Signs and symptoms
Tennis elbow causes pain and tenderness on the bony bump on the outside of the elbow, often spreading into the forearm. The American Academy of Orthopaedic Surgeons notes that the pain usually starts mild and worsens over weeks and months, and that most people who develop it are between 30 and 50.
Typical signs include:
- Pain when gripping, shaking hands or turning a doorknob.
- Pain lifting a coffee cup or a gallon of milk with the palm down.
- A weaker grip, sometimes dropping things.
- Pain with pulling exercises, rows or curls in the gym.
- Tenderness when pressing just below the outer elbow.
Despite the name, most men with tennis elbow do not play tennis. Desk work with a mouse, trades that involve repetitive gripping or tool use, and heavy pulling in the gym are common triggers.
What causes it
Tennis elbow is overuse damage to the tendon of a forearm muscle called the extensor carpi radialis brevis, which steadies the wrist when you grip. Repeated strain leads to tiny tears and degeneration where the tendon attaches to the elbow. It is better thought of as a worn, poorly healing tendon than as simple inflammation, which helps explain why it can linger for months.
Risk rises with repetitive gripping and wrist extension, sudden increases in training or workload, poor technique or equipment, and age, since tendons heal more slowly after 40. Our page on tendon pain in lifters covers similar problems in other tendons.
How it is evaluated
Tennis elbow is diagnosed mainly by history and examination. The provider presses on the outer elbow, tests grip strength and checks whether resisted wrist or finger extension reproduces the pain. The AAOS notes that X-rays may be used to rule out arthritis and that an MRI can show the extent of tendon damage or rule out other problems, such as a neck issue sending pain down the arm.
No blood test diagnoses tennis elbow. Before an injection, the provider reviews your medicines, including blood thinners, any history of bleeding or platelet problems, and whether you have had cortisone shots in the area.
Why stubborn tennis elbow is one of the better-studied uses of PRP
The first thing to know is that most tennis elbow gets better without injections. According to the AAOS, about 80 to 95 percent of patients have success with nonsurgical treatment: rest from the provoking activity, a counterforce brace, physical therapy with progressive forearm exercises and sometimes anti-inflammatory medicine. If symptoms persist after 6 to 12 months of that, surgery may be considered.
PRP sits in the gap between rehab that has stalled and surgery. It concentrates platelets from your own blood, rich in growth factors, and places them into the damaged tendon to encourage repair. Tennis elbow is one of the conditions where PRP has been studied the most, and the findings are genuinely mixed:
- The AAOS’s PRP overview says that, according to studies reported so far, PRP is effective in chronic tendon injuries, especially tennis elbow, while adding that more evidence is needed for many other uses.
- A 2021 Cochrane review of 32 trials with 2,337 participants found moderate-certainty evidence that PRP or autologous blood injections probably provide little or no clinically important benefit for pain or function compared with placebo injection at three months.
Placebo injections themselves often help, and many trials look at short time frames, which partly explains the disagreement. The honest summary: PRP is a reasonable, low-risk option for persistent tennis elbow when rehab has been done properly, but it may not work for everyone and should be paired with continued rehab. It is also an alternative to repeated cortisone injections, which the AAOS says should be used sparingly here because excessive use can weaken the tendon attachment. Our PRP versus cortisone comparison weighs the two.
What a treatment course and recovery look like
A PRP visit for tennis elbow follows the same pattern as other PRP treatments at Ultimate Male:
- A small blood sample is drawn from your arm and spun in a centrifuge to concentrate the platelets.
- The skin over the outer elbow is cleaned and numbed.
- The PRP is injected into and around the damaged tendon.
- You go home the same day; the whole visit takes under an hour.
Recovery takes patience. The AAOS notes that pain at the injection site may actually increase for the first week or two, and it may be several weeks before you feel a benefit. During that time you protect the elbow from heavy gripping, then return to a progressive rehab program as pain allows. That program usually includes slow, controlled wrist extension exercises with a light weight, grip work and stretching of the forearm, increased gradually over weeks, and a review of whatever started the problem, whether that is a mouse setup, a tool, a racquet grip or a pulling-heavy training plan. Whether one injection is enough or a repeat makes sense is decided at follow-up based on how the tendon is responding. The clinic’s PRP for tendon and joint repair page covers the procedure, and the PRP cost for joints and tendons page explains what drives pricing.
When elbow or arm pain is urgent
Call 911 if arm pain comes with chest pressure, shortness of breath, sweating or jaw pain, because heart problems can show up as arm pain. Go to urgent care or the emergency room for a hot, red, swollen elbow with fever, a deformity or inability to move the elbow after a fall, or a sudden pop at the front of the elbow followed by bruising and weakness, which can mean a torn biceps tendon.
Your next step
If your elbow has not settled after months of sensible rest and rehab, an evaluation can confirm the diagnosis and lay out what is realistic. Ultimate Male offers a free 10-minute phone call at 626-319-5261 and visits at San Gabriel or Downey with a PA-C or MD, who explains whether PRP injections make sense for you and how they fit with ongoing rehab. You can also book directly online.
