By the time he came into the clinic ten weeks had passed. Ten weeks of moving around in the same brace. Ten weeks of disturbed sleep because the knee ached whenever he turned. Ten weeks of finding stairs awkward and everyday tasks tiring.

He told us he felt weaker each week. His thigh muscles had wasted away. Walking felt heavy and clumsy. Even standing for long periods at work was draining.

The brace had stopped him from making things worse, but it had not made anything better. He admitted he had started to feel stuck.

The easiest way to differentiate the two conditions is location of pain.

Tennis elbow causes pain on the outside of the elbow. This area is linked to the tendons responsible for wrist and finger extension, which are heavily used during gripping and lifting activities.

Golfer’s elbow causes pain on the inside of the elbow. This involves a different group of tendons responsible for wrist flexion and gripping movements.

Although the locations differ, both conditions involve tendon overload rather than inflammation alone. Symptoms often include tenderness, reduced strength, aching after activity, and pain when using the hand or forearm repeatedly.

However, location alone should never be used as a final diagnosis.

One of the biggest mistakes people make is assuming they have tennis or golfer’s elbow simply because pain sits in that region. In reality, nerve related problems can refer pain into both the inside and outside of the elbow.

Irritation of nerves travelling from the neck or upper limb can closely mimic tendon pain. If this is not identified early, people can spend months treating the wrong structure with exercises, braces, or massage that will never fully resolve symptoms.

A proper physiotherapy assessment rules tendon involvement in or out while also screening for nerve contribution. This prevents wasted time, unnecessary expense, and ongoing frustration caused by treating the incorrect source of pain.

Physiotherapy remains the most effective starting point for both tennis elbow and golfer’s elbow. Treatment focuses on reducing tendon overload, restoring strength, improving movement patterns, and addressing contributing factors higher up the arm or neck.

When diagnosed correctly, most elbow tendon problems respond very well to structured rehabilitation. The goal is not simply pain relief but rebuilding tendon capacity so symptoms do not continually return.

Early treatment often shortens recovery time significantly and prevents the condition progressing into a long standing chronic issue.

If elbow pain has been present for longer than three months, the tendon often requires additional stimulation to fully recover. At this stage, shockwave therapy becomes one of the most effective treatment options available.

Shockwave therapy is specifically designed for chronic tendon conditions such as tennis and golfer’s elbow. It stimulates healing within the tendon, often providing early pain relief while also delivering a long term solution rather than a temporary fix.

Most treatment plans involve approximately six sessions performed weekly, with many patients experiencing significant improvement after struggling with symptoms for months.

If you recognise these symptoms or are unsure which type of elbow pain you have, a good first step is to book a free discovery call. We can help identify the true cause of your pain and guide you toward the most effective treatment option.

Joe Sharp

BSc (Hons) Physiotherapy