Tennis Elbow Physiotherapy in North York & Don Mills

What Is Tennis Elbow?

Tennis elbow is a condition involving the tendons that attach the forearm muscles to the outside of the elbow.

These muscles and tendons are involved in activities such as:

• Gripping
• Lifting
• Carrying
• Wrist movement
• Using tools
• Racquet sports
• Weight training

The condition is often referred to medically as lateral epicondylitis, although persistent tendon pain is not necessarily explained by inflammation alone.

For this reason, lateral elbow tendinopathy is another commonly used term.

Tennis elbow often develops when the physical demands placed on the forearm and elbow exceed what the tissues are currently accustomed to tolerating.

What Does Tennis Elbow Feel Like?

Common symptoms include:

• Pain on the outside of the elbow
• Tenderness around the outer elbow
• Pain when gripping
• Pain lifting objects
• Difficulty carrying bags
• Discomfort opening jars or turning handles
• Pain using tools
• Pain during racquet sports
• Discomfort with weight training
• Reduced grip strength
• Aching extending into the forearm

Symptoms often develop gradually, although some people notice them after a significant increase in work, exercise or sporting activity.

What Can Contribute to Tennis Elbow?

Tennis elbow is often associated with changes in the amount or intensity of activity performed by the arm.

Examples include:

• Repetitive gripping
• Manual work
• Tool use
• Gardening
• Lifting and carrying
• Racquet sports
• Pickleball
• Weight training
• Repetitive wrist or hand activities
• A sudden increase in training volume
• Returning to an activity after a period of reduced use

Work demands can also be important, particularly when a job involves repeated gripping, lifting or tool use.

For athletes, changes in training volume, technique or equipment may sometimes contribute.

Rather than assuming there is one faulty movement or muscle responsible, assessment should consider the overall demands being placed on your arm and your current ability to tolerate those demands.

How Do I Know if My Elbow Pain Is Tennis Elbow?

Not all pain on the outside of the elbow is tennis elbow.

Other problems can sometimes produce similar symptoms, including:

• Elbow joint conditions
• Other tendon problems
• Nerve-related pain
• Referred pain from the neck
• Traumatic injuries
• Fractures
• Other upper-limb conditions

A physiotherapy assessment can help determine whether your symptoms are consistent with lateral elbow tendinopathy or whether another condition should be considered.

How Does a Physiotherapist Assess Tennis Elbow?

Your physiotherapist will begin by asking about:

• When your symptoms started
• Where you experience pain
• Activities that aggravate your elbow
• Work demands
• Sports and exercise
• Recent changes in activity
• Lifting and gripping tolerance
• Previous elbow, wrist, shoulder or neck problems
• Your goals for rehabilitation

The physical assessment may examine:

• Elbow movement
• Wrist and forearm movement
• Grip strength
• Wrist and forearm strength
• Your response to resisted movements
• Functional lifting and gripping
• Shoulder or neck function when relevant
• Activities specific to your work or sport

The purpose is to understand both the condition and what you need your arm to be capable of doing again.

Can Physiotherapy Help Tennis Elbow?

Yes. Physiotherapy can help people with tennis elbow gradually improve strength and their ability to tolerate gripping, lifting, work, exercise and sports.

Your rehabilitation may focus on:

• Understanding the condition
• Managing aggravating activities
• Progressive tendon loading
• Forearm strengthening
• Grip strengthening
• Improving mobility when appropriate
• Rebuilding upper-limb capacity
• Returning to work or sport
• Developing a long-term self-management plan

The goal is not simply to temporarily reduce elbow pain.

Rehabilitation should help your arm become progressively more capable of handling the physical demands that matter to you.

How Is Tennis Elbow Treated With Physiotherapy?

Treatment should be individualized according to your symptoms, physical capacity and goals.

Education and Activity Modification

Understanding how much load your elbow currently tolerates is an important first step.

You may temporarily need to reduce or modify activities that repeatedly produce a substantial increase in symptoms.

This might involve changing:

• Lifting volume
• Grip demands
• Tool use
• Weight-training exercises
• Racquet-sport volume
• Work tasks when possible

The goal is usually modification rather than complete avoidance.

As your symptoms and strength improve, these activities can gradually be increased again.

Progressive Strengthening

Progressive strengthening is a central part of tennis elbow rehabilitation.

Exercises may target:

• Wrist extensor muscles
• Forearm muscles
• Grip strength
• Wrist and elbow strength
• Other upper-limb muscles when relevant

The appropriate resistance depends on your symptoms and current capacity.

