Is my knee going to get worse if I exercise on it?

No, appropriate exercise does not wear the joint out. In fact, the opposite is true: controlled, progressive loading strengthens the muscles that support the knee, improves joint nutrition, and reduces pain. A lot of knee pain, especially the overuse kind, is a loading problem rather than a structur

Is there any point trying physiotherapy if I have "bone on bone" arthritis?

Yes, absolutely. Even when X-rays show significant cartilage loss, exercise and physiotherapy can reduce pain, improve function and help you stay active. Scans often show things like mild wear or changes that are completely normal for someone's age and activity level, and not actually the cause of t

Can a physiotherapist actually help with jaw problems or is it only a dentist's job?

Physiotherapists can absolutely help with jaw problems, and research shows that manual therapy, exercise and education are effective first-line treatments. Dentists often fit splints to protect the teeth, which is useful, but splints don't stop clenching or address the underlying muscle and joint me

Why does my jaw click and is it going to get worse?

Clicking usually means the disc inside your jaw joint is moving slightly out of position as you open and close your mouth. It's very common and doesn't always mean serious damage. Many people have clicking without pain, and it often stays stable or improves with treatment. Pain, locking or a sudden

How long will this take to settle?

Most people with jaw dysfunction see meaningful improvement within a few weeks to three months with physiotherapy, particularly when they address the underlying causes such as clenching, stress and posture. Some cases settle faster, others take longer, especially if symptoms have been present for a

Is this damage to my jaw joint or just the muscles?

It can be either, or both. Some people have joint problems such as disc displacement or wear and tear, while others have primarily muscle pain from overload, clenching or stress. Often it's a mix. We assess the joint and the muscles separately to work out what's contributing most, and that guides th

What is causing this pain in my shoulder?

Shoulder pain is usually caused by overload or irritation of the rotator cuff tendons, subacromial bursa, or joint capsule, often driven by repetitive overhead movement, poor scapular control, or reduced mid back mobility. At Physio K, we assess not just the painful area but the whole shoulder compl

Do I need a scan to find out what is wrong?

Most of the time, no. A thorough clinical assessment, including your history, how the pain behaves, and how you move, gives us the information we need to diagnose the problem and start treatment. Scans such as MRI can be helpful when we suspect a full thickness rotator cuff tear, significant structu

Will I need surgery, or can physiotherapy fix this?

The majority of shoulder problems respond well to structured physiotherapy and exercise-based rehabilitation, and surgery is rarely the first option. Research shows that outcomes after surgical intervention and conservative management are often very similar, sometimes better in the strength rehabili

Should I just rest until the pain goes away?

Rest, most of the time in recovery, is never the answer. Sometimes we do need periods of relative rest, for example post-operatively, but even here this does not last too long. The longer that we rest for with back pain, the longer the pain will tend to stick around. We need to move the body, someti

Is my back damaged, and will it get worse if I stay active?

This is one of the most common worries I hear. Behind these questions is usually a lot of anxiety because patients are led to believe that their back pain is lifelong and that certain movement patterns will increase levels of damage. The majority of the time, this is not the case. Your back is stron

Do I need a scan to find out what is wrong?

Most people with low back pain do not need a scan. Imaging often shows age-related changes that are normal and not the cause of your pain. The Australian Low Back Pain Clinical Care Standard (2022) recommends avoiding routine imaging unless red flags are present. Your physiotherapist will assess you

How long will it take to get better?

Most people see meaningful improvement within 4 to 8 weeks with physiotherapy, exercise and activity modification. Some improve faster, others take a bit longer, and recurrences are common without ongoing management. Recovery is not always linear: you will have better days and worse days. What matte

What if this is something serious and I need a scan, not physio?

Your clinician will screen for red-flag signs that suggest a more serious problem at your first appointment, and if anything does not fit a benign pattern, you will be referred to your GP or an emergency department urgently. Most headaches are not due to serious disease, but we never ignore worrying

Is the treatment going to make my headaches worse?

It is common to feel a little sore or worked-on for a day or two after hands-on treatment or new exercises, but this usually settles quickly. Your programme is tailored to start at a level your body can tolerate and can be adjusted if symptoms flare. I show patients how to recognise normal post-trea

I've tried so many things already, how is this any different?

