Tennis elbow, formally known as lateral epicondylitis, is one of the most common causes of elbow pain in adults. Despite its name, most people who develop tennis elbow have never picked up a racquet. It affects anyone who performs repeated gripping, lifting, typing, or wrist-extension movements, from athletes to construction workers to everyday parents lifting kids or groceries.
For years, the standard approach included rest, bracing, stretching, therapy, and, if pain persisted, surgery. However, modern regenerative medicine has transformed how we treat this condition. One therapy in particular has changed the landscape: platelet rich plasma, or PRP.
Today, PRP is considered the most effective treatment for chronic tennis elbow, supported by the highest level of medical evidence. At Sacramento Orthopedic Sports & Shoulder, we use PRP regularly to help patients return to full function, reduce pain, and avoid surgery altogether.
Below is an in-depth look at what tennis elbow is, why it occurs, and how both conservative and advanced treatments, especially PRP, can help you heal faster and more completely.
What Is Tennis Elbow?
Tennis elbow is an overuse injury involving the extensor tendons that attach to the lateral epicondyle, which is the bony bump on the outside of the elbow. These tendons help extend the wrist, stabilize the hand during gripping, and support many everyday motions such as lifting, turning, and carrying objects.
When these tendons undergo repeated strain, microscopic tears develop. Over time, this leads to irritation and degeneration of the tendon. Patients often experience:
- Pain along the outside of the elbow
- Weak grip strength
- Discomfort when lifting objects
- Difficulty with twisting motions, such as opening a jar
- Pain when reaching up, forward, or away from the body
Despite being called tennis elbow, only a small percentage of cases are related to tennis or other racquet sports. Most people develop symptoms from daily, repetitive activities such as:
- Computer work
- Manual labor
- Repetitive lifting
- Gardening or home projects
- Gym workouts
- Using tools or equipment
- Household chores
If left untreated, symptoms can linger for months or even years. Early evaluation and management can significantly shorten recovery time and prevent chronic tendon degeneration.
Conservative Management: First Line Treatments That Truly Help
Most patients begin with conservative, non surgical treatments, many of which are highly effective when started early. These treatments focus on reducing irritation, supporting the tendon, and encouraging healing.
At Sacramento Orthopedic Sports & Shoulder, we offer or recommend the following options:
Counterforce Brace
A counterforce brace, sometimes called an elbow strap, helps reduce strain on the injured tendon during daily activities. By applying gentle pressure slightly below the elbow, it redistributes force away from the lateral epicondyle. This allows the tendon to rest and heal while still letting patients perform many of their usual tasks. Many people experience immediate relief when wearing the brace during lifting or gripping activities.
FlexBar Strengthening
The TheraBand FlexBar is one of the most studied strengthening tools for tennis elbow. Eccentric exercises performed with the FlexBar have been shown to reduce pain, improve tendon strength, and promote long term healing. The widely used “Tyler Twist” exercise is an example of an effective eccentric movement for this condition. When performed consistently, many patients notice improvement within several weeks, and continued strengthening can help prevent future flare ups.
Ice and Anti Inflammatories
Ice therapy helps reduce pain, irritation, and swelling after activity or flare ups. Short courses of NSAIDs, when appropriate for the individual patient, may also help manage inflammation and discomfort. Although these methods do not repair the tendon itself, they can significantly improve symptoms during the healing process.
Physical Therapy
A structured physical therapy program remains one of the most important components of recovery. Therapy typically focuses on:
- Eccentric wrist extensor strengthening
- Stretching and forearm flexibility
- Posture and ergonomic training
- Activity modification to reduce repetitive stress
- Soft tissue mobilization or manual therapy
Physical therapy not only reduces symptoms but also addresses the underlying causes of tendon irritation. This helps restore normal function and reduces the likelihood of recurrence.
Massage and Soft Tissue Work
Targeted massage, particularly techniques such as cross friction massage, can help stimulate blood flow to the tendon and enhance the healing process. Soft tissue work is often paired with stretching and strengthening programs to improve mobility, decrease stiffness, and support long term recovery.
