Tennis Elbow And The Shot

If the outside of your elbow aches every time you grip, lift or shake a hand, and it has dragged on for months, you have probably been offered a cortisone shot or told to just rest it. Both feel like the sensible move. Both tend to disappoint over the months that matter. If you have been searching for tennis elbow treatment that actually lasts, here is what the research says and how we approach it at Enhance Physical Therapy in Utah Valley.

What tennis elbow actually is

Tennis elbow, known clinically as lateral epicondylitis, is an irritated tendon on the outside of the elbow. Despite the name, most people who get it have never held a racquet. It shows up from gardening, lifting weights, working a mouse and trades that load the forearm, and it can hang around for a year or more when it is only rested or masked. The classic sign is pain on the outside of the elbow when you grip, lift a coffee cup, turn a doorknob or shake someone's hand.

Why the cortisone shot feels great, then fails

Here is the part worth knowing before you agree to an injection. A cortisone shot is the best short-term fix there is, and that is exactly the trap. The well-known research on tennis elbow found that people who got a steroid injection felt much better at six weeks, then relapsed at strikingly high rates, with roughly seven in ten flaring again, while the people who did guided exercise or simply waited it out ended up doing better at a year. The shot borrows relief from your future.

This is why so many people tell us their tennis elbow "won't go away." They get the injection, feel fixed, load the tendon again, and the pain returns a few months later. The needle quiets the symptom without changing why the tendon got overloaded in the first place.

What the research says actually works

What holds up over time is loading the tendon on purpose. A 2021 systematic review and meta-analysis in the British Journal of Sports Medicine, pooling 30 trials and more than 2,000 people, found that exercise produces better outcomes than passive treatments like ultrasound, braces and rest, though it was honest that the size of the benefit is small. A separate 2021 review focused on eccentric strengthening, the slow lowering part of a lift, reported meaningful gains in pain and grip strength when the tendon is progressively challenged rather than protected.

The pattern across the evidence is consistent. Passive care that is done to you, the shots, the ultrasound, the straps, tends to help briefly. Active care that rebuilds the tendon's capacity tends to hold.

Why we look at the whole arm, not just the elbow

What this means for you is that the elbow does not need to be rescued with a needle or waited out for a year. It needs the right load in the right dose, and it needs the reason it got overloaded addressed. Often the forearm is taking the hit for a stiff wrist, a weak shoulder or a grip pattern that never lets the tendon recover, which is why we look at the whole arm and how you use it rather than only the sore spot, then rebuild the tendon so it tolerates what you ask of it.

This is the difference between chasing the symptom and finding the source. In a one-on-one, 60-minute visit we assess the whole chain, calm the tendon down with hands-on manual therapy, and then build a loading plan matched to your work, your sport and your hands.

Common questions about tennis elbow

How long does tennis elbow take to heal? With the right loading program many people turn the corner in six to twelve weeks, though a stubborn case that has been present for a year can take longer. Rest alone often lets it linger.

Should I stop using my arm? Complete rest usually backfires. The tendon needs load to remodel, just the right amount, progressed carefully rather than avoided.

Is a brace or strap enough? A strap can take the edge off during activity, but on its own it does not rebuild the tendon. It works best as one small piece of an active plan.

Do I need an MRI or a referral first? Tennis elbow is diagnosed from your history and a hands-on exam, and in Utah you can see a physical therapist directly without a referral.

Get back to your game, your lifts and your work

If your elbow has been getting in the way of your game, your lifts or your work, you do not have to choose between a shot and waiting. You can schedule a visit at https://enhancept.janeapp.com/ and we will find the source and build a plan in order to get you back to what you love. We see active adults across Utah Valley, including Provo, Orem and Lehi.

Dr. Doug Ashton, DPT, FAAOMPT

Owner, Enhance Physical Therapy

References

• Karanasios S, et al. Exercise interventions in lateral elbow tendinopathy have better outcomes than passive interventions, but the effects are small (2021), British Journal of Sports Medicine. https://pubmed.ncbi.nlm.nih.gov/33188133/

• Cullinane FL, et al. The beneficial effects of eccentric exercise in the management of lateral elbow tendinopathy: a systematic review and meta-analysis (2021). https://pubmed.ncbi.nlm.nih.gov/34501416/

• Bisset L, et al. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial, BMJ. Still the reference point for long-term outcomes. https://www.bmj.com/content/333/7575/939