The Tennis Elbow Classroom Treatment Strategy
When it comes to Tennis Elbow treatment, it’s all too easy to find yourself scrambling from treatment, to remedy, to “cure” – without a real strategy or a deeper understanding of the injury, as you desperately seek relief…
Especially in the beginning – Before you understand how serious your Tennis Elbow is – Before you get that it's not going to just get better with a little rest, a few pills and some ice – And you suddenly realize you're trapped in a vicious cycle!
At some point, though, you have to ask yourself, “What's the plan here?” – “Do I have an actual treatment protocol with a consistent strategy?”
Follow the link above to check out the self-help program - Or read more about our protocol / strategy and philosophy below...
Well, I have one for you, based on straight-forward principles of biology and healing (that are often ignored in both conventional and alternative treatment approaches.)
It's a strategy liberally influenced by over a decade of hands-on on experience successfully treating hundreds of Golfer's Elbow and Tennis Elbow sufferers (well over a hundred, anyway.)
But it's nothing like the “Conventional Wisdom” – In fact, it's in almost complete contradiction to it!...
The Basic Principles Of Tennis Elbow Treatment: For Treating The Injury – Not The Symptoms
In a nutshell, the Tennis Elbow Classroom strategy is to take a “Mobilize, Warm and Allow” approach (move and manipulate it, use heat - not ice and allow inflammation)...
As opposed to the conventional “Suppress, Immobilize, and Cool” – Or “S.I.C.k” approach, which is basically a knee-jerk, symptom-attack strategy – (At least to begin with.)
Our strategy / protocol here is to:
- Mobilize the muscles and tendons involved in your Tennis Elbow injury with specific manual (hands-on) therapy techniques (instead of immobilizing them with a brace) This is absolutely KEY!
- Warm the area regularly to stimulate circulation and the healing that comes with good blood flow (or at least refrain from freezing the muscles and tendons with ice and inhibiting circulation)
- Allow the inflammation process to do what it's there to do, which is to initiate the healing process (rather than relentlessly trying to suppress it through pills, shots and ice)
- (And to delay rehab exercises) – Yes, strengthening exercises are essential at the right time, but often begun too early – (Our approach here is to delay rehab exercise until we first make some progress with the Therapy Techniques and the worst symptoms have significantly subsided)...
Tennis Elbow Treatment Protocol Podcast:
Here's the downloadable version of this podcast you can keep by clicking the "download" link under the player below - And please subscribe to this podcast on your favorite platform HERE
The Tennis Elbow Classroom Philosophy
I believe the key questions we must always ask ourselves and our trusted Doctors, Therapists, Coaches and Trainers are:
“Is this treatment or tactic beneficial to healing – Or could it actually interfere with it instead!?”
Our motto here is: "Pain relief through healing" – NOT: pain relief at the expense of healing.
The Tennis Elbow Classroom “philosophy” and strategy is to uncompromisingly focus on supporting our healing process.
To take a “Mobilize, Warm and Allow” approach (move, manipulate, use heat not ice and allow inflammation) – Even if it's not so comfortable for us in the short term...
And to keep our eye on the long-term goal of complete healing and recovery and the eventual, permanent pain relief that comes with it.
With the understanding that although short-term pain relief is certainly desirable (and sometimes necessary to function day to day) – Short-term pain relief is not our goal!
We realize that the short-sighted “pragmatic” obsession with short-term pain relief (often religously encouraged by Pharma-Centric medicine) is often a dangerous mirage that can lead us even deeper into the wilderness…
Because almost every conventional treatment or remedy that provides short-term pain relief, seems to do so at the expense of long-term healing! Especially the big three: Ice, Anti-inflammatories and Cortisone shots! (The 3rd of which, seems to have been proven unequivocally through medical studies.)
We fortify ourselves with confidence in the knowledge that although tendons can “resist” healing with an uncanny stubbornness, taxing even the most patient among us – They CAN and DO heal!…
And that it's extremely important to give our struggling, injured tendons the right “encouragement!”
We're committed to being highly proactive and engaged in our self-treatment and therapy process – and never fall into the “Resting, Hoping and Waiting” trap.
So, if that makes sense to you, (or at least sounds intriguing) let's take a closer look at what's wrong with the conventional treatment approach, since that's usually what's drilled into you right from the start, as a Tennis Elbow sufferer…
And, since, the first step to deciding on the right path is to see if the recommended, well-worn, well-lit path will actually lead you to your desired destination!
