We used density-functional theory based first principles simulations to study the effects of uniaxial strain and quantum confinement on the electronic properties of germanium nanowires along the [110] direction, such as the energy gap and the effective masses of the electron and hole. The diameters of the nanowires being studied are up to 50 Å. As shown in our calculations, the Ge [110] nanowires possess a direct band gap, in contrast to the nature of an indirect band gap in bulk. We discovered that the band gap and the effective masses of charge carries can be modulated by applying uniaxial strain to the nanowires.These strain modulations are size-dependent. For a smaller wire (~ 12 Å), the band gap is almost a linear function of strain; compressive strain increases the gap while tensile strain reduces the gap. For a larger wire (20 Å -50 Å), the variation of the band gap with respect to strain shows nearly parabolic behavior: compressive strain beyond -1% also reduces the gap. In addition, our studies showed that strain affects effective masses of the electron and hole very differently. The effective mass of the hole increases with a tensile strain while the effective mass of the electron increases with a compressive strain. Our results suggested both strain and size can be used to tune the band structures of nanowires, which may help in design of future nano-electronic devices. We also discussed our results by applying the tight-binding model.