Elbow and Triceps Tendinopathy: understanding and managing your pain
Elbow and triceps tendinopathy are common conditions affecting the tendons around the elbow, often seen in individuals who perform repetitive wrist, forearm, or pushing movements. Whether you’re an athlete, a manual labourer, or someone who spends long hours at a desk, these conditions can significantly impact your daily activities and performance.
What Are Elbow and Triceps Tendinopathy?
Elbow and triceps tendinopathy refer to pain and dysfunction in the tendons that attach to the elbow, typically classified as either:
• Lateral elbow tendinopathy (Tennis Elbow): Affecting the extensor tendons on the outer part of the elbow, commonly seen in racket sports, repetitive gripping, or heavy lifting.
• Medial elbow tendinopathy (Golfer’s Elbow): Involving the flexor tendons on the inner elbow, often caused by repetitive wrist flexion, throwing sports, or occupational activities.
• Triceps tendinopathy: Affecting the tendon at the back of the elbow, often caused by excessive pushing movements, weightlifting, or repetitive forceful elbow extension.
Contrary to past beliefs, these conditions are not driven by inflammation but by changes in the tendon structure due to excessive load. This is why traditional anti-inflammatory treatments like corticosteroid injections are not recommended as a long-term solution.
Recognising the Symptoms
• Localised pain on either the inside (medial), outside (lateral), or back (posterior) of the elbow.
• Increased discomfort with gripping, lifting, wrist movements, or pushing activities.
• Morning stiffness and tenderness around the elbow.
• Reduced grip strength, forearm fatigue, or difficulty with overhead or pressing movements.
• Pain that may temporarily ease during activity but worsen afterward.
Why Does It Happen?
Elbow and triceps tendinopathy are overuse injuries, meaning the tendons have been subjected to excessive or repetitive stress without adequate recovery. Some common contributing factors include:
• A sudden increase in workload (e.g., starting a new sport, lifting heavier weights, or increased manual labour).
• Poor grip technique, pushing mechanics, or improper equipment use.
• Weakness in surrounding muscles leading to increased tendon strain.
• Repetitive wrist, forearm, or elbow extension movements with inadequate recovery
Managing Elbow and Triceps Tendinopathy.
Recovery requires a combination of movement modification and progressive strengthening rather than complete rest. A physiotherapist can guide you in:
• Adjusting activities to reduce strain while maintaining function.
• Gradually strengthening the tendon through specific exercises suited to your condition.
• Addressing contributing factors such as movement patterns, grip strength, and ergonomic adjustments.
• Using symptom management strategies such as manual therapy to address muscle tension, while exercise remains the key to long-term recovery
Preventing Reinjury.
Once symptoms improve, it’s essential to gradually return to normal activities while continuing to build tendon resilience. A physiotherapist can help you implement strategies to prevent recurrence, such as:
• Ensuring a gradual return to sport, gym, or occupational tasks.
• Strengthening surrounding muscles to support the tendon.
• Improving technique and biomechanics to reduce excessive strain.
Seeking Professional Guidance
Elbow and triceps tendinopathy require a structured approach for long-term improvement. While self-management strategies can provide temporary relief, targeted rehabilitation is essential for full recovery. A physiotherapist can assess your condition, guide you through a progressive strengthening program, and help you modify activities to prevent reinjury.
For personalised advice and treatment, book an appointment with one of our physiotherapists today.
What is Tendinopathy?
Tendinopathy is a common sport injury that affects the tendon. Highly associated with an excessive cumulative load to the tendon, can cause pain in the tendon, localised swelling and stop. Tendinopathy is an umbrella term that means tendon pain and dysfunction. It is consider tendinopathy, localised pain on the tendon (i.e. Rotator cuff, Achilles, Patellar tendon) and pain during tasks that load or put stress on the tendon such as running, jumping, or throwing a ball.
Research has shown that inflammation does not drive tendon pain or pathology nor is associated with pain, so, old terms like tendinitis or tendinosis are no longer used.
