Let’s Get a Grip on that Elbow Pain

Attention rock climbers, tennis players, weightlifters, and golfers: is the repetitive motion of your favorite activity giving you elbow pain? I’ve been working with a lot of clients with this ailment lately! Most have come from a doctor who told them the classic blanket statement “you have tendonitis” and that they should take multiple weeks off. In my experience, the repetitive motion of your activities and patterns have simply tighten your fascia. Once your fascia has space and blood flow, your pain should quickly recede. Here is why fascia can be playing a role in your elbow pain and how releasing it can help you feel better quickly.

What is Tendonitis?

Let’s start with the basics. What exactly is tendonitis? Your tendons are fibrous connectors that attach your muscles to your bones. They are made up mostly of connective tissue, aka fascia. The “-itis” simply means inflammation, so tendonitis translates as inflammation in your tendon.

That doesn’t really tell you much though, does it? I’ve had a doctor long ago tell me I had tendonitis, and I’m pretty sure I met him with a blank stare. “Okay…Now what? Are you expecting me NOT to play sports while I just…do nothing?” I’m sure you can relate. This overused diagnosis leaves you with a ton of questions. Why do I have it? Is there another option besides not being active for six weeks? What happens if it’s not better after that? 

How Fascia Affects Tendonitis

If our tendons are made up of mostly fascia, it makes sense to learn more about this tissue in order to understand why we are feeling pain.

Your fascia is an intricate, 3D web of tissue that goes throughout your entire body. You can think of it like layers and layers of plastic wrap that wrap around everything in your body in order to create your shape and structure. When your fascia is healthy, all those layers of plastic wrap are gliding over each other easily and movement is fluid.  When you are doing a repetitive motion such as gripping hold after hold climbing or swinging a club over and over, your fascia can tighten in that pattern. It’s like that plastic wrap crinkled up, adhered to itself, and “hardened” in that state. 

Now you have less space to move your joints and muscles freely and less blood flow to carry out inflammation and bring in fresh nutrients. Naturally, you are attempting to continue moving like normal, but your tissue is stuck. Your fascia is restricting your full range of motion and when you try to push past those restrictions, it hurts.

Unfortunately, the typical remedies of ice and rest are not going to unstick your fascia. It may temporarily calm your pain (because you aren’t actively asking that fascia to move) but without addressing the root cause of your pain it has a high likelihood of it returning.  

How do you unstick your fascia? 

Fascia can be released and returned to its natural, happy state. Yey! Fascia will respond and release with two things: compression and shearing.

Compression is exactly what it sounds like. An outside force: your hand, a foam roller or fascia tool, or (in my career path) a foot, needs to compress the tissue. The more powerful the compression, the better. As long as you feel safe and are able to move your body while that spot is being compressed!

Then you want to move through the best range of motion you can with that nearby muscle and joint. This will help “shear” the fascia so it unsticks. For example, if you are compressing the tissue around your bicep, you want to bend and straighten your elbow and even rotate your forearm back and forth to cross-fiber that area. See the “More Resources” section at the end of this post for more on this.

Fascia Release Differences Between Inside and Outside Pain

Lastly, I want to address the differences in the parts of fascia to release if you feel the pain on the inside or the outside of your elbow.

If you are experiencing pain on the inside of your elbow (golfers, climbers, those feeling it during pull-ups, etc), begin releasing fascia throughout the medial (inside) fascia line. This connected line of fascia includes the flexors of the forearm, the medial  (inside) bicep, the subscapularis and even the lat (latissimus dorsi).

You can do fascia release on yourself or ask your trusted practitioner to work specifically on this line of fascia. Since this pain is often triggered by a “pulling” motion, also consider testing your lats for good activation and strength. If your fascia has become restricted in this line, your muscles may not be firing at full capacity. As you work on releasing the fascia, I recommend also doing slow, controlled lat exercises. A single-arm lat pulldown or single-arm row would be a great start. This will help re-pattern your muscles so your pain is less likely to come back. 

If you are experiencing outside elbow pain (tennis players, weightlifters, etc), there is a different fascial line to work through. This pain is typically caused by overusing your forearm extensors, brachioradialis, bicep, and even the pec (pectoralis major and minor).

I see this most commonly in someone who does too many bicep curls and bench presses, sports like tennis and football, and even those working at a computer for long periods of time. First, focus on releasing that fascia chain mentioned above. Since this pain is commonly felt during a “pushing” motion, pay attention to your posture (are your shoulders rounded forward?) and balancing the strength in your arms (work your posterior chain too!). Also be mindful of any repetitions that you can avoid such as typing/texting/being on your phone with your elbow in a bent position.

More Resources

This is a common ailment I tackle in my practice! If you are looking for an effective fascia release that follows the compression/shearing theory, check out Pain Liberation Academy! This virtual academy gives you a simple, follow along program for elbow pain (as well as 15 other areas that so you can tackle pain, no matter where it may pop up) and guarantees you'll feel a significant difference in your pain in as little 30 days.