This approach does not just chase pain, it looks carefully at the mechanical and lifestyle drivers of your headaches: neck stiffness, posture, jaw tension, sleep position, stress patterns and known triggers. The plan is personalised, progress is monitored, and you are given clear tools to use at hom

How long does vestibular rehabilitation take to work?

BPPV often improves within one to three sessions, with many people feeling significantly better immediately after the repositioning manoeuvre. Other vestibular conditions typically improve over 4 to 12 weeks with daily home exercises and regular clinic reviews. Some residual symptoms may take longer

Will the exercises make me feel worse?

Yes, temporarily. Vestibular exercises are designed to provoke mild to moderate symptoms so your brain can adapt and recalibrate. This is normal, necessary and not harmful. The key is finding the right level of challenge, enough to stimulate adaptation without overwhelming you. Your physiotherapist

Can dizziness come back after treatment?

BPPV can recur, with around 15 to 30% of people experiencing another episode within a year, though it usually responds well to repeat treatment. Other vestibular conditions are less likely to recur if you complete the full rehabilitation programme and address contributing factors such as neck stiffn

Is my neck pain something serious, like a stroke or spinal damage?

Most neck pain is not serious and does not indicate stroke or major structural damage. Red flag symptoms such as sudden severe headache, neurological deficits, gait disturbance or systemic illness are rare but warrant urgent medical assessment. Your physiotherapist or GP will screen for these during

Why does it hurt so much if my scan only shows wear and tear?

Pain intensity does not always match imaging findings. Many people with significant degenerative changes on scans have no pain, and many with severe pain have minimal imaging findings. Pain is influenced by inflammation, muscle tension, movement patterns, stress, sleep and nervous system sensitivity

Should I rest completely or keep moving?

Keep moving. Prolonged rest usually worsens stiffness and delays recovery. Gentle, gradual movement within tolerable limits is encouraged from the start, even in acute pain. Avoid activities that significantly worsen your pain, but stay as active as possible. Your physiotherapist will guide you on a

Should I stretch it or rest completely?

Complete rest isn't usually best. Keep walking as much as you can without significant pain, but avoid running, heavy stretching and any activity that reproduces the sharp pain. Aggressive stretching in the first few weeks can disrupt healing, so we start with gentle range-of-motion exercises and pro

Can I keep walking, working or training?

Walking is usually fine and encouraged, even in the first few days. Most people can continue working unless their job involves heavy lifting, climbing, sprinting or awkward positions that load the hamstring. Training depends on severity. You'll need to stop running and high-speed work initially, but

When can I run or play sport again?

Running is reintroduced gradually once you're pain-free with daily activities and your strength is improving. That might be a few weeks for a minor strain, or several months for a more severe tear. Sport-specific training and competition come last, only after you can sprint pain-free and your streng

Do I have to stop training completely if I have pain?

No, in most cases you do not have to stop everything. With most overuse injuries, it is about managing the load rather than complete rest. Reducing intensity, frequency or duration is usually the key to continuing activity without aggravating symptoms. A helpful guide is the traffic light system for

How long will it take before I can return to my sport or full training?

Recovery time varies depending on the injury, how irritable it is, and the demands of your sport. Uncomplicated muscle strains and ligament sprains often improve within several weeks, while tendon injuries, stress reactions in bone, and major ligament rehabilitation can take several months. Because

Why do my muscles feel tight all the time, and does that mean they are strong?

Not necessarily. Tightness and strength are two different things. In fact, sometimes a muscle feels tight because it is working harder than it should to compensate for weakness somewhere else. At the same time, for a muscle to be strong, it needs to be able to both contract and relax effectively. A

INJURIES AND CONDITIONS WE CAN TREAT

At Physio K, we treat a wide range of conditions affecting the movement system.

