You don’t have to step foot on a tennis court or swing a golf club to experience a nagging, burning ache around your elbow joint. Whether it’s a sharp pinch when you lift a coffee mug, a dull throb after a long day of typing on a computer, or a weak feeling in your hand when you turn a screwdriver, chronic elbow pain can make simple daily tasks feel incredibly frustrating.

When pain develops on the side of the elbow, it is usually driven by one of two highly common overuse injuries: Lateral Epicondylitis (Tennis Elbow) or Medial Epicondylitis (Golfer’s Elbow).

While both conditions involve inflammation and strain in the tendons of your forearm, they affect completely opposite sides of your arm and require unique treatment protocols. Let’s look at the structural differences between these two conditions, how to spot which one you are dealing with, and how physical therapy can help you restore a strong, pain-free grip.

The Anatomical Setup: The Forearm Pulley System

To understand why your elbow hurts, it helps to look at how your hand and your elbow are connected. The muscles that allow you to move your fingers, twist your wrist, and grip objects actually live in your forearm, and they anchor into the bony bumps at your elbow joint via thick, cord-like tendons.

• Tennis Elbow (Lateral Epicondylitis): This condition affects the outside bump of your elbow. The muscles that live on the top of your forearm attach here, and their primary job is to extend your wrist and lift your hand backward.

• Golfer’s Elbow (Medial Epicondylitis): This condition affects the inside bump of your elbow (closest to your torso). The muscles on the underside of your forearm attach here, and their job is to flex your wrist forward and squeeze your hand closed into a tight grip.

When you perform highly repetitive tasks—like typing on a keyboard, painting a wall, turning a wrench, or practicing your backhand swing—these tendons experience tiny micro-tears. If you don’t give the body enough rest to heal, the tissue can develop a localized, chronic state of tendon breakdown (tendonosis), leading to constant, sharp pain.

How to Tell the Difference: Outside vs. Inside Pain

To help clarify which condition might be driving your elbow discomfort, look at how their primary signs compare:

Feature	Tennis Elbow (Lateral)	Golfer’s Elbow (Medial)
Pain Location	Bony bump on the outside of the elbow	Bony bump on the inside of the elbow
Primary Trigger	Typing, lifting objects with palm down, extension	Squeezing a tool, carrying heavy bags, flexion
Daily Limitation	Pouring a pitcher, opening a door, using a mouse	Shaking hands, twisting a jar lid, lifting a kettlebell
Hand Connection	Associated with tight or weak wrist extensors	Associated with tight or weak wrist flexors and grip

How Physical Therapy Rewires Your Tendon Strength

A common mistake people make when treating elbow tendonitis is keeping their arm completely still in a rigid brace or rushing to get a cortisone shot. While cortisone can temporarily numb the area for a few weeks, medical research reveals that steroid injections can actually weaken tendon tissue over the long term, leading to worse pain down the road.

Because tendons have a very poor native blood supply, they don’t heal well with complete rest. They require specific, mechanical stimulation to trigger tissue repair. Physical therapy achieves this through a multi-step blueprint:

1. Mastering Eccentric Loading

The gold standard for treating chronic tendon pain is a concept called progressive eccentric loading. An eccentric contraction happens when a muscle is slowly lengthening under a load—like slowly lowering a dumbbell back down during a wrist curl.

Your physical therapist will teach you specific, controlled eccentric exercises tailored to your forearm muscles. By slowly lowering a light weight or utilizing specialized resistance bars, you place a controlled stretch on the tendon. This mechanical pull acts as a signal to your body to send fresh blood flow to the area, break down disorganized scar tissue, and lay down new, resilient tendon fibers that can easily handle daily physical tasks.

2. Soft Tissue Mobilization and Scraping

When a forearm tendon is chronically inflamed, it can develop sticky adhesions that bind it down to neighboring tissues. Your therapist will use advanced hands-on manual therapy—such as instrument-assisted soft tissue mobilization (often called scraping)—to safely smooth out the tendon fibers, clear out local waste products, and jumpstart your body’s natural healing cascade.

3. Clearing the Whole Kinetic Chain

Your elbow is caught in the crossfire between your wrist and your shoulder. Frequently, elbow pain happens because a patient has poor mobility in their wrist joint or severe weakness in their rotator cuff and shoulder blade muscles. If your shoulder cannot stabilize your arm properly when you reach or lift, your elbow muscles are forced to overwork to compensate. By strengthening your entire upper extremity, your physical therapist takes the mechanical burden off your elbow bone, leaving you with a resilient, pain-free arm.

Conclusion

Whether your elbow pain is located on the inside or the outside, chronic tendon strain can make simple daily movements feel exhausting. But your tendons are fully capable of adapting, remodeling, and growing stronger with the right kind of physical input. By stepping away from temporary quick-fixes and committing to a targeted, evidence-based physical therapy plan, you can rebuild your tissue resilience, reclaim your full grip strength, and get back to your favorite sports and daily activities with total confidence.

PT Pros has fifteen clinic locations throughout Kentucky. Find a clinic location near you: Barbourville, KY • Columbia, KY • Corbin, KY • Danville, KY • Elizabethtown, KY • Eminence, KY • Greensburg, KY • Harlan, KY • Hazard, KY • Leitchfield, KY • Lexington, KY • London, KY • Louisville, KY • Somerset, KY • Williamsburg, KY