Tennis Elbow vs Golfer's Elbow — Symptoms, Causes and When to See a Physiotherapist

"But I have never played tennis"

Many patients walk in with a sore outer elbow, hold it, and say the same thing: "Doctor, I don't even play tennis." Then we find out they spend nine hours a day on a laptop mouse, carry a heavy bag on a bent arm, or have just spent a weekend wringing out clothes and painting the flat. Tennis elbow is one of the most misnamed conditions in physiotherapy. Racket sports are only one of many ways to irritate the tendons around the elbow.

The same goes for its look-alike, golfer's elbow, which sits on the *inner* side of the joint. This guide explains how the two differ, what commonly causes them, what tends to help, and when it is worth getting the elbow checked.

What these conditions actually are

Both problems involve the tendons of the forearm muscles, where they attach to small bony bumps at the elbow. Those muscles move your wrist and fingers, so the tendons take a load every time you grip, lift, type or twist.

Tennis elbow (lateral epicondylitis) affects the outer side of the elbow, at the attachment of the muscles that lift the wrist back and extend the fingers. Golfer's elbow (medial epicondylitis) affects the inner side, at the attachment of the muscles that bend the wrist and grip. The general overview of tennis elbow gives more background if you want it.

The "-itis" in the older names suggests inflammation, but research suggests that in long-standing cases the tendon is often better described as overloaded and irritated, with changes in how it handles stress, rather than simply "inflamed". That matters because it shapes what helps: gradually rebuilding the tendon's tolerance to load generally makes more sense than only resting it or masking the pain.

How to tell them apart

The location of the pain is the biggest clue.

Tennis elbow typically causes pain on the outer elbow that may travel down the top of the forearm. It tends to flare when you:

• Lift a kettle, a water bottle or a *tawa*
• Shake hands or turn a door handle
• Use a mouse or keyboard for long periods
• Twist a screwdriver or wring a cloth

Golfer's elbow typically causes pain on the inner elbow, sometimes with a feeling of weakness in the grip. It tends to flare when you:

• Carry a heavy bag or shopping with the palm facing you
• Grip and flex the wrist repeatedly, such as in cricket bowling, throwing or gym pulling exercises
• Chop vegetables or knead dough for long periods

Both can start gradually and worsen over weeks. Tennis elbow is generally the more common of the two, and it commonly affects people in their thirties to fifties, though it can appear at any age.

Why desk workers and homemakers get it

The Mumbai pattern we see most is not sports-related at all. Long hours with the wrist slightly bent upward over a mouse, a laptop placed too high or too low, a chair without forearm support, and then a sudden extra load — a weekend of moving boxes, a new gym programme, or a Ganpati decoration marathon — can tip an already-tired tendon into pain. In homes, repetitive grip tasks such as squeezing, wringing, lifting heavy vessels with one hand and long spells of cooking are common triggers.

If a long desk day is part of your story, our guide to desk posture and exercises for office workers covers the setup habits that put less strain on the arm as well.

Is it really the elbow? Other causes of arm pain

Not every sore elbow is a tendon problem. Pain felt at the elbow can sometimes come from the neck, where irritated nerves can refer symptoms down the arm, or from nerve compression at the wrist or elbow, which more often causes tingling or numbness than a sharp local ache. Joint problems and, less commonly, fractures or infection can also present with elbow pain.

That is one reason to be cautious about diagnosing yourself from the internet. A physiotherapist will usually check the elbow, wrist, shoulder and neck together, because the cause of the pain is not always where you feel it. If your symptoms include pins and needles, arm weakness, or pain that starts in the neck, our page on neck pain physiotherapy explains how that is assessed.

What commonly helps

Approaches vary from person to person, and this is general information rather than a prescription, but several themes appear consistently in the research:

Load management rather than complete rest. Many patients find that cutting the aggravating activity back — not stopping everything — lets the tendon settle. Total rest for long periods can leave the tendon weaker and less able to cope when normal life resumes.

Gradual strengthening. Rehabilitation programmes for tendon problems commonly build load tolerance in stages, guided by how the elbow responds. The exact exercises, how heavy and how often depend on the individual, which is why copying a random routine can leave people worse off.

Fixing what feeds the strain. This may include the way you grip, how your desk is arranged, how you carry a bag, and how the shoulder and shoulder blade are working, since a weak shoulder can push more work onto the forearm.

Patience. Tendons heal slowly. Many people notice gradual improvement over weeks to a few months, and some cases take longer, especially if the problem has been building for a long time. Quick fixes are tempting, but the evidence for a lasting result usually favours steady rehabilitation.

Braces or straps are used by some people to reduce load during tasks, and a physiotherapist can advise whether one suits your situation. Our approach is assessment-led exercise, education and hands-on work where it helps. We do not offer needling or cupping.

When to see a physiotherapist

Consider booking an assessment if:

• Elbow pain has lasted more than two to three weeks despite easing activity
• Everyday tasks — lifting a cup, opening a jar, typing — are becoming painful or weak
• The pain keeps returning each time you go back to sport, the gym or work
• You are not sure whether the problem is in the elbow, the neck or the wrist

See a doctor promptly if the elbow is hot, swollen and red, if you cannot straighten or bend it after a fall or impact, if the arm looks deformed, or if you develop fever with elbow pain. These need medical review rather than exercise.

Our tennis elbow and golfer's elbow physiotherapy page describes how we assess and rehabilitate these conditions, and our wider sports physiotherapy service covers gym-goers and athletes.

The first consultation at our Borivali West clinic is free. You will be assessed by Dr. Shiva Jain Sangoi (PT), MPTh (Ortho), FIFA Diploma in Football Medicine, with over 10 years of practice and 8,000+ cases treated. You can reach us through the PhysioSthanak homepage or walk in at Shop No. 14, Hari-Smruti Premises, SVP Road, opposite HDFC Bank, Borivali West. (Home visits are charged separately as they involve travel time, and online consultations are a paid service.)

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*This article is for general information only and is not a substitute for professional assessment. Consult a qualified physiotherapist for advice specific to you.*