Here are some of the most common injuries or conditions we are qualified to treat:

Elbow Pain

Mark Howlin, Associate Physiotherapist, Musculoskeletal & Sports Injuries

By Mark Howlin

Associate Physiotherapist, Musculoskeletal & Sports Injuries (BSc, MSc, GEMt) · Registered with the AHPRA (PHY0004060355)

Mark Howlin is an Associate Physiotherapist at Physio K, with a focus on sporting injuries and post-operative rehabilitation, with advanced dry needling training from Ireland and Sydney. Across six years of clinical practice in Ireland and Australia, he has developed particular experience in chronic conditions such as anterior knee pain and Achilles tendinopathy, and acute lower limb muscle strains, using an integrated approach combining manual therapy, dry needling, and progressive rehabilitation. He has also served as team physiotherapist to elite GAA athletes, including during a championship-winning run at Croke Park

Elbow Pain: Causes, Assessment and Treatment

Elbow pain is a common problem due to the demands we place on our arms during everyday activities, work and sport. Whether you're lifting weights, working at a computer, gardening or playing tennis, the muscles, tendons, ligaments and joints around the elbow are regularly exposed to load.

There are many potential causes of elbow pain, including tendinopathies, ligament injuries, bursitis, osteoarthritis and irritation of the nerves around the elbow. Injuries can develop suddenly or gradually over time, and understanding how your symptoms began can help your physiotherapist identify the contributing factors and develop an appropriate treatment plan.

What Causes Elbow Pain?

Elbow pain can generally be classified as acute or chronic, depending on how it develops.

Acute elbow injuries occur suddenly, often following a specific incident, such as a fall, heavy lift, sudden twisting movement or sporting injury. These injuries may be accompanied by pain, swelling, bruising or reduced movement.

Chronic elbow pain tends to develop gradually, often without a single identifiable injury. It can be associated with repetitive movements, changes in training load, prolonged physical work or activities that place repeated stress on the muscles and tendons around the elbow.

In some cases, pain felt around the elbow may originate elsewhere, such as the neck or upper back. This is why a thorough assessment is important to identify the underlying cause rather than focusing solely on the location of the pain.

How Do Physiotherapists Assess Elbow Pain?

Your physiotherapist will begin by asking questions about your symptoms, including:

How long you have experienced the pain and whether it started suddenly or gradually.
The location of your pain and whether it spreads into your forearm, hand or upper arm.
Activities or movements that aggravate or relieve your symptoms.
Any changes in strength, grip, movement or daily function.
Your work, sporting activities and recent changes in physical demands.
Previous injuries, treatments and your response to medication, if relevant.

Most importantly, we will discuss your goals and what you would like to get back to doing, whether that's working comfortably, lifting weights, playing sport or managing everyday tasks.

Physical Assessment

Your physiotherapist may assess:

Joint movement: How well your elbow, forearm and wrist move, and whether particular movements reproduce your symptoms.
Strength and grip: The strength of the muscles around your elbow and forearm, including the muscles responsible for bending and straightening your wrist and fingers.
Palpation: Gently examining the surrounding muscles, tendons and other tissues to identify areas of tenderness.
Nerve function: Assessing nerve-related symptoms when indicated, particularly if you experience tingling, numbness, radiating pain or weakness.
Related areas: Examining the neck, shoulder, wrist and other relevant areas to determine whether they may be contributing to your elbow pain.

Your assessment findings will help guide treatment and ensure your rehabilitation is tailored to your individual needs.

Tennis Elbow and Golfer's Elbow

Forearm resting on a spiky massage ball to release tight forearm muscles

Tennis elbow and golfer's elbow are two common causes of pain around the elbow. Despite their names, these conditions are not limited to people who play tennis or golf. They can affect anyone whose work, hobbies or exercise routines place repeated demands on the forearm muscles and tendons.

Tennis Elbow (Lateral Elbow Tendinopathy)

Tennis elbow causes pain around the outside of the elbow, near the bony prominence known as the lateral epicondyle.

It typically involves the tendons of the forearm muscles responsible for extending the wrist and fingers. Repeated loading can cause these tendons to become painful and less tolerant of everyday activities.

Common aggravating activities include gripping, lifting objects with the palm facing down, using tools, carrying shopping bags and repeatedly extending the wrist.

Golfer's Elbow (Medial Elbow Tendinopathy)

Golfer's elbow causes pain around the inside of the elbow, near the medial epicondyle.

It commonly involves the tendons of the forearm muscles responsible for bending the wrist and helping to rotate the forearm. Symptoms may develop following repetitive gripping, lifting, throwing or wrist-flexion activities.

