| 17 years clinical experience | 5-star Google reviews | Free taster session | Free parking on site | Sessions available this week |
Tennis Elbow (Lateral Epicondylitis) and Golfer’s Elbow (Medial Epicondylitis) are misnomers. You do not have to play tennis or golf to get them. They are common in tradespeople, desk workers, parents, and weightlifters.
They present as a sharp, burning pain on the outside (Tennis) or inside (Golfer’s) of the elbow. The pain is often triggered by gripping, lifting a cup, or turning a door handle. It can be debilitating, making even light objects feel impossibly heavy.
The standard medical explanation is “overuse” leading to inflammation or degeneration of the tendon. The standard treatment is rest, ice, braces, and steroid injections. While these might soothe the symptoms temporarily, they often fail to fix the problem because they ignore the cause.
At Breakthrough Pain & Performance, we ask: Why is the tendon overused? Why did it fail now? The answer usually lies in the Kinetic Chain. The elbow is the middle link between the shoulder and the hand. If the shoulder is unstable or the wrist is stiff, the elbow takes the strain. We treat the neurological coordination of the entire arm to offload the suffering tendon.
Try this: squeeze your fist as hard as you can. You will feel your shoulder muscles contract. This is a normal neurological reflex. The brain stabilises the shoulder to provide a solid base for the hand.
In many elbow pain patients, this reflex is broken. You grip, but the shoulder stays loose (or the scapula wings). This means the muscles of the forearm have to generate force from an unstable base. They have to work twice as hard to stabilise the arm and grip the object.
This chronic overload causes the tendon to break down. Treating the elbow without fixing the shoulder is like changing the tyres on a car with misaligned wheels; they will just wear out again.
We test this reflex. We use neurological activation drills to reconnect the grip to the rotator cuff and scapular stabilisers. Once the shoulder is doing its job, the load on the elbow drops instantly, allowing the tendon to heal.
A very common reason for failed Tennis Elbow treatment is misdiagnosis. The Radial Nerve passes through a tunnel of muscle (the Supinator) on the outside of the elbow. If this muscle is tight, it can strangle the nerve.
This is Radial Tunnel Syndrome. The pain is almost identical to Tennis Elbow, but it is nerve pain, not tendon pain. It is often a deep, aching pain that is worse at night.
Standard Tennis Elbow exercises (strengthening and stretching) often make this condition worse because they compress the nerve further. We differentiate between the two. We use specific neurodynamic tests. If it is the nerve, we use Neural Flossing and soft tissue release to open the tunnel. Freeing the nerve often resolves “stubborn” elbow pain in a matter of sessions.
The nerves that supply the elbow muscles come from the lower neck (C5-C7). If you have a stiff neck or a minor disc bulge, it can irritate these nerve roots. This irritation might not cause neck pain, but it lowers the firing threshold of the elbow muscles.
The muscles become “twitchy” and hypertonic (tight). They sit in a state of low-grade spasm all day. This constant tension pulls on the tendon attachment at the elbow, causing pain.
We treat the neck to fix the elbow. By mobilising the cervical spine and reducing neural tension, we lower the tone in the forearm muscles. This takes the traction off the tendon, removing the source of the irritation.
Tendons do not like rest. If you rest a painful tendon completely, it loses structure and strength. When you go back to activity, it fails again.
However, tendons also hate concentric (shortening) movement when they are painful. The solution is Isometric Loading. Heavy static holds have been shown to be analgesic (pain-relieving) for tendons. They reduce cortical inhibition (brain fear) and stimulate the tendon cells to lay down new collagen without aggravating the inflammation.
We teach you the exact dosage of isometric exercise. It acts as a natural painkiller, allowing you to function while the tendon repairs.
We look at how you use your arm. Are you typing with “broken wrists”? Are you lifting with your elbows flared out? These mechanical errors increase the torque on the elbow.
We provide Movement Coaching. We teach you how to keep your wrist in neutral and your elbows tucked in. We show you how to generate force from your hips and core rather than just your arm. This redistribution of load protects the small, vulnerable tendons of the elbow.
1. The Diagnosis: Is it the tendon, the nerve, or the neck? We find the primary driver.
2. The Reset: We use P-DTR to switch off the protective spasms in the forearm.
3. The Integration: We reconnect the hand to the shoulder to restore stability.
4. The Loading: We guide you through a progressive tendon loading program to build resilience.
This clinic is for you if:
We get to the root of the overload.
