Why Does My Elbow Hurt When I Grip, Lift or Twist?

Understanding tennis elbow, golfer’s elbow and why ordinary activities can become unexpectedly painful

Elbow pain can be surprisingly disruptive. You may feel reasonably comfortable until you lift a kettle, open a jar or turn a door handle. Carrying a shopping bag becomes awkward. Picking up your child produces a sharp pain, and an object that is not particularly heavy suddenly feels difficult to hold.

These moments can be frustrating because the painful movement may seem too ordinary to explain what you are feeling. You may not remember injuring your elbow at all. Perhaps the discomfort appeared gradually, or you first noticed it as a slight ache that never quite went away. As gripping becomes painful and your hand feels less reliable, it is understandable to worry that something has been damaged.

Two common labels for this type of pain are tennis elbow and golfer’s elbow. You do not need to play either sport to experience them. Both can emerge through work, exercise, caring responsibilities, hobbies or the repeated physical demands of daily life.

Where Does It Hurt?

Tennis elbow, more accurately called lateral elbow tendinopathy, is usually felt around the bony prominence on the outside of your elbow. This is close to the shared attachment of several muscles that extend and stabilise your wrist whenever you grip or lift something.

The pain may remain close to the elbow or travel a short distance into the upper forearm. You may notice it when lifting with your palm facing down, shaking hands, turning a stiff handle, pouring from a heavy container or holding something away from your body. Your grip may feel weaker, partly because your body becomes reluctant to produce force when it expects the movement to hurt.

Golfer’s elbow, or medial elbow tendinopathy, is felt on the inside of the elbow. The muscles attaching here help to bend your wrist, turn your palm downwards and support your grip. Carrying, pulling, throwing, gardening, weight training or using hand tools can all bring the discomfort to your attention.

Pain from this area may extend down the inner forearm. Making a fist, squeezing an object or twisting a lid can become uncomfortable. If you also experience tingling or numbness—particularly in your little and ring fingers—the nearby ulnar nerve may be irritated. This is not something you need to diagnose for yourself, but it is worth mentioning when seeking an assessment.

Why Has It Started Now?

This is often the most difficult question. You may have performed the same work, exercise or household tasks for years without difficulty, so it can feel strange when your elbow begins to object now.

Tendons are living structures that respond to the work asked of them. They usually adapt well, but they can become painful when the amount or intensity of activity increases more quickly than they are presently able to tolerate and recover from.

Sometimes the change is obvious. You may have returned to the gym, started a new job, decorated a room or spent a long weekend gardening. In other situations, the increase is much less noticeable. Your child has become heavier. Work has been particularly busy. You have been carrying more, gripping for longer or repeating the same hand movement without your usual breaks.

Force can matter as much as repetition. A firm grip combined with repeated wrist movement or forearm rotation is often more demanding than movement alone. Computer work may aggravate an elbow that is already sensitive, especially if you hold tension through your hand and forearm, but this does not necessarily mean that typing caused the original problem.

Your experience may also be influenced by sleep, general health, previous injuries and the amount of recovery available between demanding activities. This does not mean that the pain is your fault or that you have used your arm “incorrectly”. Sometimes the ordinary requirements of life have simply become a larger dose than your elbow can comfortably manage at that particular time.

Does the Pain Mean That My Tendon Is Torn?

Persistent tendon pain is more complicated than the familiar idea of inflammation or tiny tears. The term epicondylitis is still widely used, but its ending suggests that inflammation is the whole explanation. For this reason, contemporary research often uses the broader term tendinopathy.

Pain does not provide a direct measurement of tissue damage. A painful tendon can become unusually sensitive to load, and its ability to tolerate gripping or lifting may temporarily reduce. This can be very uncomfortable without meaning that the tendon is continually tearing each time it hurts.

It is therefore usually more helpful to think about the relationship between demand and present capacity. What is your arm currently being asked to do, how frequently is it doing it, and what can it tolerate without a significant increase in symptoms? This approach provides room for adjustment and recovery without treating your arm as fragile.

Why Might an Assessment Look Beyond the Elbow?

Although your pain may be concentrated within a small, tender area, the movement reaching that point involves your entire arm. Many of the muscles controlling your hand and wrist begin near the elbow. They work whenever you grip, even when your wrist appears to remain still.

Your upper arm and shoulder also position your hand for whatever you are trying to do. This does not mean that every painful elbow is secretly caused by poor posture, a weak shoulder or a muscular “imbalance”. It simply means that your elbow does not work in isolation.

An assessment may therefore consider the movements that reproduce your familiar pain, the strength and comfort of your grip, the condition of the surrounding forearm muscles and the way your wrist, shoulder and upper arm contribute to the task. The aim is to understand your particular experience rather than fit you into a standard treatment formula.

If your pain followed a fall or sudden injury, or is accompanied by considerable swelling, heat, locking, marked loss of strength or persistent numbness, seeking an appropriate healthcare assessment is advisable. These features do not necessarily indicate something serious, but they deserve more than an assumption that the problem is simply tennis or golfer’s elbow.