Both conditions can cause pain, tenderness and reduced grip strength, making everyday activities more difficult.

Common Symptoms

Depending on the underlying cause, symptoms may include:

Pain or tenderness around the inside or outside of the elbow.
Discomfort extending into the forearm or, occasionally, towards the upper arm.
Reduced grip strength or difficulty holding objects.
Pain when lifting, gripping, twisting or performing repetitive tasks.
Stiffness or reduced tolerance for everyday activities.
Swelling in some cases, particularly following an acute injury.

Tennis elbow and golfer's elbow are generally associated with tendon-related pain rather than simply inflammation. Although the terms lateral epicondylitis and medial epicondylitis are commonly used, lateral elbow tendinopathy and medial elbow tendinopathy are often more appropriate descriptions of persistent tendon problems.

Is Your Elbow Pain Coming From Your Neck?

Not all elbow pain originates in the elbow itself.

Irritation or compression of nerves in the neck, known as cervical radiculopathy, can cause pain that travels into the shoulder, arm or forearm. Depending on the nerve involved, symptoms may include radiating pain, pins and needles, numbness or muscle weakness.

The C6 and C7 nerve roots can contribute to symptoms experienced around the arm and elbow, although the precise pattern varies between individuals.

Your physiotherapist may therefore assess your neck and other surrounding areas if your symptoms suggest a possible referred or nerve-related component. Identifying these contributing factors can help ensure that treatment addresses the source of your symptoms rather than just the area where you feel pain.

Elbow Pain Treatment

Effective treatment starts with identifying the factors contributing to your symptoms. Your physiotherapist will use the assessment findings to develop a treatment plan suited to your condition, activity levels and goals.

Treatment may include a combination of the following:

Manual therapy: Hands-on techniques targeting the muscles, tendons and joints around the elbow and forearm may help reduce pain and improve movement in the short term.

Strengthening and rehabilitation exercises: Progressive exercises help improve the capacity of the forearm muscles and tendons to tolerate load. The type and intensity of exercise will depend on your symptoms and stage of recovery.

Stretching and mobility work: Specific stretches and mobility exercises may help address movement restrictions and improve comfort during daily activities.

Dry needling: When appropriate, dry needling may be used alongside exercise and other physiotherapy techniques to help manage pain and muscle tension.

Education and load management: Understanding what aggravates your symptoms and how to modify your activities can help prevent repeated flare-ups while maintaining as much normal activity as possible.

A personalised treatment plan: Your physiotherapist will work with you to establish realistic goals, monitor your progress and gradually return you to your preferred activities.

How Can Dry Needling Help With Elbow Pain?

Dry needling is a treatment technique in which a trained practitioner inserts fine, sterile needles into selected muscles or other targeted tissues. It may be used as part of a broader physiotherapy program for some people experiencing elbow and forearm pain.

Potential Benefits of Dry Needling

Pain relief: Dry needling may help reduce pain sensitivity in the short term, potentially making everyday activities and rehabilitation exercises more comfortable.

Reduced muscle tension: When increased muscle tension is contributing to symptoms, needling may help reduce discomfort and improve how the muscles feel and function.

Improved movement: Some people experience a temporary improvement in movement or tolerance for activities following treatment.

Support for rehabilitation: By helping to manage symptoms, dry needling may make it easier to participate in strengthening exercises and progressively reload the affected tendons.

How Does It Work?

Dry needling is thought to influence pain processing and the sensitivity of the treated tissues. The exact mechanisms are still being investigated, and the response varies between individuals.

For tennis elbow and golfer's elbow, treatment may target selected forearm muscles when clinically appropriate. However, dry needling does not directly repair a tendon or replace the progressive strengthening needed to restore its ability to tolerate load.

Research into dry needling for elbow tendinopathy suggests that it may provide benefits for some people, particularly in the short term. However, the evidence varies according to the technique used, the condition being treated and the treatment program. It should therefore be considered an optional adjunct rather than a guaranteed solution or a standalone treatment.

Is Dry Needling Right for You?

