Tennis and Golfer’s Elbow

Depending on your version and stage/severity of Tennis or Golfer’s elbow (tendonitis, tendinopathies), different treatments, exercises and recovery periods are often required for resolution.

Tennis and Golfer’s elbow occur when the micro tearing of the sport (or other exercise) overcomes the tendon’s ability to heal. These microtears can come from several sources including one or a few bad hits with the tennis racket or golf club, technique (or equipment errors), playing too frequently, compensation from shoulder, wrist or injuries/scar tissue elsewhere or a general weakness or preparedness.
These ‘overuse’ micro tears first result in inflammation/tendonitis that can then trigger adhesions and scar tissue to develop around the elbow. These adhesions and restrictions is the body’s attempt to stabilize the area and prevent further injury. However, these adhesions are NOT elastic and can create a chronic and progressive version of Tennis or Golfer’s elbow.

Up to 90% of Tennis and Golfer’s elbow injures are NOT caused by tennis or golf but from other repetitive movements or positions involving exercise, weights, computer, phone and various activities of daily living or professional requirements.

These overuse or prolonged static postures (computer, phone etc.) will trigger first sometimes mild and unnoticeable inflammation followed by fibrotic thickening. Thickened tendon can then rub over underlying bone causing further aggravation/insult as well as create less blood flow (blocked by scar tissue) and more micro tearing of the healthy muscle and tendon to which it is attached.

Treatment Options for Tennis and Golfer’s Elbow

I usually start with Class 3 B or 4 laser (depending on depth of injury) if the injury is acute. Otherwise and in addition, I use Active Release Techniques, Graston Instruments and/or Shockwave to help break up scar tissue and help to remodel the tendons. This is followed by exercises to rebuild and made the elbow more tolerant of future activity, whether it be tennis, golf or anything else that overuse (or underuses) the elbow.

Occasionally Chiropractic therapy is useful to address postural and technique implications related to elbow injuries.

Often, 3-6 treatment are required for full resolution or significant healing.

Should I try a brace for Tennis and Golfer’s elbow?

Many golfers and tennis players find a brace can help. A brace MAY limit further damage by providing a reminder to you (and your opponent!), that you are not 100% and should back off. Also, the compression of a brace may serve as a pain modifier and a deterrent to excessive ranges of motion.
However, an elbow brace will NOT fix true Tennis or Golfer’s elbow because it doesn’t get to the root cause.
Having said that, a brace is often worth a try as it can often work to reduce pain if the tendonitis is mild and simple or until better treatments are sought.
Other treatments include various injections, including cortisone (a steroid). These can occasionally work to reduce symptoms (usually temporary if effective) and only if inflammation is the root cause and adhesions have NOT developed.