What Can Help?

When an ordinary movement repeatedly hurts, avoiding it altogether can feel like the safest option. Unfortunately, complete rest is not always practical—especially when the painful activity is part of your work or involves caring for someone—and prolonged avoidance may leave the arm less prepared for those demands when they return.

Recovery often begins with manageable changes. You might temporarily reduce the weight you lift, hold an object closer to your body, use both hands or break a repetitive task into shorter periods. These are not admissions of weakness. They are ways of reducing the immediate irritation while allowing your arm to remain active.

As the elbow becomes more settled, carefully graduated strengthening can help restore confidence and capacity. This should meet you where you are. If the elbow is easily aggravated, the starting point may be gentle and controlled; it does not need to involve heavy weights or pushing through considerable pain. The 2022 clinical practice guideline produced by Lucado and colleagues supports combining education, progressive resistance and selected physical treatments according to the individual presentation.

Soft tissue therapy may also form a useful part of this process. Massage and other hands-on techniques can be directed towards tender or persistently tense muscles in your forearm, upper arm or shoulder. The intention may be to make movement more comfortable, reduce the sense of guarding around the painful area and help you approach strengthening or everyday activity with greater ease.

Muscle energy techniques use gentle, controlled contractions and relaxation, while neuromuscular techniques can be applied to particularly sensitive or overactive areas. The methods chosen—and the pressure used—should reflect how your arm feels on that day. A painful elbow does not automatically require forceful friction or an uncomfortable attempt to “break down” tissue.

The evidence does not support claiming that massage mechanically repairs a tendon. A 2024 Cochrane review by Wallis and colleagues found that manual therapy and exercise may provide some short-term improvement in lateral elbow pain and disability, although the evidence remains uncertain and longer-term benefits are less clear. This places soft tissue therapy in a supportive and potentially valuable role: helping with comfort and movement while the arm’s tolerance is gradually rebuilt.

How Long Will It Take?

It is natural to want a clear recovery date, particularly when elbow pain is affecting your work, training or ability to care for your family. Unfortunately, tendon pain does not follow an identical timetable for everyone.

Jennifer Wolf’s 2023 clinical review noted that many cases of lateral elbow tendinopathy settle over six to twelve months. Some people improve much sooner, while others experience a more uneven course in which progress is interrupted by temporary flare-ups. A more painful week does not necessarily mean that all previous improvement has been lost.

Progress may first appear through small but meaningful changes. You can pour the kettle with less hesitation. Carrying a bag becomes easier. Your grip feels more dependable, or the discomfort settles more quickly after activity. These changes matter even if the elbow has not yet become completely pain-free.

If the pain remains unchanged, continues to worsen or is becoming increasingly difficult to manage, an assessment can help clarify what may be contributing to it. It can also identify whether the symptoms fit a muscular or tendon problem, whether a nerve may be involved, and whether another form of healthcare would be more appropriate.

Looking More Closely at the Elbow and Forearm

Tennis elbow and golfer’s elbow are useful shorthand, but they do not fully describe what you are experiencing. They cannot explain why your pain appeared now, why one movement hurts while another does not, or why an activity that feels effortless to someone else has become difficult for you.

Your symptoms exist within the reality of your work, hobbies, exercise, health and responsibilities. A useful approach should recognise that reality, help you understand what your arm is currently struggling with and find practical ways of rebuilding what you need it to do.

In the members’ article, I explore the elbow and forearm in greater depth: the muscles and tendons involved, the ordinary activities that can place them under strain, the overlapping problems that can resemble tendon pain, and how soft tissue therapy, movement and carefully managed strengthening can be adapted to your individual needs.

References

DeLuca, M.K., Cage, E., Stokey, P.J. and Ebraheim, N.A. (2023). Medial epicondylitis: current diagnosis and treatment options. Journal of Orthopaedic Reports, 2(3), 100172. https://doi.org/10.1016/j.jorep.2023.100172

Lucado, A.M., Day, J.M., Vincent, J.I., MacDermid, J.C., Fedorczyk, J., Grewal, R. and Martin, R.L. (2022). Lateral elbow pain and muscle function impairments: clinical practice guidelines. Journal of Orthopaedic & Sports Physical Therapy, 52(12), CPG1–CPG111. https://doi.org/10.2519/jospt.2022.0302

Wallis, J.A., Bourne, A.M., Jessup, R.L., Johnston, R.V., Frydman, A., Cyril, S. and Buchbinder, R. (2024). Manual therapy and exercise for lateral elbow pain. Cochrane Database of Systematic Reviews, 5, CD013042. https://doi.org/10.1002/14651858.CD013042.pub2

Wolf, J.M. (2023). Lateral epicondylitis. New England Journal of Medicine, 388(25), pp. 2371–2377. https://doi.org/10.1056/NEJMcp2216734