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Elbow Pain

Dr. Michael Hoiles has created this resource to help you better understand Elbow Pain, including its common causes, symptoms, treatment options, recovery expectations, and when it may be appropriate to seek an assessment. Whether your symptoms started suddenly or developed gradually over time, this guide is designed to provide clear, evidence-informed information to help you make informed decisions and return to the activities you enjoy with confidence.

 

What Is Elbow Pain

Elbow Pain refers to discomfort or dysfunction around the elbow joint and surrounding tendons, muscles, and soft tissues. It is most commonly related to overuse or repetitive strain rather than a single traumatic injury. 

The elbow acts as a load-transfer joint between the shoulder and wrist, making it vulnerable to repetitive gripping, lifting, and rotational forces. 

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Common Causes 

  • Lateral epicondylitis (tennis elbow)  

  • Medial epicondylitis (golfer’s elbow)  

  • Tendon overuse or strain from repetitive gripping  

  • Poor wrist/forearm mechanics during lifting or work tasks  

  • Repetitive computer or mouse use  

  • Gym-related overload (curling, pulling, pressing)  

  • Acute strain or minor trauma  

  • Neck or nerve-related referral (cervical involvement)  

 

Often, elbow pain develops gradually due to a combination of factors rather than a single injury. 

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Common Symptoms 

  • Pain on the outside of the elbow (lateral) or inside (medial)  

  • Pain with gripping, lifting, or carrying objects  

  • Weak grip strength  

  • Discomfort with wrist movement (bending or extending)  

  • Aching that may radiate into the forearm  

  • Tenderness over bony areas of the elbow  

 

Symptoms can vary depending on the tissues involved and the severity of the condition. 

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What Makes It Worse? 

  • Repetitive gripping or lifting  

  • Wrist extension or flexion under load  

  • Computer mouse use or typing for long periods  

  • Gym exercises involving pulling or curling  

  • Twisting motions (e.g., using tools, opening jars)  

  • Sudden increase in training or workload  

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What Helps? 

Many people find relief through: 

  • Relative rest from aggravating activities (not full immobilization)  

  • Activity modification (reduce gripping intensity/volume)  

  • Gradual loading of forearm muscles  

  • Ice in early inflammatory stages  

  • Forearm mobility and soft tissue work  

  • Ergonomic adjustments for desk or work tasks  

  • Breaking up repetitive tasks with rest periods  

 

Staying active and addressing contributing factors often leads to better long-term outcomes than relying solely on passive treatments.

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How Chiropractic Can Help 

Chiropractic care may assist with elbow pain by: 

  • Assessing whether pain is local or referred from the neck or shoulder  

  • Improving mobility in the elbow, wrist, and cervical spine  

  • Reducing muscle tension in the forearm and surrounding structures  

  • Addressing movement patterns contributing to overload  

  • Providing rehabilitation exercises for tendon loading and strength  

  • Improving ergonomics and load management strategies  

Elbow pain is often part of a larger kinetic chain issue involving the wrist, shoulder, and neck. 

 

When Is Shockwave Therapy Recommended for Elbow Pain? 

For some elbow conditions, Shockwave Therapy may be recommended as part of a comprehensive treatment plan, particularly for persistent tendon-related pain that has not improved with exercise and other conservative treatments. 

Shockwave therapy is commonly used for tennis elbow (lateral epicondylitis) and golfer's elbow (medial epicondylitis). It delivers acoustic pressure waves to the affected tendon, which are thought to stimulate the body's natural healing response, improve blood flow, and reduce pain sensitivity. 

Current research suggests that shockwave therapy can be an effective treatment option for many chronic tendon injuries, particularly when combined with progressive strengthening exercises, manual therapy, and gradual return to activity. 

During your assessment, we'll determine whether shockwave therapy is appropriate for your condition and whether it should be included as part of your rehabilitation plan. 

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Recovery Timeline 

Every case is unique, but general recovery timelines may include: 

  • Mild overuse irritation: 1–3 weeks  

  • Tendinopathy (tennis/golfer’s elbow): 4–12 weeks  

  • Chronic or persistent cases: 3–6+ months  

Recovery is usually gradual and depends heavily on load management and consistent rehab. 

