Assessment
A detailed history, then a thorough examination of movement, strength and the affected area. You leave with a working diagnosis you understand and a plan agreed with you, not handed to you.
Tennis elbow and golfer's elbow usually mean the forearm tendons are being loaded faster than they can take. We combine specialist hand therapy with graded loading to settle the symptoms and rebuild the capacity your work and sport demand of the elbow.
Overview
Elbow pain, in desk-based and active people alike, usually comes down to load applied faster than the tissue can take it. Get the diagnosis right and the rehabilitation works; guess at it and it stalls.
The common elbow problems behave differently:
At Kaizen our hand-therapy assessment identifies the specific tissue and the overload behind it, then builds a loading plan around how you actually type, train and lift. We refer for imaging or a specialist opinion when that is the right next step. Self-referral; no GP referral needed.
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David helped me when I started to have a strong tibia pain only 5 weeks before the marathon. I genuinely thought at some point that I wasn’t going to be able to do it and I did my PB!
After suffering with terrible back pain, Gus has helped me make huge improvements. Very professional and happy to explain the processes and treatments. Many thanks
Couldn’t recommend this physio team enough! They helped me recover from a knee injury 3 weeks before the London Marathon which I thought was going to prevent me from running it! Everyone was really friendly, supportive and genuinely cared about helping me reach my goal. Special thanks to Charlie, Gus, Brad and Stef!
I came to Dave with an ongoing injury that I’ve been struggling with for months! He helped sort it out straight away, also giving me some exercises to help target the area to get back to full strength. I’m now back to running pain-free already and training properly — I’ll definitely be recommending Kaizen Physiotherapy to my clients!
Gus worked miracles to get me running a marathon after being injured 6 weeks out. He worked out the issue really quickly and provided a clear and actionable plan to deal with it. The sports massages were the best I’ve ever had too — thanks Peggy! Can’t recommend Gus and Peggy enough.
I had such a positive experience working with Brad at Kaizen. He supported me through a meniscus tear and got me all the way back to running a half marathon and HYROX training. Everything was structured, progressive, and easy to follow, and I always felt like I was in safe hands.
Outer and inner elbow pain behave differently and need different plans. Our specialist assessment identifies the tissue and the load behind it, and we refer for imaging or a specialist opinion when that is the right step.
Both are forearm tendon-overload problems, and rest alone tends to fail. Load modification plus progressive forearm exercise settles pain faster and rebuilds the grip and lifting tolerance your work and training demand, in line with NICE summaries for tennis elbow.
We look at how you type, grip and lift through the day and adjust the load on the elbow, so the tendon can recover while you stay at your desk and keep training in a modified form.
Typing, gripping and lifting all day load the forearm tendons faster than they adapt. Graded strengthening of the forearm, wrist and shoulder rebuilds the capacity behind everyday tasks, from carrying bags to racket sports and climbing.
When the shoulder and wrist lack strength, the elbow absorbs load it is not conditioned for. Physiotherapy works on the whole upper-limb chain, so the elbow is not left doing more than its share.
Racquet sports, gym work and climbing all ask a lot of the elbow. We stage the return week by week, building tendon tolerance ahead of the load you are going back to, so a rapid jump in training does not set off the same pain again.
Why it happens
Repetitive or sustained gripping, typing and mouse use that loads the forearm tendons faster than they can adapt, the common driver of tennis elbow and golfer's elbow
A rapid increase in gym, racquet, or climbing load that overloads the elbow tendons without adequate recovery
Strength and capacity deficits in the forearm, wrist, and shoulder, so the smaller structures absorb load they are not conditioned for
A previous elbow injury that was not fully rehabilitated, leaving the tendons with less capacity
Recovery after elbow surgery or a fracture, where stiffness and reduced strength need structured, graded rehabilitation
Your initial visit runs 45–60 minutes: a detailed history, then a thorough examination of movement, strength and the affected area. We explain what we find in plain English and agree a working diagnosis together.
Treatment starts the same day, and you leave with the first exercises of a plan built around your goal.
Better than yesterday. Kaizen means continuous improvement: small, repeatable gains, built session by session, until you are back to what you love and no longer need us.
Book online through Jane and self-refer, with no GP letter needed. If you are using private health insurance, check your policy first: some insurers ask for a GP referral before your first session.
Everything starts with a proper assessment. We find what is driving the problem, treat it, and build the strength that keeps it fixed, so you finish performing, not just pain-free.
A detailed history, then a thorough examination of movement, strength and the affected area. You leave with a working diagnosis you understand and a plan agreed with you, not handed to you.
Hands-on care to settle symptoms and restore movement: manual therapy, with acupuncture, shockwave or soft-tissue work where they genuinely help. The first home exercises go with you the same day.
Progressive exercise that returns strength, control and load tolerance, from Reformer Pilates to strength and conditioning. Each follow-up reassesses against your baseline, so progress is measured rather than guessed.
Criteria-based milestones return you to work, sport and training. Discharge happens by mutual agreement once you can manage independently, with a Performance MOT available to catch the next weak link early.
Treatment approach
Specialist hand-therapy assessment identifies the affected tissue around the elbow and combines activity modification, manual techniques and a graded exercise plan, the core approach for tennis elbow, golfer's elbow and other forearm tendon problems.
See treatment detail →Hands-on physiotherapy addresses the wider chain of forearm, wrist and shoulder strength and control, and delivers the progressive loading that rebuilds tendon capacity rather than only settling symptoms.
See treatment detail →FAQ
Tennis elbow is often self-limiting and many cases improve over months, which NICE Clinical Knowledge Summaries reflect. However, complete rest tends to let the tendon lose capacity, so symptoms return with activity. Load modification combined with progressive forearm exercise usually settles pain faster and rebuilds tolerance, and that is what hand-therapy rehabilitation provides.
Both are tendon-overload problems of the forearm, but they affect opposite sides of the elbow. Tennis elbow (lateral epicondylalgia) causes pain on the outer elbow, typically with gripping and lifting. Golfer's elbow (medial epicondylalgia) causes pain on the inner elbow. Both respond to load modification and progressive loading rather than rest alone.
Usually not. Complete rest tends to let the forearm tendons lose capacity, so pain returns as soon as you pick activity back up. We adjust how much gripping, lifting and training you do while the tendon settles, then build its tolerance with progressive forearm exercise so you can keep working and training.
Seek urgent care if you have severe pain after trauma, an obvious deformity, you cannot bend or straighten the elbow, or there is rapidly spreading redness, fever, or numbness with significant weakness. Symptoms that steadily worsen, or numbness and tingling spreading into the hand, also warrant prompt assessment.
Get Started
Kaizen Physiotherapy & Performance • 111 Charing Cross Road, Soho, London WC2H 0DT
Book OnlineAppointments typically available within 1–2 weeks