Managing Tennis Elbow: Why Rest Isn't Always Enough
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Published in The Ospina Orthopedic Blog ~ 5 min read ~ Last Updated: November 18, 2025
The Frustration of "Rest and Ice"
It starts as a nagging soreness on the outside of your elbow. You stop playing tennis, you take a break from the gym, or you modify how you lift your coffee cup. You ice it, you rest it, and you wait. But weeks later, the moment you try to use your arm again, the pain returns with a vengeance. Why doesn't rest work?
The answer lies in the nature of the injury itself. Despite its name, "Tennis Elbow " (Lateral Epicondylitis) is rarely a problem of inflammation. It is a problem of degeneration. At Ospina Medical, we help patients break the cycle of chronic elbow pain by treating the condition for what it truly is: a tendon that has forgotten how to heal.
Tendinitis vs. Tendinosis: Knowing the Difference
Most people assume their elbow is inflamed (tendinitis), which is why they reach for ice and anti-inflammatories. However, in chronic cases, the tissue has actually entered a state of tendinosis. This means the collagen fibers in the tendon are breaking down, becoming disorganized and weak.
Because the tendon has poor blood supply, resting it simply halts the damage temporarily—it doesn't repair the weakened tissue. In fact, total disuse can make the tendon weaker. To heal, the tendon needs a biological "wake-up call" and the right kind of mechanical stress.
Why Cortisone Can Make It Worse
A common "quick fix" for tennis elbow is a cortisone shot. While this powerful steroid eliminates pain rapidly, studies have shown that it can be detrimental in the long run. Cortisone can inhibit the cells responsible for tendon repair, leading to a higher rate of recurrence and potentially causing further tissue degeneration. One systematic review found that while steroids were effective short-term, patients had worse outcomes at one year compared to those who did nothing or had physical therapy.
The Active Recovery Solution
Dr. Matthew Kohler advocates for a two-pronged approach to fixing tennis elbow for good:
1. Regenerative Intervention
Using PRP by Regenexx, we inject high concentrations of your body’s own healing platelets directly into the damaged tendon. This procedure:
- Delivers growth factors that stimulate blood vessel formation.
- Recruits repair cells to the site of degeneration.
- Restarts the natural healing cycle that had stalled. Comparative studies show PRP offers superior long-term pain reduction compared to cortisone.
2. Mechanical Loading
Once the biological repair is initiated, the tendon needs to be strengthened. We work with physical therapists to guide you through specific eccentric exercises. These controlled movements help align the new collagen fibers, making the tendon strong and flexible again.
Get Back in the Swing of Things
You don't have to accept elbow pain as your new normal, and you certainly don't have to rely on damaging steroid injections. By combining regenerative medicine with active recovery, Ospina Medical can help you restore the health of your elbow.
Schedule a consultation with Dr. Matthew Kohler today to discuss a treatment plan that actually fixes the problem, rather than just covering it up.
A Riley Publication ~ Branded Thought Leadership by Riley Partners and Publications, Inc.
Medically Reviewed by: Matthew Kohler, MD
References
Coombes, B. K., et al. (2013). Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. The Lancet, 376(9754), 1751-1767.
Mishra, A., & Pavelko, T. (2006). Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. The American Journal of Sports Medicine, 34(11), 1774-1778.
Peerbooms, J. C., et al. (2010). Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial. The American Journal of Sports Medicine, 38(2), 255-262.
Tyler, T. F., et al. (2010). Rehabilitation of the elbow in the throwing athlete. International Journal of Sports Physical Therapy, 5(5), 225.
Disclaimer
This article is for informational purposes only and does not constitute medical advice. Please consult with your healthcare provider for any personal health concerns.