Exercises should gradually progress rather than remaining at the same light resistance indefinitely.

Grip Strengthening

Reduced grip strength is common with tennis elbow, particularly when gripping itself is painful.

Rehabilitation may progressively include:

• Isometric gripping
• Repeated gripping
• Carrying
• Lifting
• Sport-specific grip demands
• Work-specific tasks

The goal is to restore useful grip strength rather than simply measuring whether the elbow is pain-free at rest.

Mobility

Some people may have restrictions in wrist, forearm or elbow movement that are relevant to their symptoms or function.

Mobility exercises may therefore be included when appropriate.

Not everyone with tennis elbow requires extensive stretching.

Manual Therapy

Hands-on treatment may sometimes help improve comfortable movement or provide short-term symptom relief.

Manual therapy is generally most useful when it supports an active strengthening and rehabilitation program rather than becoming the primary treatment.

What Exercises Help Tennis Elbow?

There is no single exercise that is best for everyone with tennis elbow.

Depending on your assessment, rehabilitation may include:

• Wrist extension strengthening
• Forearm strengthening
• Grip exercises
• Wrist and forearm mobility
• Elbow strengthening
• Upper-limb strengthening
• Functional lifting and carrying
• Progressive resistance exercises

Some programs use isometric, concentric or eccentric exercises at different stages.

The exact exercise label is less important than developing a program that provides an appropriate and progressively increasing load based on your symptoms and goals.

A tradesperson who needs to use heavy tools may eventually require a different level of rehabilitation from someone whose main difficulty is lifting household objects.

Similarly, a tennis or pickleball player may need rehabilitation that progresses toward racquet-specific demands.

Elbow Exercise Video Library

What Can I Do at Home for Tennis Elbow?

Self-management is an important part of tennis elbow rehabilitation.

Keep Using Your Arm Within Tolerance

Complete rest is usually unnecessary.

Continue comfortable everyday activities while temporarily modifying tasks that repeatedly produce a substantial or lasting increase in symptoms.

Reduce Aggravating Loads Temporarily

If repeated gripping, lifting or carrying significantly aggravates the elbow, temporarily reduce the amount or intensity.

This does not mean permanently avoiding those activities.

The goal is to gradually rebuild your ability to tolerate them.

Continue Your Strengthening Exercises

Consistent progressive strengthening is an important part of rehabilitation.

Follow the exercise program recommended by your physiotherapist and gradually increase resistance as appropriate.

Change How You Lift When Necessary

During a more painful period, changing the way you lift or carry an object may reduce symptoms.

For example, using two hands for a heavier object or temporarily reducing the amount being carried may allow you to remain active without repeatedly aggravating the elbow.

Take Breaks From Highly Repetitive Tasks

If your work or hobby involves prolonged repetitive gripping or wrist movement, brief changes in activity may help manage symptoms.

Don’t Chase Every Painful Sensation With Stretching

Forearm stretching can be useful for some people, but tennis elbow is not simply caused by “tight muscles.”

If stretching repeatedly aggravates the outer elbow, more aggressive stretching is not necessarily the answer.

Use Heat or Cold if You Find It Helpful

Heat or cold can be used for temporary comfort if you find either helpful.

Neither replaces progressive rehabilitation.

The goal of self-management is to manage symptoms while progressively rebuilding the capacity of your arm, rather than protecting the elbow indefinitely.

Should I Rest Tennis Elbow?

Complete rest is usually not necessary.

Temporarily reducing highly aggravating activities can help settle symptoms, but prolonged avoidance may also reduce your ability to tolerate those activities.

A better approach for many people is to identify a manageable level of activity and then gradually build from there.

For example, you may temporarily reduce:

• Heavy gripping
• Repetitive lifting
• Racquet-sport volume
• Heavy upper-body exercise
• Prolonged tool use

These activities can then be progressively reintroduced as your strength and tolerance improve.

Is It Okay to Exercise With Tennis Elbow?

In many cases, yes.

Exercise is an important part of tennis elbow rehabilitation.

Some discomfort during strengthening does not automatically mean that the tendon is being damaged.

However, exercise intensity should be appropriate for your symptoms and your response afterward.

If an exercise causes a large or prolonged increase in symptoms, the resistance, volume or technique may need to be adjusted.

Your physiotherapist can help determine an appropriate starting point and progression.

Why Does My Elbow Hurt When I Grip or Lift?

The forearm muscles involved in gripping and wrist control attach near the outside of the elbow.

