Why your elbow won't heal

If you've been icing, bracing, and resting your elbow for weeks (or months) and it's still not better, it's because the problem isn't at the elbow. Lateral and medial epicondylalgia — what most people call tennis elbow and golfer's elbow — are overload conditions. The tendons at the elbow are doing too much work because something upstream isn't doing its share.

A stiff wrist that can't extend properly. A shoulder that lacks internal rotation. A cervical spine that isn't providing proper neural input to the forearm muscles. These upstream deficits force the elbow to compensate — and eventually, the tendons can't keep up.

How we assess elbow pain

We don't just test the elbow. We assess the entire upper extremity chain to find where the mechanical breakdown is occurring.

  • Wrist extension and radial/ulnar deviation range of motion
  • Shoulder internal rotation and scapular function
  • Cervical spine screening — neural tension and segmental mobility
  • Grip strength testing — bilateral comparison
  • Forearm muscle palpation and provocation testing

How we treat it

Treatment addresses both the local tissue and the upstream drivers. Dry needling the common extensor or flexor tendons and forearm musculature can provide significant pain relief and improve tissue healing. IASTM helps restore fascial glide through the forearm compartments.

But the real fix is restoring the mobility and motor control deficits upstream — at the wrist, shoulder, and cervical spine — so the elbow stops being overloaded. We prescribe specific loading exercises for the tendon (eccentric and isometric protocols) alongside mobility work for the joints that need it.

For grapplers and climbers: Elbow pain is extremely common in grip-intensive sports. If you're training BJJ, rock climbing, or any sport that loads the forearm heavily, the approach is the same — find the upstream deficits, restore wrist and shoulder capacity, and progressively reload the tendon.

What to expect

Tendon conditions take patience. While pain often improves meaningfully in the first few weeks of treatment, full tendon recovery and return to loading can take 8–12 weeks depending on severity and how long the problem has been present.

The key is progressive loading — not rest. Complete rest actually weakens tendons further. We'll guide you through a structured loading protocol that builds tendon capacity while managing symptoms.