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How to Get to the Root of Elbow Pain

Tennis elbow is not about too much tennis—and it's not even about your elbows! Read on to learn about the source of your pain and strategies for relief.

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Pain and Anatomy Advisor

In most places across the country, tennis season is in full throttle. I say most only because I have a friend from Maine who told me that summer is the one time folks up there put their rackets down. Since summer in Maine lasts about 15 minutes, people use that short amount of time to play golf while they can and resume getting their tennis fix by playing indoors during the colder rest of the year.

As I said, it’s outdoor tennis season, and across the country people are back in full tennis swing. And with that tennis swing, some of them are getting a painful condition commonly known as tennis elbow. But tennis elbow is actually about the shoulder, and its painful symptoms can be alleviated rather quickly through aligning the body’s posture and restoring its balance.

First, the anatomy.

The shoulder joint is formed by three bones coming together, the humeral (upper arm bone), the clavicle (collar bone), and the scapula (shoulder blade). The actual joint surface of this confluence is a shallow indentation, primarily in the scapula, and it allows for a full range of motion in the shoulder, the elbow and the wrist, not only separately but also simultaneously.

Now, a quick test. Hold out an arm straight in front of you, palm down. (If you are suffering from tennis elbow, hold out the unaffected arm as the affected one is already compromised.) Now, rotate that arm palm up then back to palm down. Do it a couple of times. Notice how the shoulder is doing the rotating and the elbow and wrist are working in concert? Notice, also, how little that motion strains the forearm.

Go ahead and shake that arm out, then hold it out again, palm down. Again, rotate that arm to palm up and back to palm down, but don’t use the shoulder this time; just use the elbow to rotate the wrist. Notice the difference? There’s a much greater strain on the forearm and elbow. Now shake the arm out and try this: Hold your arm out in front of you, palm down, and roll your shoulders forward and rotate your hand to palm up. Feel the strain on the elbow? You’ve compromised the shoulder by rolling it forward, taking it out of play, in effect, and asked the elbow to fill in. What’s amazing is that the elbow can fill in, that is, even when our shoulders aren’t working properly, the body still finds a way to enable us to do what we’re asking it to do. But that compromised way is the source of that painful condition known as tennis elbow.

As I’ve said before, barring birth defects or a recent traumatic injury, the site of your pain is never the source of your trouble. The problem with tennis elbow isn’t the elbow; it’s the shoulder, specifically, the inability to rotate your arm from the shoulder. If your shoulder is out of alignment, when you swing your arm (either for tennis or golf or any number of activities), the stress is being taken from the elbow down. Keep rotating that arm with a compromised shoulder, and eventually you will get tendon stress in the elbow, medial or lateral. That tendon stress is tennis elbow. (Incidentally, it’s also carpal tunnel syndrome. It’s not about your wrist; it’s about your shoulder.)

Often, you will read that the problem of tennis elbow is one of overuse. Overuse is not the problem. We are not fragile. Our bodies are strong and resilient. They are perfect, but only if they are aligned properly and balanced symmetrically. Regarding tennis elbow and so much other pain, it’s not the condition, it’s the position. The problem is not the tennis you’re playing, no matter how much of it you’re playing. The problem is the shoulder that you’re bringing to the tennis you’re playing. You’ve got to get that shoulder back where it belongs.

Here’s one quick way for some immediate relief.

But this will help only temporarily. For complete, consistent relief from tennis elbow, you need to fully align and balance your body. But it’s not just tennis elbow. Unfortunately, that same compromised shoulder that gives you tennis elbow will probably give you rotator cuff and back issues as well.

Known as the Father of Postural Therapy, Pete Egoscue has helped relieve thousands of people from their chronic pain, including many of the world’s leading athletes. For more information on Pete and any of his 25 clinics worldwide, go to

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