Treating & Beating Angler’s Or Fisherman’s Elbow – Inner Or Outer Elbow Pain & Injury From Fishing

The pain can sometimes begin with barely a whisper, like the gentle “swish” of fly line through the misty, morning air…

You may start noticing an annoying, little ache or “pinch” at your elbow as you cast or reel, especially if you’ve hooked a feisty bass…

And your arm may feel heavy and tired at night after a long day on the water, punctuated by a dull, burning throb at your inner or outer elbow.

“Nothing to worry about” you may be thinking at this point – “Maybe it’s just another sign I’m getting older??… (Ah, let’s not go there)”…

Eventually, as the season passes, however, it can become such a searing, stabbing source of misery that nothing will quell it for long.

The pills, ice, braces, creams, patches and other nonsense only seem to take the edge off.

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You find yourself chasing the pain, maybe getting just enough fleeting relief to allow yourself a few hours of peaceful casting – maybe some light paddling if you happen to fish from a boat.

(Paddling being a big double whammy, though, when it comes to stress on your elbow, wouldn’t you know it – but holding the tiller and steering an outboard can be a real pain, too!)

You’re not afraid of a little pain, of course! A fish hook through your thumb, that wicked ankle sprain from the slippery river rocks – No big deal. You wrap it up and keep fishing. It heals…

But you start to get a sense that this elbow thing is here for the long haul.

More and more often you’re getting jolts of pain from simply turning doorknobs, picking up your coffee mug and brushing your teeth.

It seems to be getting worse – Even if you take time off from fishing and rest, which is the last thing you want to do!…

You finally have to admit that this “silly” elbow tendon thing is really starting to suck the joy out of your fishing!

And then there’s the question of “How MUCH worse could it actually end up getting!?”

Could it get so bad you actually need surgery and have to take months off? – (God forbid, during the season.)

The bottom line is, you may be facing a real injury – Not a sudden, acute injury, like a cut, bruise or fracture (all of which heal fairly predictably)…

But another species, entirely: A slippery, mysterious, incredibly frustrating fish called a ‘Repetitive Strain Injury!’

Call it Angler’s or Fisherman’s Elbow for now…

It’s the kind of injury, you start to realize, that does NOT heal predictably, AT ALL!

And it’s one you may have to start taking a lot more seriously.

You may also be wondering:

How Common Are These Tendon Injuries Among Anglers?

It turns out these fishing injuries don’t just annoy you and your fishing buddies.

They’re a notorious affliction among anglers worldwide (Everybody’s wading wounded.)

According to Mike Cork, writer for Ultimate Bass, Fishing Elbow is probably the most common injury anglers experience:

“If you fish for bass long enough you will get certain common injuries. Probably the most common is Fishing Elbow…”

“An angler that flips or pitches repeatedly will have wrist and forearm pain, conversely an angler that rips rattle traps or cranks ledges a lot is going to suffer shoulder pain eventually.”

Mike Cork, UltimateBass.com
Bass Fishing Injuries and Pain

No one really knows how many recreational fishing enthusiasts suffer silently with these injuries, self-medicating and never seeking treatment…

But there is growing evidence that Angler’s / Fisherman’s Elbow (and other, similar injuries of the wrist and shoulder) have reached “epidemic” levels among pro sport fishermen in the past 20 years, too.

According to a ‘Bass Fan’ Special Report:

“More tournaments and more practices and higher stakes, alongside new or expanded techniques that punish the extremities, have led to painful days, cortisone injections, surgeries and altered fishing styles.”

“Estimates vary as to how extensive injuries actually are in the sport…”

“…Scott Suggs believes that 60% of all anglers have some type of issue with the shoulder, elbow or hand.”

BassFan Special Report
Is There An Injury Crisis In Pro Fishing?

Those are some sobering statistics if they’re on target. The pro sport fisherman seem to be in the worst shape.

(This is the opposite of what you find in the tennis community, interestingly. Pros tend to have fewer cases of Tennis Elbow.)

And, apparently, Angler’s / Fisherman’s Elbow is a such a common injury in Florida, the “Fishing Capital of the World…”

…that a group of surgical clinics, Ortho Now, recognizes and markets to this condition specifically. Check out their article:

Angler’s Elbow: Defining A Common Painful Condition Amongst Fishing Enthusiasts

What Are The Symptoms Of ‘Angler’s Elbow?’

The most common symptom is burning pain at the inner or outer elbow area, which often makes it feel like the bone itself hurts.

And even the slightest bump to that bony knob, whether in your boat or to a doorjamb at home, can bring you to your knees in pain.