The Standard Tennis Elbow Treatment Protocol And What's Wrong With It
The standard medical approach to Tennis and Golfer's Elbow (and common wisdom) incorrectly blames inflammation for a significant part of the problem…
Treats it as if it were a type of injury that it's not (as if it were an Acute injury, which it usually isn't)…
And begins to intervene with a strategy best summarized as:
“Suppress, Immobilize and Cool” - Or the S.I.C.k approach:
- Suppress inflammation with pills and even Cortisone shots,
- Immobilize the area with a brace or other “support” and...
- Cool the area with ice or cold packs – Often several times a day,
- (And later, to begin Rehab Exercises, which do make sense at the right time.)
“Treating” Inflammation Is NOT A Treatment For Your Injury
If you've had Tennis or Golfer's Elbow longer than 5 minutes, you've undoubtedly already been told or read on numerous websites that you should start treating your injury this way.
(Icing the area, taking handfuls of anti-inflammatory pills / NSAIDs, and then resorting to Cortisone shots if that's not enough.)
What three treatments; pills ice, and Cortisone shots, have in common, (as I'm sure you already know) is supposedly inflammation…
Inflammation is supposedly the rebellious, unruly “Bad Boy” these “treatments” are supposed to take care of and “settle down.”
I can't emphasize enough what utter rubbish this is – And the sooner you see why, the sooner you can focus on the cause of your problem, rather than chase the tail of its symptoms around in a vicious circle.
There are several problems why this inflammation-fighting strategy is not the right way to treat Tennis Elbow...
The first is that it's based on an old, outdated theory – A medical myth that Tennis Elbow is a form of Tendonitis involving “excessive” inflammation, which was shown to be incorrect decades ago.
See the following article and video for more on that:
In the simplest sense, however, inflammation is a symptom of the injury (if it's even present – see link and article above) – A symptom of the HEALING process at work. It's not the problem!
Blaming inflammation for the problem is probably the biggest, single road block to healing when it comes to the standard medical approach (and the “common wisdom” of the general populace.)
Braces, Splints And Supports Do Not Support Tennis Elbow Healing
Using a splint to immobilize the area or even a softer, flexible brace to partly immobilize the muscles and tendons involved may sound perfectly reasonable at first, but unfortunately, this is also a big mistake – A dead end in most cases.
The short version being that Golfer's and Tennis Elbow are usually NOT the type of injuries that benefit from, or require, immobilization.
Yes, they are technically “injuries” but they are not sudden injuries involving Acute Trauma, (forceful injury damage) like tears, bruises or fractures.
Tennis and Golfer's Elbow are almost always chronic, degenerative injuries that involve no acute trauma, which would necessitate a period of immobilization.
Yes, it's true that part of the reasoning behind the “Immobilize, Cool and Suppress” approach is simply to garner some relief by suppressing uncomfortable symptoms…
But, without asking the key question of whether this tactic is beneficial to healing – Or might actually interfere with it!
So, when it comes to more on how NOT to treat it, (assuming your goal is healing – and not just temporary pain relief, anyway) please see the following articles and videos going into much more detail about why these standard treatments are not in your best interest:
- Should You Ice Your Tennis Elbow? No – Here's Why
- Why Getting A Cortisone Shot May Be The Worst Mistake You Could Make
- Should You Wear A Brace To Treat Your Tennis Elbow? No – Only In These Situations
- How Important Is Rest In Treating Tennis Elbow?
Some of these mistakes are relatively benign, like icing a little now and then, ("Now and then" does not mean 15 minutes, 3 times a day regimen!) which may slow healing somewhat, but provide some much-needed temporary relief.
Unfortunately, some have the potential to completely alter the course of ones recovery for the worse.
Cortisone shots being the worst offender; capable of causing long-term damage that's very challenging and sometimes impossible to recover from.
Even wearing a brace and “resting” the area too much (not moving and challenging it enough and allowing it to stagnate) can have adverse effects – Making you feel better in the short term but potentially prolonging your recovery.
I know we've spent quite a bit of time looking at the “wrong way” to treat Tennis and Golfer's Elbow, but these ideas are so entrenched I think they needed to be addressed before we can move on to the question of “what's the correct way to approach these injuries”
What's The Right Way To Treat Golfer's Elbow And Tennis Elbow Injuries?
