When the outside of your elbow hurts every time you grip a coffee mug, shake a hand, or turn a doorknob, it's not in your head — and it usually isn't tennis. We get you the right diagnosis and a plan that actually calms it down.
Conservative-first treatment for tennis elbow at LAOSS.
Tennis elbow — clinically called lateral epicondylitis or, more accurately, lateral epicondyle tendinosis — is one of the most common elbow conditions we see at LAOSS. It's the pain you feel on the bony bump on the outside of the elbow, and it has a tendency to derail simple things: typing, lifting a jug of milk, shaking a hand, even holding a coffee mug.
First, the name. Most of our tennis elbow patients have never played a set of tennis in their lives. The condition was named in the 1880s after lawn-tennis players, but today we see it just as often in office workers, plumbers, painters, carpenters, chefs, hairstylists, and new parents. Anything that involves repetitive gripping or repetitive wrist extension can light it up. The mechanism — not the activity — is what matters.
What's actually happening is a breakdown in the common extensor tendon where it attaches to the outside of the elbow. Despite the old "-itis" name, modern research shows there's very little inflammation at play. Instead, the tendon develops microscopic tears and disorganized collagen — a degenerative process called tendinosis. That distinction matters, because it changes the treatment. Pure anti-inflammatories and steroid injections can mask the pain for weeks, but they don't fix a tendon that needs to remodel. Loading the tendon correctly is what actually helps it heal.
The good news: roughly 80–90% of tennis elbow improves with conservative care within 6–12 months. The bad news: that timeline is long, and most people try to push through it without changing what's causing it. We focus on shortening that timeline.
This condition, commonly called tennis elbow, is a breakdown of the tendons that connect the forearm muscles to the elbow. The pain is felt at the lateral epicondyle — the bony bump on the outside of the elbow — and is triggered by gripping and lifting. Watch how the anatomy works and why repetitive loading is the root cause.
Animations licensed from ViewMedica · Swarm Interactive
The outside of your elbow is where the muscles that lift your wrist and fingers all share a single attachment point — the lateral epicondyle. The biggest contributor in tennis elbow is a tendon called the ECRB (extensor carpi radialis brevis). Every time you grip, type, or lift with your palm down, that tendon is loaded. Repeat it enough without recovery and the fibers start to break down faster than they can rebuild.
Diagnosing tennis elbow is largely a clinical decision — meaning most of the work is done at your visit, not in the imaging suite. Our specialists palpate the lateral epicondyle to find the exact spot of tenderness, then run a few provocative tests: resisted wrist extension with the elbow straight (Cozen's test), resisted middle-finger extension (Maudsley's test), and resisted forearm rotation (Mill's test). If those reproduce your pain, you almost certainly have tennis elbow.
We still take X-rays at your first visit at most of our offices. Not because they show tennis elbow — they don't — but because they rule out things that mimic it: arthritis, a loose body in the joint, a stress reaction in the bone, or calcium deposits in the tendon. Ultrasound is a quick, in-office way to see the tendon itself and grade the degree of tendinosis or any partial tearing. MRI is reserved for cases that have been going on for many months, haven't responded to treatment, or where we suspect something else — like a partial tear of the common extensor origin, a ligament injury, or radial tunnel syndrome (a nerve compression that can masquerade as tennis elbow).
The other thing we look for is what's actually driving it. Tennis elbow is almost always a mechanical loading problem. We ask about your work setup, your grip style, your training, what you do with your hands all day. That's not chitchat — it's the difference between treating the pain and fixing the cause. You'll leave your first visit with a diagnosis, a clear treatment plan, and the specific changes you need to make today.
The overwhelming majority of tennis elbow patients get better without surgery. Our job is to compress the timeline from "a year of nagging pain" to "meaningful relief in a few months." We start conservative, escalate only when needed, and reserve procedures for the cases that genuinely call for them.
Tendon problems heal with controlled loading and time, not pure rest. The plan is built around both.
If 3–6 months of conservative care hasn't moved the needle, we have several next steps before we ever get near an operating room.
Tennis elbow looks simple from the outside. In practice, it's a condition where the difference between "a year of frustration" and "meaningful relief in three months" comes down to specifics — brace fit, exercise dosing, injection choice, ergonomic detail.
Our upper-extremity specialists move stepwise — start with the least-invasive option that fits your situation, escalate only when it doesn't.
If most of these match your situation, an evaluation with an elbow specialist is the next step.
These signs typically point toward an in-person evaluation with an elbow specialist.
Your first visit is built to give you an answer the same day, not just another referral.
Before your appointment — and during treatment — these two changes do more than almost anything else.
This is the single best-supported exercise for tennis elbow in the orthopedic literature. It uses a rubber FlexBar to load the tendon eccentrically — the part of muscle work that drives tendon remodeling.
A small strap worn about two finger-widths below the elbow. It changes how force travels through the tendon, taking load off the painful insertion.
Tendons heal slower than muscle or bone — but with the right loading plan, the curve is predictable. Here's what to expect.
The first month is about quieting the tendon enough to start loading it. We modify the loads that are driving it and start the basics.
This is where the real healing happens. Eccentric loading remodels the tendon — but only if it's done consistently.
Once pain is gone and grip strength is back, the focus shifts to staying there — and catching any recurrence early.
We talk through risks and benefits with every patient — informed consent is a conversation, not a form.
Most tennis elbow treatment carries very low risk. The trade-offs are mostly about time and which intervention to pick.
When we move to a procedure, the risk profile shifts — and so does the conversation about which to choose.
At LAOSS, you'll find personalized, accessible elbow care led by board-certified orthopedic surgeons with deep expertise in tendon disorders, sports injuries, and upper-extremity reconstruction. Many of our shoulder and elbow specialists trained in busy sports-medicine fellowships and see tennis elbow every week — which matters, because experience is what separates a six-week recovery from a six-month one. From your first evaluation through treatment, our team will explain what's actually happening at the tendon, what you can do today, and what comes next if it doesn't settle.
Dr. Bastian figured out my elbow in 15 minutes after months of being told it was just "tennis elbow, rest it." Brace, the FlexBar exercise, and a PRP injection later — I'm back to lifting and typing without pain.
Book a visit with an elbow specialist at any of our eight Los Angeles–area offices. Most tennis elbow patients leave their first visit with a diagnosis, a brace, and the exact exercise plan that starts working that week.