The major symptoms are:

• Burning pain at the outer elbow (Lateral Epicondyle)
• Burning pain at the inner elbow (Medial Epicondyle)
• Occasional, intense, sharp twinges of pain at either location
• Tension, weakness, soreness and pain in the muscles of the forearm (either side)
• Stiffness, achiness and soreness in those areas every morning
• And sometimes sleep disruption more on how to deal with sleeping with the pain here

And, if you’re experiencing these fishing-related elbow and forearm symptoms, feel free to call it Angler’s or Fisherman’s Elbow, Fly Fisher’s Elbow or even Caster’s Elbow…

However, technically, it’s most likely going to be either Tennis Elbow or Golfer’s Elbow.

These are the common language medical terms for these conditions, which don’t necessarily have anything to do with playing tennis or golf.

(There are a couple of other possibilities, which involve joint and ligament injury that we’re not going to get to, because Tennis and Golfer’s Elbow are by far the most probable injuries – depending on whether your inner or outer elbow hurts.)

• Tennis Elbow (Technically Lateral Epicondylitis / Epicondylopathy) – Is most often what outer elbow pain turns out to be (involving the Tendons of your wrist and finger Extensor Muscles where they attach at your OUTER elbow.)
  
  
• Golfer’s Elbow (Technically Medial Epicondylitis / Epicondylopathy) – Is most often what inner elbow pain turns out to be (involving the tendons of your wrist and finger Flexor Muscles where they attach at your INNER elbow.)

These tendons of your wrist and finger muscles ‘originate’ from little bony protrusions on either side of your elbow called ‘Epicondyles.’

Not the BIG bony knob on the underside (what is often referred to as THE elbow) but, rather the little bony knobs on either side, which are about the size of your little finger’s knuckle.

Again, one of the most common symptoms is anything from mild to crazy-intense burning pain right at these tendon attachment spots on these bony knobs which can make if feel as if the bones themselves are literally “ON FIRE!”

Don’t panic, though. There’s nothing unusual about this symptom IF you have Tennis or Golfer’s Elbow! It’s typical or “normal” for these conditions.

Before we go any further, though, do you know what you have?

Get Your Free Tennis Elbow Introductory Course

If you don’t already have a good sense of whether you have Tennis or Golfer’s Elbow, then I invite you to take my free introductory course, ‘Tennis Elbow 101’

You’ll learn the differences between Golfer’s and Tennis Elbow, and I’ll walk you through some simple tests you can do to quickly assess yourself.

Here’s where you can learn more and get the free Tennis Elbow 101 Video Course.

How Does Fishing Cause Tennis Or Golfer’s Elbow?

The cause of these painful disorders is not as simple as one would tend to think, unfortunately.

But start by picturing patterns of tension and repetitive motion causing a gradual overload and leading to a creeping breakdown of your tissues.

There are obviously a lot of motions that are performed over and over again in the sport of fishing.

And repetitive motions can lead to fatigue and overload, even though each little cast and snap of the fly or lure is nothing, a minuscule effort…

And what’s the big deal about a few hundred cranks on the reel? Even a few thousand in a day?

Eventually, the total load just becomes too much.

The injury progression goes something like this:

1. Overloaded muscles become tense, weak muscles,
2. Tense, weak muscles will feel achy, sore and painful – in protest,
3. Persistent, ‘chronic’ muscle tension eventually overloads the tendon,
4. And the tendon begins to break down – often increasingly painfully.

Now, the exact process of how all of this causes the tendon to be injured – (WHY it breaks down rather than healing) – is still not fully understood, surprisingly. Medical research is ongoing.

The key to beginning to understand what IS well-known about these injuries, however, is that the process is usually:

A chronic, ‘degenerative’ processes…

Always keep in mind that this is a continuum with stages of severity…

A gradual, insidious breakdown that creeps up on you (at least, at first)

And it’s a process that can start, stall, progress, heal and reverse and then get worse again.

Averages or “typical healing times” for these injuries are also meaningless.

It’s RARELY an all-at-once, acute (sudden trauma) injury – like a sprain or other type of tear.

Even if it FEELS like it’s the end of the world because it’s painful as hell!

(Yes, tears sometimes eventually happen to tendons that have been significantly weakened by this degenerative process)…

(IF it progresses unchecked long enough – This is the extreme end of the continuum. We’re usually talking about a process that takes years to get this severe, though.)

And one of the most insidious and also largely unrecognized factors, from my perspective (perhaps because you can’t see it on an Xray or MRI?) is the process of:

Adhesion Formation

This is the process whereby layers of muscles and tendons literally stick together – They adhere to each other.

It’s partly the nature of the Collagen Protein that most of our tissues are largely composed of.

