Upper body tendons
Tennis elbow, golfer's elbow & rotator cuff tendinopathy
Upper body tendon pain is often dismissed as a minor issue — until it affects everything from typing to lifting a coffee cup. Here's what's actually going on and what to do about it.
Clear guidance from a registered clinician — no hype, no guessing
Why upper body tendons become painful
Upper body tendons are uniquely vulnerable because so much of modern life loads them repetitively — keyboards, phones, tools, sports. The cumulative load often exceeds what the tendon can tolerate before it has time to recover.
Unlike lower body tendons, upper body tendons are also heavily influenced by posture, joint position, and proximal strength. A complete approach addresses not just the tendon itself, but the context it operates in.
Lateral Epicondylitis
What's happening
Tennis elbow affects the extensor tendons on the outside of the elbow, most often at the lateral epicondyle. Despite the name, it's very common in non-tennis players — anyone who performs repetitive gripping, typing, or tool use is at risk.
Common symptoms
- Pain and tenderness on the outer elbow and forearm
- Weakness with gripping and wrist extension
- Pain when shaking hands, turning a doorknob, or lifting
- Often aching at rest after a day of activity
✓ What to do
- 1 Reduce provocative loads temporarily — don't stop all hand use
- 2 Wrist extension isometrics: elbow extended, 5 × 45s at moderate discomfort
- 3 Progress to eccentric and heavy slow resistance: wrist curls over a table edge
- 4 Review grip size, workstation ergonomics, and tool handles
Medial Epicondylitis
What's happening
Golfer's elbow affects the flexor-pronator tendons at the inside of the elbow. Gripping sports, throwing, and desk work are common contributing factors. It often presents more subtly than tennis elbow.
Common symptoms
- Pain on the inside of the elbow and upper forearm
- Discomfort with gripping and wrist flexion
- Pain with throwing or overhead activities
- Sometimes associated with ulnar nerve tingling
✓ What to do
- 1 Identify and reduce the specific loads driving symptoms
- 2 Wrist flexion and pronation isometrics for pain relief
- 3 Progress to eccentric exercises: slow controlled wrist flexion lowering
- 4 Address grip strength deficits and forearm muscle imbalances
Rotator Cuff Tendons
What's happening
The rotator cuff is a group of four tendons that stabilise the shoulder. Supraspinatus tendinopathy is most common, often presenting as painful arc syndrome. It's frequently linked to rapid increases in overhead load or prolonged poor posture.
Common symptoms
- Painful arc when raising the arm between 60–120°
- Difficulty reaching overhead or behind the back
- Night pain when lying on the affected shoulder
- Weakness and fatigue with sustained shoulder activity
✓ What to do
- 1 Avoid extreme compression positions (sleeping on shoulder, arm above head)
- 2 Shoulder isometrics in a pain-free range for early management
- 3 Progressive rotator cuff strengthening: external rotation, side-lying raises
- 4 Address thoracic mobility and scapular control as contributing factors
Evidence-informed.
Clinically grounded.
PainFreeTendon bridges the gap between clinical research and the guidance real people actually need.
Grounded in current research
Every recommendation on this site reflects the latest tendinopathy science — load-based rehab, pain science education, and progressive capacity building.
Paul Cramer, RMT
A Registered Massage Therapist with deep clinical focus on tendon rehabilitation, translating complex research into practical, accessible guidance.
Practical, not theoretical
Clear next steps, not academic abstracts. Designed for people navigating real life — not a clinical protocol for researchers.
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Progressive, evidence-informed rehab programs designed specifically for elbow and shoulder tendon recovery.