As I said earlier, I recommend that most Tennis and Golfer's Elbow sufferers move and “mobilize” the muscles and tendons involved instead of immobilizing them, use heat – (Or at lease avoid ice) – And allow the inflammation process to do its job.
The Tennis Elbow Classroom “Mobilize, Warm and Allow” strategy:
1) – We Mobilize the muscles and tendons involved in our Tennis Elbow injuries with specific manual (hands-on) therapy techniques.
This strategy is all about reversing the harmful trend at the root of most Tennis and Golfer's Elbow injuries:
Stagnation! - (And its consequence, Tendinosis.)
Stagnation is the essence of the problem. It's the unfortunate nature of tendons, with their lessor blood flow (compared to muscles) to have challenges with healing – To not heal poorly or not at all.
When damage happens, (and that's usually a gradual, cumulative process) the healing process (kicked off by inflammation) either never really gets going or stalls at some point – Or can't keep up with the damage.
This results in a gradual, chronic, degenerative tendon injury know as Tendinosis (NOT to be confused with Tendonitis! Picture tooth decay – rather than a sunburn.)
So, we mobilize the tissues to stimulate healing in our tendons and reverse this stagnation and degeneration
Allowing our muscles to move (instead of immobilizing them with a brace) And...
2) – By Warming the area regularly to stimulate circulation and all the healing potential that comes with good blood flow
(Or, at the very least, we refrain from freezing our muscles and tendons with ice and inhibiting circulation) AND...
3) – By Allowing the inflammation process to do what it's there to do, which is to initiate the healing!
(As opposed to relentlessly, religiously trying to suppress inflammation via pills, shots and ice as if it were some kind of demonic possession!)
Because we understand, as unpopular and contradictory-sounding as it is, in direct opposition to the “common wisdom” that inflammation is a necessary part of the healing process.
...That there is NO healing without inflammation.
4) – (Also by delaying the start of rehab exercises) – With the understanding that strengthening exercises, although certainly an essential part of Tennis Elbow rehab, are often begun too early.
(Rather than the conventional approach of starting rehab exercises fairly early on in the healing and recovery process, the minute one begins Physical Therapy, for instance.)
Many Tennis Elbow sufferers seem to find rehab exercises aggravating – (At least in my experience) – And that sometimes even includes highly specialized “Eccentric-Only Exercises” which are thought to be “safer” and “gentler.”
And this is especially true when those exercises are begun suddenly after days or weeks of Suppressing, Immobilizing, and Cooling.
It's like trying to shift gears suddenly from reverse to forward, and then go full speed ahead! (With a cold engine that hasn't had a chance to warm up!)
Our approach here is to delay exercise until we first make some progress with the Therapy Techniques and the worst symptoms have significantly subsided...
Again stretching and exercises are an important part of the rehab process – There's no denying that!
And sometimes the right stretches and exercises can even “nip” the process “in the bud” before it becomes a full-blown injury, if one catches it in time, at the first early warning sign or in the very early stages, at least.
But past a certain point in the injury process, stretches and exercises, alone, may not be enough.
The Most Important “Tool” In Our Tennis Elbow Treatment Toolbox
I believe the most important tools in the box when it comes to breaking that vicious injury cycle are very specific, hands-on “advanced Massage Therapy” techniques. I firmly believe it's the missing link.
I haven't seen or heard (so far) of a better way to release the muscular tension and Scar Tissue in the muscles and tendons involved in Tennis and Golfer's Elbow.
AND to stimulate and encourage the reversal of that awful state of stagnation, where healing just isn't happening.
I just don't see a better way to deal with all that tension, Scar Tissue and stagnation / degeneration – Which is the ROT at the root of the injury...
Because once it's well established, it tends to stubbornly persist.
The inconvenient fact is that it often doesn't just heal and “go away” all by itself, no matter how long one plays the “Resting, Hoping and Waiting” game.
Sure, you can go to a professional like myself who specializes in this kind of therapy…
(My clinic, Body In Balance is in Corte Madera, which is in Marin County in the San Francisco Bay Area) if you need me – However...
It's also entirely possible – and often completely practical – to learn these techniques and use them on oneself.