Dry needling is not necessary for everyone with elbow pain but can certainly help with symptoms and muscle tightness, contributing to your pain. Your physiotherapist will consider your symptoms, assessment findings, medical history, preferences and suitability before recommending it.

Temporary soreness, minor bleeding or bruising can occur after treatment. Your physiotherapist should explain the potential benefits and risks and obtain your consent before proceeding.

For the best results, dry needling is generally most useful when combined with an appropriate rehabilitation plan, including strengthening, activity modification and education.

Elbow Exercises You Can Try at Home

The following exercises may help improve forearm flexibility and strength for some people with tennis elbow, golfer's elbow or general forearm tightness. They should complement, rather than replace, an individualised physiotherapy program.

Your physiotherapist can help determine which exercises are appropriate for your condition and how to progress them safely.

1. Forearm Extensor Stretch

This stretch targets the muscles on the back of your forearm, which help straighten your wrist and fingers.

Sit or stand comfortably and straighten your affected elbow.
Turn your palm towards the floor.
Gently bend your wrist downwards. You can make a fist with your thumb tucked inside if comfortable.
Use your other hand to apply gentle pressure until you feel a stretch along the back of your forearm.
Hold for approximately 20 seconds, then relax.

Repeat two to three times, keeping the stretch comfortable rather than forcing the movement.

2. Forearm Flexor Stretch

This stretch targets the muscles on the palm side of your forearm, which help bend your wrist and fingers.

Extend your affected arm in front of you with your elbow straight and palm facing upwards.
Gently extend your wrist so your fingers point towards the floor.
Use your other hand to apply light pressure through your palm until you feel a stretch along the inside of your forearm.
Hold for 20–25 seconds, then relax.

Repeat three times. Keep the movement gentle and avoid pushing into sharp pain or tingling.

3. Eccentric Wrist Extension (Tennis Elbow)

This exercise helps progressively strengthen the wrist extensor muscles and load the tendons associated with tennis elbow.

Equipment: A light dumbbell of approximately 0.5–1 kg, or another suitable household weight.

Sit with your forearm supported on a table or your thigh, with your palm facing down and your wrist just beyond the edge.
Hold the weight and use your other hand to help lift your wrist upwards.
Slowly lower the weight using your affected wrist over approximately 3–6 seconds.
Use your other hand to assist the wrist back to the starting position.
Repeat with controlled movement.

Start with 2–3 sets of 10 repetitions, provided the exercise is comfortable. Progress gradually towards 15–20 repetitions as your strength and tolerance improve.

The load and number of repetitions should be adjusted to your symptoms and recovery stage. Eccentric wrist extension is commonly used for tennis elbow, but other loading exercises may be more suitable depending on your presentation.

A Note About Exercise

Some mild discomfort may occur during tendon rehabilitation, but sharp, increasing or persistent pain is a reason to reduce the load or stop and seek advice. Symptoms should settle rather than continue to worsen after exercise.

If your elbow pain began after a significant injury, or you have marked swelling, deformity, a hot or red joint, new or progressive weakness, or persistent numbness, seek appropriate medical assessment before starting these exercises.

Ready to Get on Top of Your Elbow Pain?

Elbow pain can interfere with work, exercise, sport and everyday activities, but the right combination of assessment, education and rehabilitation can help you work towards recovery.

At Physio K, we aim to identify the factors contributing to your symptoms and develop a treatment plan tailored to your needs. Whether your pain is related to tennis elbow, golfer's elbow, muscle tension, joint stiffness or possible nerve irritation, our physiotherapists can help guide you through the next steps.

Book an appointment with our physiotherapy team to find out what may be causing your elbow pain and which treatment options are right for you.

Reviewed by Kenny Merlevede, senior physiotherapist, founder and director · Registered with the AHPRA (PHY0002060505)

Kenny is a physiotherapist with over 18 years’ experience in musculoskeletal and sports rehabilitation. He has a focus on identifying the contributing factors behind pain and treating complex presentations including chronic spine pain, neck and headache disorders, jaw dysfunction, and persistent sports injuries. His approach combines manual therapy, dry needling, and active rehabilitation with strong emphasis on education and patient outcomes.

This article is for general information only and is not a substitute for personal medical advice. If you have concerns about your health, please consult a qualified clinician or your GP.