In order to promote mathematical understanding among English Language Learners (ELLs), it is necessary to modify instructional strategies to effectively communicate mathematical content. This paper discusses the instructional strategies used by four pre-service teachers to teach mathematics to secondary students in English-medium schools in Arusha, Tanzania as a result of the tensions they faced and reflections on their teaching. Strategies such as code switching, attending to sentence structure, non-linguistic representations, and placing the content within a familiar context proved to be beneficial strategies for conveying mathematical ideas.