Along with the key stretches (Not the usual way of stretching, which is pretty risky, though – Rather a safer, better way.)...
And the essential exercises, of course (just delayed somewhat – Not beginning right off on day one!)
That's what I teach my students to do here in the Tennis Elbow Classroom Members Area. Just follow the link below to learn more...
Learn To Treat And Heal Your Own Tennis Or Golfer's Elbow Right Here:
I'll be your personal tutor guiding you through easy-to-follow lessons, where you'll get the therapy techniques, key stretches and essential exercises you need to treat and recover from your injury at home.
Just watch the videos, follow along and start putting an end to your elbow pain today.
Tennis Elbow sufferers, get started here: Tennis Elbow Classroom
Golfer's Elbow sufferers, get started here: Golfer's Elbow Classroom
Featured Treatment-Related Articles, Videos and Podcasts:
These five featured articles, all with videos and podcasts are all on the topic of treatment and remedies. To view the exercise topic please visit: the Tennis Elbow Exercises page.
Is Platelet-Rich Plasma An Effective Tennis Elbow Treatment?
Could Platelet-Rich Plasma (PRP) Therapy be an effective, new treatment breakthrough for Tennis Elbow and other stubborn, chronic tendon problems?
(Based on all the attention it's getting, PRP certainly looks like it could be a promising, new approach...)
Or is it actually an expensive, unproven fad, driven by rock star-athlete publicity and questionable medical studies? Is PRP An Effective Tennis Elbow Treatment?
Tennis Elbow Surgery: When Is It Time To Consider It?
At some point, after struggling with Tennis Elbow for months or even years – Seeing all kinds of professionals and trying all manner of treatments – You may eventually have to ask yourself, “Is it time for surgery?”
If you're like most people, however, you regard surgery as a last resort – A serious decision not to be rushed into or taken lightly.
So how do you know when it's time for surgery? – That you've completely exhausted your more conservative options, and it's time to step aboard the ship to the “last resort” AKA: Scalpel Island?
How Long "Should" It Take To Heal Tennis Elbow?
How long does it take to fully recover from a Tennis Elbow injury? Some injuries seem to only take weeks to heal, while others take a number of months or even years – Why is that?
Since the injury is to the tendons this is a more difficult question than it would seem, and a glance at several conventional medical websites seems to confirm this - Estimates for healing time seem to be "all over the map!" How long does Tennis Elbow take to heal?
Cortisone Shots: Dangerous, Damaging AND Ineffective?
Cortisone shots: They can often erase pain like magic, sometimes producing total pain relief in the short term.
Research shows, however, that the powerful but often fleeting benefits of Corticosteroids can come with a very high price tag in the form of lasting and sometimes very serious negative effects.
Is the pain relief worth it? – And does the relief you get actually have anything to do with healing your injury? Why getting a Cortisone shot is the worst thing you can do
Should You Treat Your Elbow Tendonitis By Icing It?
Ice or ice therapy is still recommended by everyone from Doctors, to PTs to Fitness Trainers - Pretty much everyone says ice "to reduce the inflammation!"
It seems to make sense and often feels great as it temporarily relieves the pain, but there's more to the story you should know about.
Discover why inflammation is NOT the real problem, why trying to "ice it down" won’t help your elbow heal - And how icing may actually slow your recovery. Why you should NOT use ice to treat your Tennis Elbow!
How Important Is Rest When Treating Tennis Elbow?
You nearly always hear how important it is to "rest it as much as possible while it heals" – Or so they say… Unfortunately, the idea that healing will "just happen" while you’re resting is a major misconception when it comes to tendon injuries.
Learn why tendons need a lot more than just rest and "R.I.C.E." – And why they don't necessarily heal themselves while you're resting, hoping and waiting. How important IS rest in treating Tennis Elbow?
Are Braces a Good Treatment for Tennis Elbow?
Braces, splints, bands wraps and straps – Most medical websites, Physical Therapists and sports blogs still recommend that you wear some kind of "support" supposedly to help your Tennis Elbow heal…
But this video explains why they are not only unhelpful – they can even slow your recovery, in large part because it's simply not the kind of injury that benefits from being immobilized for days or weeks:
Tennis Elbow Treatment - Braces: Not a Good Idea! (Article, Video, Podcast)
Featured Podcasts On Treating Tennis Elbow: