It’s surprising just how debilitating elbow tendonitis can be.  It can turn the simplest actions like lifting a coffee mug or holding a steering wheel into arduous, painful tasks. For many, this elbow pain is easily treated, but some folks end up with chronic pain that does not respond well to the usual treatment methods. Fortunately, specific fascia therapies can often resolve even the most difficult, chronic cases of elbow pain. 

Tendonitis can occur on either the inside or outside of the elbow—commonly called “golfer’s elbow” or “tennis elbow,” respectively.  While golf and tennis are common causes of these issues, many other forms of repetitive stress can also be responsible.  

In ages past, when writing was done with a quill and ink, there was “writer’s cramp.”  The equivalent today is elbow stress caused by typing on a keyboard for hours at a time, but in some cases there is no obvious source of repetitive stress to blame. Regardless of the cause, however, the treatment is usually the same.  

Typical Treatment 

Frontline conventional treatment methods can stop many cases of elbow tendonitis in their tracks. Initially, the most crucial parts of treatment include rest, ice, and often a compression strap to stabilize the elbow muscles. It’s important to stretch and strengthen those muscles consistently, too. These exercises should be started slowly, then gradually increased over time to improve both strength and flexibility. While cortisone injections can offer short-term relief, research shows they often cause poorer results in the long run. 

When possible, returning to an activity such as tennis or typing should be done with careful ergonomic improvements. For instance, a tennis player might need a different racquet or technique, while a computer user might need an armrest or ergonomic keyboard. When an obvious repetitive stressor is the cause, intentional changes must be made to help minimize this stress, or the pain will eventually return.  

Fascia Therapy 

In my practice, I see many cases of elbow tendonitis where all the above treatments have been applied, but the patient still deals with significant pain. The focus of my treatment for this and many other forms of tendonitis is on the fascia—fibrous connective tissue—of the tendon and its muscle. Elbow tendonitis often comes with tissue degeneration without inflammation. The connective tissue fibers of the tendon are less tightly organized, which can cause them to become wavy or tangled in appearance when seen under a microscope. At our office, these fibers are a key focus of successful treatment outcomes. 

Gentle manual therapy is applied to release restrictions from the affected muscle and tendon fascia. This restores pliability to the connective tissue, and over time, can restore uniform alignment of those “tangled” connective tissue fibers. Research demonstrates that incorporating treatments of the thoracic and cervical spine can improve results with elbow tendonitis, and I have found this to be true in my practice. Restrictions in the fascia of the wrist and shoulder can also affect the muscles that attach to the elbow.    

Shirley’s Case 

A woman, whom I will refer to as Shirley, is a recent example of successful elbow tendonitis treatment at my office.  Shirley had “golfer’s elbow”—also known as medial epicondylitis—as a result of her work as a massage therapist. She had been diligent with her stretches and strength exercises, and a course of physical therapy had also helped to decrease her pain.  But over time, the pain returned, at which point, conventional treatments no longer relieved her pain. When I first saw her, she had been living with pain for two years and felt the need to leave her profession, as the constant, repetitive motions were becoming too painful.   

On examination, I found problematic fascia restriction in the elbow tendons, several muscles in her mid and lower neck, and the pectoral muscles in her chest.  Over the course of treatment, these restrictions were relieved through a technique called Neuro-fascial Strain Release. Shirley was given new exercises to perform daily. With the combination of fascia release and these specialized exercises, her pain gradually eased.  She was able to return to a full schedule of massage work with only mild pain, then continued to improve with her home stretching and exercise program.   

Elbow tendonitis can become frustrating when regular treatment fails, but fortunately, fascia release therapy is often quite successful in these cases. In my experience, the best treatment combines rest, stretches, strength exercises, ergonomic modification of stressful activities, and most importantly, fascia release therapy tailored to the patient’s restrictions. With these tools, most folks can leave behind the sharp, searing pain of tendonitis and, ultimately, return to the activities that bring them joy.  

Dr. Eric Winder has 29 years in practice and focuses on relieving pain and restoring alignment and motion through fascia release therapies. For more information, visit https://gentlebay.com/