burning sensation, decreased range of motion, and sometimes a tender lump near the affected area. This distinction matters because treating chronic tendon degeneration requires a different approach than treating simple inflammation. An ultrasound can distinguish between the two.
Causes and Risk Factors
Despite the sporty nicknames, most elbow tendonitis comes from repetitive motions at work or during daily activities. A population-based study in Rheumatology found that manual work quadrupled the odds of developing lateral epicondylitis. Repetitive bending and straightening of the elbow for more than an hour a day was independently linked to both types, with a 2.5 times higher risk for tennis elbow and a 5 times higher risk for golfer’s elbow.
Common culprits include plumbing, carpentry, painting, assembly line work, frequent computer use, cooking, and gardening. Any activity that involves repeated gripping, twisting, or wrist movement can overload these tendons over time. The longer you continue the aggravating activity after symptoms appear, the longer rehabilitation will take.
Exercises That Help Tendons Heal
The American Academy of Orthopaedic Surgeons recommends a combination of stretching and eccentric strengthening exercises. Eccentric exercises focus on the lowering phase of a movement, which stimulates tendon repair in a way that standard strengthening doesn’t.
Stretching
For the outside of the elbow, straighten your arm and bend your wrist back like you’re signaling “stop.” Use your other hand to gently pull your fingers toward you until you feel a stretch along the inside of your forearm. Hold for 15 seconds. For the inside of the elbow, straighten your arm palm-down and bend your wrist so your fingers point toward the floor, then gently pull your hand toward your body. Hold for 15 seconds. In both cases, avoid locking your elbow. Do 5 repetitions, 4 times a day, 5 to 7 days per week.
Eccentric Strengthening
The core exercise uses a light dumbbell (1 to 3 pounds). For tennis elbow, you work on wrist extension: use your opposite hand to help curl the weight upward, hold for one count, then slowly lower it over three counts without assistance. For golfer’s elbow, you do the same thing with wrist flexion. The key is that only the lowering portion loads the tendon during early rehab. Do 30 repetitions once a day, 5 to 7 days per week. Start with no weight at all. When you can complete 30 reps on two consecutive days with no increase in pain, add one pound and repeat the process, eventually working up to three pounds.
Injections: Short-Term vs. Long-Term Relief
Two types of injections are commonly used for elbow tendonitis, and they work on very different timelines.
Corticosteroid injections provide fast relief. They reduce pain and improve function within 2 to 8 weeks. But these effects decrease over time, and steroids don’t address the underlying tendon damage.
Platelet-rich plasma (PRP) injections, which use concentrated healing factors from your own blood, work more slowly. You won’t notice the same immediate improvement. However, a systematic review of five major studies found consistent evidence that PRP produces better long-term outcomes (beyond 8 weeks) across all measures: pain, function, disability, and pressure sensitivity. If your goal is lasting relief rather than quick symptom control, PRP has the stronger evidence behind it.
Do Counterforce Braces Work?
Counterforce braces, the strap-style bands worn just below the elbow, are one of the most commonly recommended tools for elbow tendonitis. The idea is that the strap reduces the load on the damaged tendon by compressing the muscle below it. However, a recent study measuring tendon stiffness during muscle contraction found that the brace had no significant biomechanical effect on the tendon, either at rest or during wrist extension at various effort levels. Many people report that braces feel helpful, and they’re inexpensive and low-risk, but the mechanical theory behind them doesn’t hold up under testing.
When Surgery Becomes an Option
Surgery is reserved for cases that meet specific criteria: conservative treatment has failed for more than 3 months, symptoms have lasted longer than 6 months, and pain remains severe. The most common open technique involves cleaning out the damaged portion of the tendon. This is not a first-line option, and the vast majority of people recover without it.
Preventing Recurrence
If your elbow tendonitis is related to computer use or desk work, a few ergonomic adjustments can reduce the strain on your forearm tendons. Your forearms should form a 90-degree angle with your upper arms while typing. Your wrists should extend straight, not angled up or down. Avoid raising the back of your keyboard, which actually increases wrist strain. If your hands sit below keyboard level, use a wrist pad to bring them even. Adjusting your chair height is often the simplest fix.
For manual tasks, the principle is the same: reduce the duration and intensity of repetitive gripping, twisting, and elbow bending. Taking breaks every 30 to 45 minutes during repetitive work, alternating hands when possible, and using tools with larger, cushioned grips all lower the cumulative load on these tendons.