This happens gradually to all of us as we age and is a large part of our resulting loss of flexibility and mobility (although not entirely inevitably!)

BUT this process accelerates in specific areas that are under a lot of stress.

That stress includes: Tension, compression, circulation stagnation and lack of oxygen.

(This state of stagnation and low oxygen in muscle tissue, in particular, can cause a toxic tissue state known as ‘ischemia’ or ‘hypoxia’ which is suspected in highly irritable, painful knots called ‘Trigger Points‘) 

And it’s this accumulation of adhesions from muscle overload, fatigue and tension that I believe is the root of the issue driving the injury progression.

A progression that eventually ends in the breakdown of the tendon – (The thing that connects the muscle to the bone – in the case of Tennis and Golfer’s Elbow, the bony knobs at the outer or inner elbows.)

And, the MOST critical thing about these tendon injuries, whether we’re talking “Tennis,” “Golfer’s” or “Angler’s” Elbow is that…

These injuries are usually of a degenerative nature,

They’re usually a chronic condition called ‘TendinOSIS’

NOT an acute condition called ‘TendonITIS’ – Which would be an inflammatory condition.

Especially once they become truly chronic, (which is just a technical term for stubbornly persistent, in this case, after several months or longer.)

This is where tendon injury sufferers of all kinds are often led astray.

The myth that these injuries are inflammatory ‘TendonITIS’ is STILL extremely persistent in both medical circles and layman’s lore.

(Even though this has been dead wrong for over 30 years, according to medical research.)

Which leads SO MANY people astray and down the wrong treatment path – chasing the wrong thing and not healing or even making it a lot worse!

So, let’s get into the right and wrong ways to treat these frustrating, disruptive injuries, once they become chronic (persistent.)

Why The Standard Treatment Strategy Is The Wrong Approach

The standard treatment approach unfortunately focuses on the acute symptoms (pain etc.) rather than the chronic causes (adhesion buildup, chronically shortened, weakened muscles, etc.)

I call this conventional / Allopathic strategy “The S.I.C.K. Approach”

• S – Suppress symptoms: Pain and inflammation
• I – Immobilize: Via braces and splints
• C – Cool: To “reduce” inflammation and swelling
• K – Which “Kills” your healing process

(Or perhaps a better way to put it is, suppressing, immobilizing and cooling can SLOW your healing process and “kill” your chance of recovering in a timely manner!)

Yes, this standard approach will tend to reduce your symptoms! (Temporarily, anyway.)

But is mere temporary relief really your goal?

Or do you actually want healing!… and a long-term recovery that lasts so you can keep fishing and stop worrying?

The Inflammation MYTH: The Essential Error

Apart from braces, most of the standard medical and “common wisdom” treatments, including others not listed above, are misdirected at chasing and trying to suppress inflammation.

And the short answer to why this is utter madness is because:

Inflammation is an essential part of the healing process.

Which naturally raises the question of:

“How could a stage of the healing process itself be a cause of the injury – or even a problem?”

You can’t heal a ‘Soft Tissue’ injury (damage to muscle, tendon, ligament etc.) without an inflammatory process.

This is one of the most commonly learned and promptly forgotten facts learned in medical and nursing schools!

(And in Acupuncture / Chinese Medicine schools / programs, perhaps?)

And as we just covered, these kinds of injuries are almost always of a degenerative nature, called ‘Tendinosis.’

NOT an acute, inflammatory condition called ‘Tendonitis’ – (at least not past the earliest stages.)

I have extensive articles on all of the standard medical and “common wisdom” treatments, going into greater detail about what’s wrong with them, the most common of which are listed below.

And here’s my overall Treatment Strategy for Tennis / Golfer’s Elbow Injuries

Anti-inflammatory pills:

Both prescription and over-the-counter. To “reduce” inflammation (which act systemically on your whole body, since taken internally.)

More on the inflammation story here

Topical remedies: Lotions, creams, liniments, etc:

Again, to “reduce” inflammation or simply relieve symptoms. At least they are more locally applied and not taken internally, so do less harm.

And some liniment-type preparations may actually be useful, since they warm the area and increase circulation.

More on the topical remedy topic here

Icing / Cryotherapy / cold packs:

Can be used to simply relieve pain temporarily (you could do worse) but you’ll be told you need to ice, once again, to “reduce inflammation.”

Read more about icing

Corticosteroid (Cortisone) Injections:

The Cortisone Shot is a very powerful way of suppressing pain and inflammation directly in and around the injured tendon like magic…

(But these shots can be very damaging and detrimental to your long-term tendon healing, even causing further degeneration.)

