Chronic elbow pain may develop from golf, tennis, or normal activities. Who you see first for a health problem will determine the journey, results, and risks. Recently, I have seen a few of these cases that resulted in surgical excision of a painful ligament for tennis elbow. In both cases, surgery was performed after injections failed to resolve the pain that affected elbow extension and external rotation. After weeks of post-surgical therapy and a healed scar, was the problem resolved, or was the symptom of a larger mechanical dysfunction in the body relieved? In my experience, bad things happen when patients and their doctors chase pain, and good things happen when the cause is resolved. To fully understand elbow pain, you need to connect the dots. Elbow pain is caused by repetitive strain on the elbow. What causes the strain and then the pain? If you believe doctor Google, it is from overuse or from repetitive motion. If you ask other people who do what you do, play the same sports or perform the same activities, you may find out most of them are free of elbow pain, so why are you hurting? To understand elbow pain, wrist pain, thumb pain, and even shoulder pain, you must understand why the forearm has tightened and your flexibility and even your grip strength have waned. Is it due to the pain or is the pain a byproduct? Did the sport cause the problem or was there something we did in the sport that did? Was the pain related to how I functioned while playing the game? Did you have an old injury that was never properly addressed? Was this traumatic? In tennis, elbow pain often begins with the way we hold and swing the racket. Often a better-fitted grip will improve elbow pain along with better form with our swing. A better swing happens with how we use our body rather than just how we use the arm and the elbow. Elbow pain results from body mechanics, the fascial systems' adaptation to it, and how we move. The resulting repetitive strain on the elbow is what we feel. The idea is that the elbow is a problem because that is where the pain is, shows a lack of understanding of the mechanism causing the pain. If you watch people play tennis and notice that it's people who move, rather than just elbows, you can understand this idea. We all move differently. Warning signs of mechanical problems resulting in elbow pain Flexibility issues in my lower body? Any history of shoulder problems such as frozen shoulder? Can you bring your arms above your head easily? Is your grip strength weak? Are you dropping things? Numbness or tingling in the hands while driving or waking up? Simple self-tests to determine if your shoulders or other parts of the body are causing the pain. Arm extension and supination of the hand (turning it upright as if you are holding soup in the palm of your hand) with elbows fully extended. Can you fully extend the elbow? Is the arm rotation more restricted as is seen in this photo on the side of pain? Can you extend the wrist in this fully extended position? If any of these maneuvers cause pain in the lateral elbow, the problem is caused by another part of the body which will eventually cause problems in the wrist and may even be associated with a painful shoulder. Conversely, restricted pronation (palm down with arms extended) causes pain in the medial elbow otherwise known as golfers elbow must diagnostically use the same line of thought. In order to properly diagnose and treat elbow pain, it is important to fully evaluate the person to fully understand why you have elbow pain. You cannot understand elbow pain without understanding the forces placed upon it. As the fascial system tightens in response to the forces placed upon it, the joints and the ligaments will be placed under more stress resulting in tendonosis and micro tears in the area. Do we treat the elbow or should we instead treat the mechanism causing the arm to tighten, which may solve many other problems such as knee, back, hip, foot, and neck pain? Why you should see a chiropractic sports physician first. Chiropractic sports physicians are holistic in their history and examination meaning they will question and evaluate everything and try to connect the dots. The idea that you require a specialist for a painful joint is a medical construct. The body just doesn't work that way and requires a holistic approach to evaluation, history taking, and treatment. They will determine the cause, explain it, and work on the mechanism behind the pain, rather than attempting to inject or treat the pain medicinally or then suggest a surgery that will permanently affect the integrity of the area. Using methods such as myofascial release, active evaluation, exercises, joint manipulation, and even foot orthotics to level the pelvis, which is a common cause of upper body pain, they resolve most of these types of problems safely and naturally. A natural holistic approach to elbow pain is also likely to help you avoid other problems later on in the shoulders, knees, back and neck. Got elbow pain? Think chiropractic sports physician first. Book online here.