What it feels like
Pain on the outside of the elbow (tennis elbow). Pain on the inside of the elbow (golfer's elbow). Weak grip or pain when gripping. Pain that started after lifting something awkward. Elbow pain that doesn't improve with rest or bracing.
What’s actually causing it
Elbow pain usually falls into a few categories. The most common is overuse — tennis elbow (lateral epicondylitis) and golfer's elbow (medial epicondylitis) are both repetitive strain injuries where the tendons at the elbow get irritated from too much use. Another common one I see is a strain from lifting something with an outstretched arm, palm down, gripping something heavy. That position loads the wrist extensors in a way they're not designed to handle, and they get strained at their attachment point on the elbow. But here's the one that gets missed: sometimes the elbow itself is fine. The pain is coming from dysfunction higher up the chain — the shoulder, the upper back, even the neck. If the muscles that stabilize your shoulder blade aren't firing correctly, your forearm and elbow have to compensate for every movement of your arm. Over time, that compensation causes pain at the elbow even though the real problem is upstream.
How I treat it
I test the muscles around the affected area individually, find which ones aren’t firing, and reset the connection using gentle techniques. No cracking, no popping.
How long it takes
Most patients feel a difference after one session. Chronic cases typically resolve in 4–6 sessions.
The Three Patterns I See
Overuse (tennis/golfer's elbow): Repetitive gripping, typing, or racquet sports overwork the forearm muscles. The tendons where they attach at the elbow get inflamed. Treatment is myofascial release of the forearm extensors or flexors, plus figuring out what's driving the overuse — poor grip mechanics, weak wrist stabilizers, or too much volume without recovery.
Acute strain: You lifted something awkward — arm outstretched, palm down, gripping hard. The wrist extensors took a load they weren't prepared for. This usually responds quickly to soft tissue work and a few days of smart rest.
Referred from higher up the chain: This is the one that stumps people. They've rested the elbow, worn a brace, maybe had a cortisone shot — and it's still there. That's because the elbow isn't the problem. I check the shoulder, the scapular stabilizers, and sometimes the neck. If your shoulder blade muscles are inhibited, every time you reach, lift, or grip, your elbow absorbs force it shouldn't have to. Fix the shoulder, and the elbow calms down.
What I Do
I start with muscle testing at the elbow and forearm to see what's happening locally. Then I check up the chain — shoulder stability, scapular position, grip strength. Once I find the pattern, treatment is targeted soft tissue work on the overworked muscles, plus reactivation of whatever shut down upstream. For overuse injuries, I also look at what you're doing that's causing the repetitive strain and help you modify it.
Timeline
Acute strains and simple overuse injuries respond quickly — 2–4 visits. Chronic elbow pain that's been around for months takes longer, especially if the real issue is upstream at the shoulder. Expect 4–8 weeks for those. The referred pattern cases are the most satisfying to treat because once you find the real cause, the elbow pain often resolves surprisingly fast.
“I had been suffering for years and was unsuccessfully treated by others. In one visit, Dr. Ladd was able to find and address the real issue.”
Patient review · Elbow Pain patient
Techniques I use for elbow pain
Common questions
Why hasn't my elbow brace helped?
Because the brace treats the symptom, not the cause. If the real problem is upstream — weak shoulder stabilizers or scapular dysfunction — a brace on your elbow isn't going to fix anything.
Do I need to stop playing tennis/golf?
Not necessarily. We might modify your activity for a few weeks while the tissue calms down, but the goal is getting you back to full activity with the underlying issue fixed.
Could my elbow pain be coming from my shoulder?
Absolutely. If your shoulder blade muscles aren't firing correctly, your forearm compensates for every arm movement. I check up the chain on every elbow patient because this pattern is more common than people realize.
How fast does it get better?
Simple overuse: 2–4 visits. Chronic or referred pain: 4–8 weeks. Once we find the actual cause, elbow pain usually responds well.
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