Gripping, carrying and lifting therefore place demand on the area commonly affected by tennis elbow.

When the elbow is sensitive, even everyday tasks such as lifting a kettle or carrying groceries may become uncomfortable.

Rehabilitation gradually increases these demands so that your arm becomes better able to tolerate them again.

Can a Brace Help Tennis Elbow?

Some people find a counterforce strap or wrist support helpful for temporarily reducing discomfort during certain activities.

A brace may be useful for:

• Work tasks
• Sports
• Repetitive gripping
• Activities that are difficult to temporarily avoid

However, bracing does not replace progressive strengthening and rehabilitation.

If you use a brace, it should generally be considered a tool for symptom management rather than something your elbow must permanently depend on.

Your physiotherapist can help determine whether a brace is appropriate and how to use it.

Tennis Elbow From Work: Do I Need to Stop Working?

Not necessarily.

For work-related tennis elbow, the goal is usually to keep you functioning while adjusting demands when possible.

Depending on your job, temporary changes may involve:

• Reducing repetitive gripping
• Alternating tasks
• Modifying lifting
• Changing tool use
• Taking short movement breaks
• Gradually rebuilding work-specific strength

Rehabilitation should ultimately prepare your arm for the actual physical requirements of your job.

For work-related injuries, Physiomobility also provides physiotherapy rehabilitation for eligible WSIB cases.

WSIB Physiotherapy & Work Injury Rehabilitation

Can I Play Tennis, Pickleball or Golf With Tennis Elbow?

Many people can return to racquet sports and other recreational activities following appropriate rehabilitation.

Whether you should continue playing while symptomatic depends on:

• How painful the elbow is
• How it responds after playing
• Your current strength
• How frequently you play
• Recent changes in training volume
• Your sporting goals

You may temporarily need to reduce playing time or intensity while continuing rehabilitation.

As strength improves, treatment can progress toward:

• Repeated gripping
• Faster movements
• Higher resistance
• Racquet or club-specific activity
• Return-to-sport drills

Technique or equipment may also be considered when relevant.

Sports Injury Physiotherapy

How Long Does Tennis Elbow Take to Improve?

Recovery varies considerably.

Some people improve within several weeks, while persistent tendon-related elbow pain can take several months to fully settle.

Factors that may influence recovery include:

• How long symptoms have been present
• Work demands
• Sports and exercise demands
• Current physical capacity
• Ability to modify aggravating activities
• Consistency with rehabilitation

Progress should not be measured only by whether pain has completely disappeared.

Meaningful improvements may include:

• Stronger grip
• Carrying heavier objects
• Greater work tolerance
• Returning to gym exercises
• Playing sport for longer
• Less pain during everyday activities

Do I Need an X-Ray, Ultrasound or MRI?

Imaging is not routinely required for a typical presentation of tennis elbow.

The condition can often be identified through your history and physical examination.

Imaging may sometimes be considered when:

• There has been significant trauma
• Another condition is suspected
• Symptoms are unusual
• Progress is not occurring as expected
• Imaging may influence further medical management

Your physiotherapist can recommend medical assessment when further investigation may be appropriate.

When Should Elbow Pain Be Medically Assessed?

Seek appropriate medical assessment if elbow pain is associated with:

• Significant trauma or suspected fracture
• An obvious deformity
• Significant swelling following an injury
• Redness, heat or swelling accompanied by fever or illness
• New or progressive numbness or weakness
• Severe unexplained pain
• Rapidly worsening symptoms
• Symptoms that do not appear consistent with a typical musculoskeletal elbow problem

Your physiotherapist can also recommend additional medical assessment when examination findings suggest that another condition should be considered.

Tennis Elbow Physiotherapy at Physiomobility

At Physiomobility in CF Shops at Don Mills, physiotherapy is at the centre of our approach to tennis elbow rehabilitation.

Our physiotherapists combine individualized assessment, education and progressive exercise to help improve grip strength, lifting tolerance and overall arm function.

Treatment can progress from managing aggravating activities toward:

• Progressive tendon loading
• Grip strengthening
• Functional lifting
• Work-specific rehabilitation
• Gym and exercise rehabilitation
• Return to tennis, pickleball, golf and other sports
• Long-term self-management

Patients also have access to Physiomobility’s Elbow Exercise Video Library to support their individualized home exercise programs.

Physiomobility is a multidisciplinary clinic, and other services may complement care when appropriate, while physiotherapy, progressive strengthening and active rehabilitation remain central to our tennis elbow approach.

Book a Physiotherapy Assessment