When Rest and Bracing Are Not Enough
Tennis elbow starts as an ache on the outside of the elbow, usually following repetitive gripping, racquet sports, or manual work. For most people, rest and a brace improve things temporarily. But lateral epicondylitis has a way of returning, especially when the underlying tendon degeneration has not been addressed.
Patients who come to Superior PT for tennis elbow have often been managing it for months: icing it, avoiding certain movements, cutting back on the sport or activity they enjoy. Some have tried cortisone injections and found the relief short-lived. What they need is treatment that targets the tendon tissue directly, not just treating the symptoms.
If your tennis elbow keeps returning or has not improved with conservative measures, there are effective interventions specifically designed for chronic tendon conditions.
What Is Lateral Epicondylitis?
Lateral epicondylitis, commonly called tennis elbow (and also known as lateral epicondylosis or lateral elbow tendinopathy), is a tendon condition affecting the common wrist-extensor tendon where it attaches to the lateral epicondyle—the bony point on the outside of the elbow. It often develops when repetitive or increased loading exceeds the tendon’s current capacity, producing pain with gripping, lifting, carrying, or wrist extension.
Despite the name, most people who develop tennis elbow are not tennis players. It is common among tradespeople, desk workers, pickleball and other racquet-sport players, and recreational athletes. Although the term epicondylitis suggests inflammation, persistent cases more commonly involve changes in tendon structure and its ability to tolerate load. Treatment typically focuses on modifying aggravating activities and progressively rebuilding the tendon’s strength and capacity, with additional treatments considered based on the individual’s symptoms, goals, and stage of recovery.
Tennis Elbow Treatment at Superior Physical Therapy
Keely Behning, PT, SCS, ATC brings 20+ years of orthopedic and sports medicine experience to elbow assessment and treatment. Her Board Certification as a Sports Clinical Specialist, held by fewer than 2% of physical therapists in Minnesota, directly informs how she approaches tendon conditions: precise diagnosis first, targeted intervention second.
Treatment for lateral epicondylitis at Superior PT may include FDA-cleared electromagnetic focused shockwave therapy (Storz device), which stimulates tendon tissue repair and is well-supported for chronic lateral epicondylitis; dry needling to address trigger points in the extensor muscle group and promote healing; as well as manual therapy (hands-on techniques) with progressive loading (often through the use of blood flow restriction) to restore full elbow and wrist function. This combination is particularly effective for patients who have not improved with rest, bracing, or cortisone.
What to Expect at Your Tennis Elbow Assessment
Clinical Assessment
Targeted Treatment
Recovery Plan
What Tennis Elbow Treatment Delivers
Tendon repair at the source: Shockwave therapy triggers the body's healing response in degenerated tendon tissue, addressing structural change rather than masking symptoms.
Return to grip-intensive activity: Most patients return to racquet sports, manual work, or full daily use of the arm following a complete protocol.
Durable results: Unlike cortisone injections, which can weaken tendon tissue with repeated use, shockwave and dry needling support genuine tissue recovery.
Frequently Asked Questions About Tennis Elbow Treatment
Acute cases often start to see improvement within four to eight weeks of targeted physical therapy. Chronic lateral epicondylitis, particularly when tendon degeneration is present, typically requires a longer protocol. Shockwave therapy courses run six sessions (once a week), with continued tissue remodeling and symptom improvement in the months that follow.
Yes. Shockwave therapy has strong evidence for chronic lateral epicondylitis, particularly in cases that have not responded to rest, bracing, or cortisone injections. It stimulates blood flow and the body's natural healing response in the affected tendon, addressing the tissue-level changes that maintain chronic pain.
Tennis elbow (lateral epicondylitis) involves the tendons on the outside of the elbow. Golfer's elbow (medial epicondylitis) involves the tendons on the inside. Both respond well to the same treatment approaches, including shockwave therapy and dry needling.
No referral is required. Superior Physical Therapy is fully out-of-network, and you can book directly for an initial assessment.
Dry needling targets trigger points in the extensor muscle group and promotes healing at the tendon insertion site. It is commonly used alongside shockwave therapy, manual therapy and progressive loading (such as with blood flow restriction) for chronic tennis elbow and can accelerate recovery when the condition involves both tendon and muscle involvement.
Ready to Treat the Tendon, Not Just the Symptoms?
FDA-approved shockwave therapy, dry needling, blood flow restriction and skilled manual therapy delivered by Keely Behning, PT, SCS, ATC, a Board Certified Sports Clinical Specialist with 20+ years in orthopedic and sports rehab. If your tennis elbow keeps returning, this is the next step.
Superior Physical Therapy
1415 Mendota Heights Rd, 100Mendota Heights, MN
55120 View Staff & Treatments
