Why Your Elbow Might Hurt When You Grip, Lift or Train

Tennis elbow is one of those injuries that sounds like it only happens to tennis players. In reality, many people who develop it have never picked up a racquet.

It can start as a small ache on the outside of the elbow, then slowly become more noticeable with simple things like lifting a coffee cup, opening a jar, gripping a dumbbell, using a mouse or carrying shopping bags.

The proper clinical name is lateral elbow tendinopathy, also commonly called lateral epicondylitis. In simple terms, it is pain and irritation around the tendons on the outside of the elbow, usually related to repeated gripping, lifting, pulling, twisting or wrist movements.

What Is Tennis Elbow?

Tennis elbow is pain around the outside of the elbow, near the bony point called the lateral epicondyle.

In plain English, the tendon has been overloaded. It has been asked to do more than it can currently handle.

More technically, tennis elbow usually involves the common extensor tendon, particularly the extensor carpi radialis brevis muscle. This muscle helps extend the wrist and stabilise the hand when you grip, lift or hold objects.

Although many people still use the term “epicondylitis,” the condition is not always purely inflammatory. In many cases, it behaves more like a tendinopathy, meaning the tendon has become sensitive, irritated and less tolerant to load.

That is why simply resting it for a few days often does not solve the problem. It may calm down temporarily, but if the tendon has not regained strength and capacity, the pain often returns as soon as you return to normal activity.

Why It Happens

Tennis elbow usually develops when the muscles and tendons of the forearm are repeatedly loaded beyond what they can tolerate.

This can happen from one sudden increase in activity, but more often it builds up gradually over time.

Common causes include repeated gripping, lifting or carrying, gym exercises such as rows, deadlifts, pull-ups or curls, racquet sports, heavy mouse and keyboard use, manual work, tool use, painting, gardening, cleaning, DIY jobs, or suddenly increasing training and workload.

A common example is someone who starts a new gym program, has a busy period at work, does a big weekend of gardening, or spends more time than usual using a mouse. The elbow starts off slightly uncomfortable, then slowly becomes more painful and harder to ignore.

Signs and Symptoms

The most common symptom is pain on the outside of the elbow, usually made worse by gripping, lifting or twisting movements.

People often notice pain when shaking hands, opening jars, lifting a kettle, carrying shopping bags, holding a dumbbell, using a mouse, typing for long periods, turning a door handle, using tools, playing tennis or golf, or picking something up with the palm facing down.

Other common symptoms include tenderness over the outside of the elbow, weak grip strength, aching into the forearm, morning stiffness, pain after gym or work, and difficulty lifting with the arm straight.

A common sign is that the elbow feels reasonably fine at rest, but becomes painful as soon as you grip, lift or load the wrist.

Why It Can Linger

One of the most frustrating things about tennis elbow is that it often does not disappear quickly.

That is because tendons usually need time and progressive loading to recover properly.

Pain may settle with rest, massage, anti-inflammatory medication or avoiding certain tasks, but if the tendon is still weak or sensitive, symptoms can return as soon as normal activity resumes.

This is why treatment needs to focus on more than short-term pain relief. The long-term goal is to improve the tendon’s ability to tolerate daily activities, gym training, sport and work demands.

How Physio Helps

Physiotherapy treatment for tennis elbow is aimed at reducing pain, improving strength, restoring function and helping you return to normal activity without repeated flare-ups.

A proper assessment is the first step. Your physio will look at elbow movement, wrist and forearm strength, grip strength, tendon sensitivity, neck and shoulder contribution, nerve symptoms, and the work, gym, sport or daily tasks that may be contributing to your pain.

Load management is also important. This does not mean complete rest. It means reducing or modifying the things that are irritating the tendon while keeping you active where possible. This may involve changing gym exercises, grip position, work tasks, mouse use, lifting technique, tennis volume, tool use or training frequency.

Strengthening is usually a key part of rehab. Depending on your symptoms, this may include isometric wrist extension holds, wrist extensor strengthening, eccentric loading exercises, grip strengthening, forearm rotation work, shoulder strengthening and gradual return-to-gym or return-to-sport loading.

In simple terms, the tendon needs to be re-trained to handle load again.

Manual therapy can also help reduce pain and improve movement. This may include soft tissue release, forearm muscle treatment, joint mobilisation, neural mobility work, taping, and wrist, elbow or shoulder mobility treatment.

A tennis elbow brace or counterforce strap may be useful for some people during gripping or lifting tasks. It does not fix the tendon by itself, but it can reduce load through the painful area and make daily activities more manageable while rehab is underway.

Technique and ergonomic advice can also make a big difference. For office workers, this may involve changes to mouse position, keyboard setup, desk height or work habits. For gym-goers, this may involve adjusting grip, wrist position, exercise selection, training volume or load. For tennis players, this may involve racquet grip size, backhand technique, shoulder strength and playing volume.

When to Get Help

You should consider seeing a physio if your elbow pain has lasted more than one to two weeks, is getting worse, affects work, gym or sport, makes gripping or lifting difficult, keeps coming back, causes weakness, or is associated with pins and needles, numbness or neck pain.

It is also worth getting assessed sooner if the pain started after a fall, trauma or sudden injury.

Tennis elbow is not just a tennis injury, and it is not always something that improves with rest alone. The key is working out what is irritating the tendon, reducing the right loads, building strength back gradually, and addressing any contributing factors from the wrist, shoulder, neck, work setup, gym program or sport technique.

If you are dealing with ongoing elbow pain, weak grip strength, or pain with lifting and gripping, the team at Urban Physiotherapy in North Sydney can assess the cause and guide you through a clear treatment plan.