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Exercises Commonly Recommended 

The most appropriate exercises depend on the specific cause of elbow pain and your stage of recovery. These examples represent exercises that are commonly recommended for many elbow conditions but should be individualized following an assessment.

Phase 1: Reduce Pain and Restore Mobility

The focus during the early phase is to calm irritated tissues, maintain gentle movement, and avoid complete rest.

  • Gentle Wrist Flexion and Extension Range of Motion

  • Forearm Pronation and Supination Mobility

  • Finger Tendon Gliding Exercises

  • Grip Squeezes with a Soft Ball (Pain-Free)

  • Isometric Wrist Extension or Flexion Holds

  • Gentle Stretching of the Wrist Flexors and Extensors

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Phase 2: Restore Strength and Tendon Capacity

As pain begins to settle, rehabilitation shifts toward rebuilding strength and improving the tendon's ability to tolerate load.

  • Eccentric Wrist Extension Exercises (particularly for tennis elbow)

  • Eccentric Wrist Flexion Exercises (particularly for golfer's elbow)

  • Hammer Rotations (Pronation/Supination Strengthening)

  • Theraband Wrist Strengthening

  • Grip Strengthening with Therapy Putty or Hand Gripper

  • Radial and Ulnar Deviation Strengthening

  • Biceps and Triceps Strengthening

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Phase 3: Return to Activity and Prevent Recurrence

The final stage focuses on restoring endurance, coordination, and preparing the arm for work, sport, or gym activities.

  • Farmer's Carries

  • Push-up Progressions (wall → incline → floor as tolerated)

  • Resistance Band Pull-Aparts and Rows

  • Medicine Ball Tosses or Plyometric Drills (for athletes)

  • Sport- or Work-Specific Grip Training

  • Progressive Return to Lifting or Racquet Sports

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Can I Still Exercise? 

Yes — in most cases exercise should continue with modifications. 

Recommended: 

  • Lower body training  

  • Pain-free pulling/pushing with reduced load  

  • Wrist-neutral strength training  

  • Light resistance band work for forearm rehab  

  • Controlled grip training (as tolerated)  

Avoid early on: 

  • Heavy gripping or curling movements  

  • High-volume repetitive forearm loading  

  • Painful wrist extension under load  

  • Sudden increases in training intensity  

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When To Seek An Assessment 

Consider booking an assessment if: 

  • Pain lasting more than 1–2 weeks without improvement  

  • Increasing pain despite rest or modification  

  • Weak grip or loss of function  

  • Pain affecting work, sport, or daily tasks  

  • Recurrent episodes of elbow pain  

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Common Mistakes That Slow Recovery 

  • Continuing to overload painful gripping activities  

  • Completely resting the arm for too long  

  • Returning to heavy gym work too early  

  • Ignoring shoulder or neck contribution to symptoms  

  • Not progressing tendon loading gradually  

  • Poor ergonomics at work or training  

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When Should I worry?  

Seek urgent assessment if you experience: 

  • Sudden severe pain after trauma  

  • Visible deformity or swelling in the elbow  

  • Inability to move the elbow or forearm  

  • Numbness or significant tingling into the hand (nerve involvement)  

  • Signs of infection (redness, heat, fever)  

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Summary 

✔ Elbow pain is most often caused by overuse of forearm tendons, commonly seen as tennis elbow or golfer’s elbow 
✔ Symptoms include pain with gripping, lifting, wrist movement, and reduced grip strength 
✔ Common triggers include repetitive work, gym loading, and sustained gripping activities 
✔ Most cases improve with load management, progressive strengthening, and activity modification 
✔ Chiropractic care may help by addressing joint mobility, muscle tension, and contributing neck/shoulder mechanics 
✔ Red flags such as trauma, deformity, or neurological symptoms require urgent assessment 

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Ready to Get Back to Moving Comfortably?

If your elbow pain pain isn't improving, keeps returning, or is preventing you from working, driving, exercising, or enjoying your daily activities, an assessment can help identify the underlying cause and determine the most appropriate treatment plan. 

Dr. Michael Hoiles is a Calgary chiropractor who provides evidence-informed care combining hands-on treatment, exercise-based rehabilitation, and practical advice to help people recover from injury, move better, and stay active. 

Book an appointment with Dr. Michael Hoiles today to start your recovery and get back to doing what you enjoy. 

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