Injections: Corticosteroid vs. PRP
Steroid injections can provide short term relief, especially for acute flare ups. However, medical studies repeatedly show that they do not provide long term healing and may weaken tendon tissue over time.
This is where PRP stands apart as a regenerative option that supports true healing.
PRP: The Most Effective Therapeutic Treatment for Tennis Elbow
Platelet rich plasma therapy is a regenerative treatment that uses a patient’s own concentrated platelets to stimulate healing. Platelets contain growth factors and proteins that promote tissue repair at the cellular level.
Why PRP Is Considered the Gold Standard for Tennis Elbow
Tennis elbow was the first medical condition to have Level I clinical evidence, which is the highest level of scientific research, supporting PRP as an effective treatment. Numerous randomized controlled trials have demonstrated that PRP:
- Provides better long term outcomes than steroid injections
- Reduces pain significantly
- Promotes true tendon healing, often visible on imaging
- Leads to a faster return to full activity
- Decreases the need for surgery
This research has genuinely transformed the way physicians treat tennis elbow.
At Sacramento Orthopedic Sports & Shoulder, PRP is performed in-house using high quality processing systems to ensure optimal platelet concentration and treatment effectiveness. PRP treatment typically involves:
- Drawing a small sample of the patient’s blood
- Spinning the blood in a centrifuge to isolate platelets
- Injecting the concentrated PRP directly into the injured tendon under ultrasound guidance
This targeted technique supports a natural healing process that helps restore tendon strength and function over time.
What to Expect After PRP Treatment
While every patient heals at a slightly different pace, most notice:
- Very minimal downtime after the procedure
- Improvement beginning around 8 weeks and up to 6 months
- Continued healing over 3 to 6 months as the tendon remodels
- Long lasting relief with a significantly reduced chance of recurrence
Because PRP treats the underlying tendon degeneration rather than simply masking pain, patients commonly experience more complete and durable recovery compared to traditional treatments.
When Is Surgery Necessary?
Before PRP became widely used, surgery was often recommended when patients failed conservative treatments such as bracing, therapy, or injections. Today, surgery is far less common, but it still plays an important role for certain cases.
Debridement and Repair
During surgery, damaged tissue is removed in a process known as debridement. The extensor tendons are then repaired and reattached to the lateral epicondyle. This procedure can be very effective, but it requires a period of restricted activity followed by several months of rehabilitation.
Is Surgery Successful?
Yes, tennis elbow surgery typically has a high success rate. However, like all surgical procedures, it does not guarantee complete or permanent relief. Recovery time is also longer compared to PRP, making surgery more appropriate for cases where conservative and regenerative treatments have not been successful.
Why Surgery Is Needed Less Often Now
With the proven success of PRP, the number of patients needing surgery has decreased dramatically. PRP provides a natural, regenerative approach that promotes true healing without surgical risks or extended downtime. As a result, surgery is now reserved for:
- Severe or chronic cases
- Tendons with significant structural damage
- Patients who do not respond to PRP or other conservative therapies
Why Choose Sacramento Orthopedic Sports & Shoulder for Tennis Elbow Treatment?
At Sacramento Orthopedic Sports & Shoulder, we specialize in the latest orthopedic and sports medicine treatments, including PRP, to help patients recover quickly and safely.
When you seek care with Dr. Takenishi, you receive:
- A detailed and accurate diagnosis
- A customized treatment plan tailored to your specific activities and goals
- Access to conservative treatments and advanced regenerative therapies
- Surgical expertise if needed
- Local, in-house procedures with minimal downtime
- Compassionate and patient centered care
Our goal is to help you return to the activities you love, whether that is playing sports, working with your hands, or simply living without elbow pain.
When to Schedule an Appointment
If you have been experiencing elbow pain for more than a few weeks, or if your symptoms are interfering with your work or daily routines, now is the right time to seek help. Early treatment leads to better outcomes and a faster recovery.Schedule an appointment with Dr. Takenishi at Sacramento Orthopedic Sports & Shoulder to learn more about PRP treatment and your options for healing tennis elbow.