Tennis & Golfer's Elbow
Elbow pain is a tendon-load problem. We assess the load before we treat the pain.
Assessment-led rehabilitation for lateral and medial elbow tendinopathy, for athletes and active adults. From the first session: a diagnosis, a plan, and treatment — not a referral to come back next week.
Assessment + treatment from session one · $750 MXN · Zona Rio, Tijuana.
Conditions
What we treat.
Tendon-load mismatch affecting the wrist extensor tendons on the outside of the elbow. Common in racquet sports, but also in repetitive gripping and manual work.
Tendon-load mismatch affecting the wrist flexor and pronator tendons on the inside of the elbow. Common in golf, throwing sports, and repetitive gripping activity.
Reduced grip and forearm strength secondary to tendon pain, often the limiting factor in return to racquet, club, or manual work activity.
Elbow tendon pain that has persisted for months or keeps returning after previous treatment. Usually reflects a load-capacity deficit that was never fully closed.
Elbow pain driven by technique, equipment, or training-volume changes in tennis, padel, and pickleball. Addressed through load management alongside tendon rehabilitation.
Medial or lateral elbow pain linked to swing mechanics and training volume. Assessed alongside grip and forearm loading capacity.
Tendon irritation from repetitive gripping, lifting, or manual tasks unrelated to sport. Same underlying loading-capacity approach applies.
Persistent or recurring elbow pain without a confirmed diagnosis. Assessment identifies the source and drives a targeted treatment plan — not generic management.
Who we see
Three kinds of elbow patients.
The racquet or club-sport player.
Tennis, padel, pickleball, or golf, with elbow pain that started with a change in volume, technique, or equipment. Assessment identifies the load driver — grip strength deficit, swing mechanics, or training volume — and rebuilds capacity around the sport, not away from it.
The worker with repetitive-strain elbow pain.
Gripping, lifting, or manual tasks that load the forearm tendons repeatedly through the workday. The rehabilitation principle is the same as in sport — progressive tendon loading — adapted to occupational demand rather than athletic performance.
The chronic or recurrent case.
Elbow pain that has been present for months, or that keeps returning after rest and previous treatment. This usually reflects a tendon-capacity deficit that was never fully closed. Assessment identifies exactly what that deficit is and builds it back systematically.
The approach
How elbow tendon rehabilitation works here.
Assessment first
Grip strength testing, pain provocation, and functional wrist and forearm testing in session one. The treatment plan follows what the examination finds — not what the complaint sounds like.
Progressive tendon loading
Rest does not rebuild a tendon. Controlled, progressive loading of the wrist extensors or flexors — through appropriate range and at appropriate intensity — is what drives recovery. We establish what the tendon can tolerate and build from there.
Return-to-sport criteria
Clearance to return to racquet or club activity is based on clinical criteria — grip strength benchmarks, load tolerance, pain-free function — not a calendar. You return when the tendon is ready, with evidence, not assumption.
Same clinician throughout
Every session is with Leonardo. The same assessment logic, the same clinical reasoning, the same relationship from session one through to discharge. No handoffs.
Case example
What recovery looks like.
A 38-year-old recreational padel player presented with four months of lateral elbow pain, worse with backhand strokes and gripping tasks at work. Previous advice: rest and an elbow strap. Symptoms improved slightly but returned within days of resuming play.
Assessment revealed a significant grip strength deficit on the affected side and pain reproduced specifically under resisted wrist extension — a classic tendon-load mismatch, not an inflammatory process requiring further rest.
Treatment: graded isometric and then isotonic wrist extensor loading, progressive grip strengthening, and a phased return to padel with modified stroke volume. By session eight, grip strength had normalized and full training volume was restored without symptom recurrence.
Case presented with patient consent. Identifying details modified.
What delays recovery
Three things that slow elbow tendon rehabilitation.
Resting too long.
Pain reduction through rest does not equal recovery. Tendon capacity is not rebuilt through unloading — it requires progressive loading. Extended rest leads to further strength loss and a longer return-to-sport timeline.
Relying on braces or injections alone.
A brace or injection can reduce symptomatic load or pain temporarily, but neither rebuilds tendon capacity. Without a loading program behind it, symptoms tend to return once the brace comes off or the injection wears off.
Returning to full volume before the tendon is ready.
Clearance based on pain reduction alone is not safe clearance. Return to racquet or club sport requires grip strength benchmarks to be met and load tolerance to be demonstrated. Skipping this step is how the pain comes back.
Questions
Common tennis & golfer's elbow questions.
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What is the difference between tennis elbow and golfer's elbow?
Tennis elbow (lateral epicondylalgia) affects the tendons on the outside of the elbow, involved in wrist extension. Golfer's elbow (medial epicondylalgia) affects the tendons on the inside, involved in wrist flexion and grip. Both respond to the same underlying principle — progressive tendon loading.
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Do I need to stop playing to recover?
Not necessarily, and complete rest often makes tendon pain worse in the long run. After assessment we establish a load threshold — what grip, swing, and racquet or club activity the tendon can currently tolerate — and build training and recovery around it.
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How long does it take to resolve?
Tendon conditions are generally slower to resolve than acute injuries because tendon tissue adapts gradually to load. Timelines depend on how long the condition has been present and how much capacity deficit exists. Assessment gives an honest, condition-specific estimate.
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Will a brace or injection fix it?
A brace can reduce symptomatic load during activity and may be a useful short-term aid, but it does not rebuild tendon capacity on its own. Injections may reduce pain temporarily but do not address the underlying load-capacity deficit.
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How is this different from standard physiotherapy?
Standard treatment often centers on rest, ice, and passive modalities that reduce symptoms without rebuilding tendon capacity. PhysioPro uses a performance rehabilitation model: grip and load assessment, progressive tendon loading, and a structured return to racquet or club activity — not just a plan for daily comfort.
Read more: Why Physical Therapy Didn't Work The First Time →
More questions? See the full FAQ →
Book an assessment
Find out what is actually driving your elbow pain.
Assessment + treatment from session one. $750 MXN. Zona Rio, Tijuana.