Localise it
Lateral, medial, nerve or neck — these need different treatment, so assessment comes before anything else.
Home/What We Help With/Tennis & golfer’s elbow
Shockwave & chiropracticTennis elbow and golfer’s elbow treatment in Morgan Hill, CA
Pain gripping a kettle, turning a doorknob, or shaking hands. Most people who get it have never held a racket.
Two names, one mechanism
Tennis elbow is lateral — the outer elbow, where the wrist extensor tendons attach. Golfer’s elbow is medial, on the inner side, where the flexors attach. The tissue changes are the same in both: a tendon attachment that has become disorganised and stopped repairing properly.
The suffix “-itis” is misleading here too. Biopsy studies of chronic tennis elbow generally show degenerative change rather than active inflammation, which is why an anti-inflammatory approach so often disappoints past the first few weeks.
What actually causes it
Rarely tennis. Far more often it’s a sustained gripping load with the wrist held in one position — trade work, gardening, lifting a toddler, a new gym programme, or a mouse and keyboard setup that keeps the forearm in tension all day.
There is usually a second contributor further up. Restricted shoulder or thoracic movement makes the forearm do work the shoulder should be sharing, and stiffness in the neck can refer symptoms toward the elbow and blur the picture. Treating the elbow alone is why this condition has a reputation for coming back.
Where shockwave fits
Lateral epicondylitis is, with plantar fasciitis, the best-studied musculoskeletal use of shockwave, and the tendon attachment sits close enough to the surface to be a good target for a radial device. Reviews generally support it for pain and function in chronic cases.
The same two caveats apply as everywhere else on this site: chronic responds better than acute, and shockwave with a loading programme beats shockwave alone. For the elbow the loading piece is eccentric and isometric wrist work, plus grip retraining — unglamorous and effective.
Details of the device, pricing and contraindications are on the shockwave therapy page.
When it isn’t the tendon
Radial nerve entrapment, a cervical spine referral, elbow joint arthritis, and in throwing athletes ligament injury can all masquerade as tendinopathy. Numbness, pins and needles, night pain, locking, or symptoms that spread past the forearm all point away from a simple tendon problem and are worth investigating before treatment starts.
At your first visit
What we look for
- History covering grip demands, occupation, hobbies and recent load changes
- Palpation to localise the attachment involved, lateral or medial
- Resisted wrist and grip strength testing
- Neck, thoracic and shoulder screening, since these commonly contribute
- Neurological screening to exclude nerve entrapment or cervical referral
- An honest view on whether shockwave suits your presentation
Next step
An assessment first. Shockwave suits some presentations and not others, and Dr. Diana will tell you which yours is before you book a course.
Or call (408) 778-6770.
Our approach
How we work on tennis & golfer’s elbow
Shockwave to the attachment
Radial pressure wave to the affected tendon attachment, typically three to six sessions a week apart.
Load the tendon
Isometric then eccentric wrist work and graded grip retraining. This is what remodels the tendon; the shockwave supports it.
Free up the chain
Adjusting and soft-tissue work for the elbow, wrist, thoracic spine and neck so the forearm stops carrying the whole load.
Change the daily load
Grip technique, tool and mouse setup, and how you carry things. The reason it recurs is almost always here.
Refer when needed
Nerve entrapment, joint or ligament findings get referred on rather than treated as tendinopathy.
This describes our general clinical approach and is not a promise of a specific outcome. Every case is assessed individually, and results vary between patients.
Before you book
Tennis & golfer’s elbow — common questions
Why does it take so long to get better?
Tendon attachments have a modest blood supply and remodel slowly, and most people cannot stop using their hands while it happens. Recovery in chronic cases is realistically measured in months rather than weeks. The upside is that the changes usually hold once the tendon has genuinely rebuilt.
Do those elbow straps and braces work?
They can take the edge off by changing where the tendon is loaded, which makes them useful short term. They don’t rebuild anything. Treat a strap as a way to keep working while the real work happens, not as the treatment.
Should I just rest it completely?
Complete rest usually backfires. The tendon gets weaker and the pain returns as soon as you resume. Reducing the aggravating load while progressively loading the tendon in a controlled way is the better path, and it’s what the loading plan is for.
Is a cortisone injection a good idea?
A question for you and your physician. Injections often help in the short term, but several trials in tennis elbow have found worse outcomes at a year compared with exercise or a wait-and-see approach. A recent injection in the same site also means delaying shockwave.
Ready to find the why?
Most new patients are seen within the same week. Call the office, or send a short request and we'll get back to you.