Elbow tendinitis (also elbow tendonitis) can be frustrating because it slowly becomes increasingly painful and intrusive into one’s life. Also known as tennis elbow or golfers elbow, the pain can occur on either side of the elbow. Symptoms may range from a simple tenderness along the forearm muscle and epicondyle to severe pain when attempting to lift even the lightest of objects.
Elbow tendinitis begins when extra tension of a forearm muscle results in microscopic damage of the tendon where it attaches to the bone. Inflammatory chemicals build up in the area in an attempt to remove damaged tendon fibers and build new tendon fibers. Because the stress on the tendon continues, the repair process is inefficient and unresolved.
I often compare elbow tendinitis to a never ending home remodel. If the old paint, paper, and tile are not completely removed, application of new pain, paper, or tile doesn’t go well. The remodel process fails to resolve. It ends up being a chronic mess of painting and scraping, analogous to unresolved healing.
In fact, the more accurate term for long-term tendinitis is “tendinosis.” Tendinosis involves tendon damage complicated by a relative lack of inflammation (clean-up and repair).
Manual treatment for elbow tendinitis or tendinosis should focus on instigating more inflammation (appropriate healing) at the tendon while addressing the abnormal muscle pull that causing increase tension on the tendon in the first place. An example of this would be massage of a forearm muscle, instrument assisted soft tissue manipulation of the tendon, and strengthening exercises to resolve the predisposing muscle imbalance.