Common symptoms are:
Morning stiffness, localised pain, pain with activities that load the tendon i.e. squatting, lifting the arm, running, jumping, are characteristics of tendinopathy. It is also a common feature the “warm up phenomena”, it hurts at first, but once you warm up, the pain either reduces or disappears, however it can hurt even more afterwards.
Musculoskeletal and Sport Physiotherapists are the first contact “SPECIALIST” health care practitioner you should go to. We specialise in musculoskeletal and sport related injuries and well trained to help you. You do not need a referral to see a physiotherapist. We can accurately diagnose and treat you. Tendinopathy diagnosis is based on patient’s history and clinical examination, and further investigation is rarely necessary, only for differential diagnosis purposes.
What causes tendinopathy?
Tendinopathy is a load related injury, hence referred to as an overloading injury. This means, you can develop tendinopathy when you exceeded your tendon load capacity during a certain activity or sport. Tendons don’t like surprises, or sudden changes in load. When that happens, you can present with tendinopathy symptoms mentioned above.
Overloading can be either cumulative or sudden (Chronic or Acute).
Cumulative overloading: you suddenly increased your training load and at the end of one or two weeks, the cumulative effect was greater than your tendon capacity and its ability to recover between training sessions.
Acute overloading: you exceeded the tissue (tendon) capacity in ONE session of training, ie. Achilles pain after one intense uphill running session, or a Rotator cuff related pain after moving houses, packing and carrying heavy items or after that intense cricket session.
I read this on Instagram and I think it explains the overloading analogy quite well.
“If someone took 3x the recommended dosage of a medication and experienced side effects, the initial intervention would be to simply adjust the dosage”
What is the most effective treatment?
There are a lot of research out there comparing the effectiveness of different treatment for tendinopathy.
Key things we know from research:
– Rest is NOT the answer for tendinopathy. If you rest, your tendon/muscle will become deconditioned and tolerate even less load.
– Ice, heat etcetera don’t seem to work
– Anti-inflammatories such as ibuprofen or corticosteroid injections do not work, with the latter being detrimental to the tendon structure, as there is no inflammation in tendinopathy.
So what does work?
Exercises to progressively build up your tendon load capacity, increase your tendon fitness level and therefore a stronger tendon.
Load management, understanding where and how you over did it and readjust your training load so you tendon can recover and together with the exercises increase the load capacity in the tendon to tolerate this new change in load you now require.
Tendinopathy is a slow recovery injury and can take at least 3-4 months to get better, and even longer for some patients. You should not give up before 3 or so months of progressive exercise program. This does not mean you will have to see your physio 4x a week for 3 months. Your physio will give you advice regarding load management and a home exercise program to do, and you should give enough time to see results. There are NO QUICK FIX treatments. Stay away from “magical”, “new” treatments, they do not work for tendinopathy.
Dry needling, massage, anti-inflammatory and rest, do not resolve tendinopathy. Instead massaging a tendon or dry needling in the tendon can actually aggravate your pain.
With tendinopathy you need an active treatment. YOU, responsible for your recovery, with the guidance from your physio in managing and progressing load accordingly.
The most effective treatment for tendinopathy is a personalised, progressive loading program and advice regarding exercise progression and how to manage flare ups from you physiotherapist.
Your physio can also work alongside your personal trainer, exercise physiologist, training coach, if you have one, or health professional that is helping your fitness and working on other body parts as well.
Taping can also help you during your recovery, in a few cases.
The progression back to your previous level of exercise should be constant and tailored to your needs.
To inject or not to inject?
Doctors used to inject tendinopathy with corticosteroid for years. Today, with science evolving and more research available, we know that corticosteroid can cause more harm than good in your body. Each case is different and in 99% of the cases you should try a progressive exercise program with your physiotherapist before anything else.
Also, research shows that corticosteroid injections for tendinopathy should be avoided at all costs.
If you have any questions, come and talk to your physio. We can help.
Gabriel Fernandes | APAM | CMP |
Titled Certified Mulligan Practitioner (CMP) | Titled Sports Physiotherapist (SONAFE – BRA) | Member of the APA Sports National Group |
| Mphil Candidate at QUT | Accredited Australian and Brazilian Physiotherapist |
Senior MSK & Sports Physiotherapist.
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