by Eric Winder, D.C. 

It’s surprising how uncomfortable elbow tendonitis can be. It can transform simple tasks such as being able to lift a coffee mug or hold a steering wheel into a painful ordeal. For many, this elbow pain is easily treated, but others experience chronic, unrelenting pain that does not respond well to the typical treatments. Fortunately, specific fascia therapies can often resolve even difficult, long-term cases of elbow tendonitis. 

Tendonitis can occur either on the inside or outside of the elbow, often referred to as “golfer’s elbow” or “tennis elbow,” respectively. While golf and tennis are common causes of this problem, many other forms of repetitive stress can also contribute to this pain.  

In previous eras, when writing was done with a quill and ink, the condition was frequently known as “writer’s cramp.” The equivalent today is elbow stress from typing on a computer for hours at a time. However, in many cases, there is no obvious cause for repetitive stress to blame. In all these scenarios, though, treatment is usually the same. 

 Typical Treatment 

Frontline conventional treatment methods can stop many cases of elbow tendonitis in their tracks. Initially, the most critical aspects of treatment include rest and ice, often alongside a compression strap to support the elbow muscles. It’s also important to gradually stretch and strengthen the muscles and tendons to improve flexibility and range-of-motion.  

While cortisone injections can offer short-term relief, research shows these interventions often cause poorer results in the long-term. Whenever possible, returning to an activity such as tennis or typing should take ergonomic improvements into account. For example, maybe a tennis player needs a different racquet or a better technique. Whereas a computer user needs an armrest or an ergonomic keyboard. When an obvious repetitive stress is the cause, changes must be implemented to alleviate stress, or the pain will return.  

Fascia Therapy 

In my practice, I treat many cases of elbow tendonitis where all the above treatment methods have been tried, but the patient still has significant pain. My treatment focus for this issue and many other types of tendonitis is on the fascia (fibrous connective tissues) in the tendon and muscle. Often, elbow tendonitis presents as tissue degeneration without inflammation. The connective tissue fibers are less tightly organized and become wavy or tangled when seen under a microscope. In our office, these fibers are a key focus of successful treatment. 

Gentle manual therapy can help release restrictions in the affected muscle and tendon fascia. This restores pliability to the connective tissue, which can restore uniform alignment of the “tangled” connective tissue fibers over time. Research also shows that treating the thoracic and cervical spine can yield even better results with elbow tendonitis, and I have found this to be true in my own practice. Restrictions in the fascia of the wrist and shoulder can affect the muscles that attach to the elbow as well.    

Shirley’s Case 

A woman, whom I will refer to as Shirley, is a recent example of successful elbow tendonitis treatment in my office. Shirley developed “golfer’s elbow,” also known as medial epicondylitis, as a result of her work as a massage therapist. She had been diligent with exercises to stretch and strengthen her elbow, and she had physical therapy to decrease the pain.  However, her pain gradually returned, and conventional treatments could no longer offer relief. When I first saw her, she had been in pain for two years, and was on the cusp of leaving her profession. 

On examination, I found problematic fascia restriction in the elbow tendons, several muscles of the mid-back and lower neck, and in the chest pectoral muscles. Over the course of multiple visits, these restrictions were released by gentle manual therapy. Shirley was given new exercises to perform daily. With the combination of fascia release and those specialized exercises, her pain eased. She could return to a full schedule of massage work with only mild pain, and she continued to improve with her home exercise program.   

Elbow tendonitis can become frustrating when conventional treatment fails, but fascia release therapies are usually quite successful in these cases. In my experience, the best treatment combines adequate rest, exercises to stretch and strengthen the elbow, ergonomic modifications of stressful activities, and most importantly, fascia release therapy tailored to a patient’s specific pattern of restrictions. With these tools, most individuals can heal from the sharp, searing pain of tendonitis and return to the activities they love. 

Dr. Eric Winder has 25 years in practice and focuses on relieving pain and restoring alignment and motion through fascia release therapies. For more information, visit GentleBay.com.