Tennis Elbow Physical Therapy in Houston, MS: What Helps

It starts as a dull ache on the outside of your elbow after a long day. Then it is there when you pick up a coffee cup, shake a hand, or turn a stubborn bolt. Tennis elbow physical therapy in Houston, MStreats the cause of that ache, a forearm tendon that has taken more load than it can handle, and for most people the answer is a smarter plan rather than an operation. We see it in carpenters, mechanics, cooks, gardeners, line workers, and office staff far more often than in tennis players, and at Houston Physical Therapy & Performance Center the approach is the same for all of them: find out what is overloading the tendon, then build it back up.

What is tennis elbow?

Tennis elbow, or lateral epicondylitis, is pain where the forearm muscles that pull your wrist back attach to the bony bump on the outside of the elbow. Repeated gripping and wrist movement creates tiny areas of damage in that tendon faster than the body can repair them. The tendon most often involved is the extensor carpi radialis brevis, which steadies your wrist every time you grip something firmly.

The name is misleading. According to the American Academy of Orthopaedic Surgeons (AAOS), most people who get tennis elbow are between 30 and 50 years old, and painters, plumbers, carpenters, auto workers, cooks, and butchers are more prone to it. It usually affects the dominant arm, and sometimes there is no clear cause at all.

It is also common. In a 2006 population study in the American Journal of Epidemiology, Shiri and colleagues found definite lateral epicondylitis in 1.3% of adults aged 30 to 64, with the highest rates between 45 and 54. In a working community like Houston and the rest of Chickasaw County, where a lot of jobs and hobbies mean gripping tools all day, that adds up to plenty of sore elbows.

What are the symptoms of tennis elbow?

The main symptom is pain or burning on the outside of the elbow that gets worse when you grip, lift, or twist with your wrist. It usually comes on gradually rather than from one injury. The AAOS notes that it can make the grip feel weak, and MedlinePlus from the National Library of Medicine describes pain that can spread from the outside of the elbow into the forearm and the back of the hand.

A simple pattern helps tell it apart: lifting with your palm facing down often hurts, while the same lift with your palm facing up tends to hurt less. That is one of several things a therapist checks, because pain on the outside of the elbow can also come from the neck or from a joint problem, and the treatment is different for each.

Does physical therapy help tennis elbow?

Yes. For most people, therapy that manages the load on the tendon and then strengthens it gradually is the main treatment for tennis elbow, and it is often enough on its own. The AAOS reports that approximately 80 to 95% of patients have success with nonsurgical treatment, and physical therapy exercises sit at the center of that care.

The honest part is that there is no single magic exercise. What helps is a plan that matches the tendon to the work you ask it to do. The research on quick fixes is a good warning. A randomized trial by Coombes and colleagues, published in JAMA in 2013, followed 165 people with tennis elbow and found that a corticosteroid injection led to worse results at one year than a placebo injection. Shots can calm the pain for a while, but they do not make the tendon stronger.

What does tennis elbow therapy involve?

Tennis elbow therapy starts with an evaluation of the elbow, wrist, shoulder, and neck, then combines load management, progressive strengthening, hands-on treatment, and changes to how you grip and lift. Our clinic has a Certified Hand Therapist on staff, and our hand therapy and orthopedic rehabilitation programs both handle elbow problems like this one.

1. 1Evaluation. Grip strength, the movements that hurt and the ones that do not, tenderness at the tendon, and a screen of your neck and shoulder. We also ask exactly what your hands do at work and at home, because that is where most of the overload comes from.
2. 2Easing the load. Not stopping, just pacing. That might mean splitting a long task into shorter blocks, swapping which hand does the heavy gripping for a while, or wearing a counterforce strap during the jobs that flare it.
3. 3Progressive strengthening. Slow, controlled wrist and grip exercises, often starting with holds and moving to lifting and lowering against light resistance, such as a flex bar or small weight. The dose goes up only as the tendon tolerates it.
4. 4Hands-on care. Soft tissue work on the forearm can help calm a flare. Our therapists are trained in the Graston Technique and dry needling, and we use them when they suit your case, alongside the exercise program.
5. 5Shoulder and whole-arm strength. A strong shoulder and upper back take load off the small forearm muscles. Building them helps the elbow stay calm once you are back to full work.
6. 6Changing the grip. Tool handle size, wrist position, lifting with the palm up instead of down, and how long you hold any one grip. Small changes, done every day, take a lot of strain off the tendon.

If your elbow started hurting on the job, our industrial therapy team works on exactly this kind of repetitive strain, including at the Franklin MFG onsite clinic in Houston. For athletes and weekend players, our sports therapy program adds the return-to-sport testing that tells us when the arm is ready for a full swing again.

Should you rest tennis elbow or keep using it?

Short-term relief from the task that flares it helps, but complete rest usually does not, because a tendon that does nothing gets weaker and flares again when you go back to work. MedlinePlus suggests resting the arm for 2 or 3 weeks and avoiding or changing the activity that causes symptoms as a first step. From there, the goal is to bring load back in a measured way.

Here is how the common options compare. Most people start at the top of this table, and only a small number ever need the bottom row.

How long does tennis elbow take to heal?

Tennis elbow is often slow to settle, and the timeline depends on how long the tendon has been overloaded and how much of your day keeps loading it. There is no honest single number. What we can say is that the outlook is good: the AAOS reports that most patients improve without surgery, and surgery is usually considered only after 6 to 12 months of nonsurgical treatment has not helped.

A few things tend to make the road longer: waiting months before doing anything, pushing through sharp pain every day, stopping the exercises as soon as the elbow feels better, and going back to the same grip on the same tool. A few things tend to make it smoother: starting early, sticking with a progressive home program, and fixing the task that started it. Your therapist rechecks your grip strength and pain at each visit so the plan changes if progress stalls.

When elbow pain is not tennis elbow

Not every sore elbow is tennis elbow. Pain on the inside of the elbow is more likely golfer's elbow, a pinched nerve in the neck can send pain and tingling down the arm, and numbness in the thumb and first fingers points toward the wrist instead. Our guides to neck pain physical therapy and carpal tunnel physical therapy cover those sides of the picture.

None of these rule out therapy. They mean a medical check comes first, so the plan matches what is really going on.

Frequently asked questions

Cass Tapley, PT

Cass Tapley, PT, is the owner and physical therapist at Houston Physical Therapy & Performance Center, the only locally owned, operated, and staffed physical and occupational therapy clinic in Houston, MS, serving Chickasaw County. Meet the team.

Disclaimer: The content on this page is for informational purposes only and is not medical advice. Results vary by individual and are not guaranteed. Before starting any new treatment, diet, exercise, or supplement regimen, consult a licensed healthcare provider.