Here’s the full story on Cortisone Shots

Braces, splints and other supports:

Unlike sprains and fractures, tendon ‘overuse’ injuries do not heal better when completely immobilized. They need movement to heal properly.

So these are not the kinds of injuries you should wear a brace around all day and try not to move at all.

Read more about why braces are wrong here

Complete and total rest

Total rest is usually not helpful once the injury has passed its earliest stages – often even if it feels better while you’re resting.

It’s important to allow gentle, normal movement as you go about your day and not to try and immobilize and limit all activity.

More on the idea of why “Total Rest” is wrong

The bracing exception:

The case for using a brace of some kind is if you’re going to continue to fish while you’re recovering from your Angler’s / Tennis / Golfer’s Elbow.

OR you’re just starting to cast again after your recovery, and you want the extra protection as you ease back in.

And perhaps use it judiciously, (if at all) for shorter periods when performing heavier, critical tasks you can’t avoid, if your work is very physical, for example, or you suddenly need to change a tire.

The Right Way To Treat These Injuries

Now, assuming you have a pretty good idea that you have either a Golfer’s Elbow or a Tennis Elbow fishing injury, what do you do about it?

A better treatment approach involves:

• Using heat instead of ice – (or at least NOT icing several times a day, as is often recommended)
  
  
• Allowing symptoms, especially inflammation – (Again, it’s an essential part of your healing process.)
  
  
• Encouraging more circulation and metabolic activity in and around the tendon to stimulate healing and keep it progressing…
  
  
• And mobilizing the area – especially with Massage Therapy or self-massage and stretching techniques

#1 Priority: Releasing The Adhesions

The goal is that with the right approach, you can free up all that built-up “stuckness.”

Your chronic tension and adhesion-restricted muscles can be released, which takes the load and stress off your tendons.

Here are the 3 top self-massage techniques I recommend

Will any massage technique help? Yes, probably so some extent. Many kinds of hands-on manipulation may be beneficial.

However, in all honesty, freeing up dense sticky adhesions is not the easiest thing to accomplish, especially without the right techniques.

Merely pressing (with hands or tools), rubbing, rolling (with foam rollers, etc.) and kneading tissues can be terribly inefficient.

There are countless videos out there showing you all manner of techniques, which may be good for reducing tension and good for overall muscle health – but…

These other techniques may not get the adhesion-release job done!

It requires a trifecta of pressure, friction and tension – in the right combination.

And the good news is that this is something you can learn to do yourself at home. (More on that shortly)…

#2 Priority: Stimulating The Tendons

What this comes down to is strategically “bothering” your tendons with the right amount of friction (and some heat if you’re not afraid to use it!)…

To encourage circulation and break the cycle of stagnation.

(A lot of this is accomplished with the 2nd technique in the article, called ‘Cross Fiber’)

Article on 3 top self-massage techniques, including Cross Fiber #2

Tendons, once again, have this nasty habit of not healing well and slipping into a state of stagnation and degeneration.

Newer medical interventions acknowledge and attempt to address this through techniques like:

• Platelet Rich Plasma Injection Therapy
• Dry Needling, an older, cruder method
• And perhaps Graston / IASTM therapies

BUT I don’t believe its necessary (or such a great idea) to go to such invasive extremes to accomplish this, (although the last one, Graston / IASTM, is not surgical and not invasive if performed by a skilled practitioner.)

I’ve been getting great results for years working on tendons by hand and teaching people Self-Massage Techniques to use themselves at home.

#3 Priority: Strengthening The Muscles And Tendons

The key, in my approach, is that strengthening should be the THIRD priority – Not the first or even the second!

Yes, exercises for strengthening your muscles and tendons are an essential part of a complete rehab program.

But, from my perspective, these rehab exercises are often begun way too soon, which seems to cause flare ups and unnecessary pain, frustration and sometimes significant setbacks for far too many sufferers.

My approach is to defer those exercises until significant progress is first made with the first two therapy priorities and then to gradually introduce the exercises.

More on my overall rehab exercise approach to these injuries

If you need some help putting together a self-help plan, you’re certainly in the right place!

Just follow one of the links below, depending on whether you have Tennis or Golfer’s Elbow.

Learn To Treat And Heal Your Own Tennis / Golfer’s / Angler’s Elbow Injury At Home

You’ll get instant access to a complete VIDEO program designed by a professional therapist to help you take charge and break your vicious cycle of pain and frustration!…

I’ll be your personal tutor guiding you through step-by-step video lessons, where you’ll get the therapy techniques, key stretches and essential exercises you need to treat and recover from your injury at home. (Without any special equipment.)

Tennis Elbow sufferers: Learn more about that program here

Golfer’s Elbow sufferers: Learn more about that program here