Active Release Technique for Tennis Elbow and Golfer's Elbow in Greenville, SC

Targeted Treatment for Stubborn Elbow Pain

Elbow pain from tennis elbow or golfer's elbow can be maddeningly persistent. You've rested. You've worn the brace. You've tried the stretches. And yet every time you grip a doorknob, shake a hand, lift a coffee cup, or swing a club, the pain is still there.

That's because most treatments for elbow tendonitis address the inflammation but ignore the adhesions. Active Release Technique (ART®) does the opposite — it identifies and releases the specific scar tissue in your forearm muscles and tendons that is causing your pain. And it works remarkably fast.

At Popwell Scota Spine Center in Greenville, SC, our certified ART providers treat tennis elbow and golfer's elbow as primary conditions — not as an afterthought to a general adjustment.

Understanding Tennis Elbow and Golfer's Elbow

Tennis Elbow (Lateral Epicondylitis)

Tennis elbow involves pain on the outside of the elbow where the forearm extensor muscles attach to the bone. These are the muscles that extend your wrist and fingers — you use them every time you type, grip, turn a wrench, shake hands, or hit a backhand.

Despite the name, most people with tennis elbow don't play tennis. It's caused by any repetitive gripping, twisting, or wrist extension activity. The extensor muscles develop microtrauma, the body repairs with scar tissue, and that scar tissue gradually accumulates into adhesions that restrict the muscles and irritate the tendon attachment.

Golfer's Elbow (Medial Epicondylitis)

Golfer's elbow involves pain on the inside of the elbow where the forearm flexor muscles attach. These are the muscles that flex your wrist and fingers — you use them when you grip, curl, pull, and swing.

Like tennis elbow, golfer's elbow is caused by repetitive overuse — and it's not limited to golfers. It's common in weightlifters (especially heavy pulling movements), rock climbers, carpenters, plumbers, and anyone who grips tools or equipment repeatedly.

Why These Conditions Are So Stubborn

Both conditions tend to linger for months or even years because the adhesions at the tendon attachment don't get adequate blood flow to heal on their own. The more you use the arm, the more microtrauma accumulates.

The more scar tissue forms, the more restricted the muscle becomes. And the more restricted the muscle, the more strain falls on the already-injured tendon attachment.

Rest helps temporarily by reducing the irritation, but the adhesions remain. When you return to activity, the pain returns — often within days.

How ART Treats Elbow Tendonitis

ART breaks the cycle by releasing the adhesions in the forearm muscles and tendons directly.

Forearm Extensor Release (Tennis Elbow)

Your provider identifies the specific adhesions in the extensor carpi radialis brevis, extensor digitorum, and surrounding forearm extensors. Then, using ART protocols, they apply precise tension to each adhesion while you extend and flex your wrist and fingers. This separates the adhered tissue layers, restores normal muscle glide, and takes strain off the tendon attachment.

Most patients feel a noticeable reduction in grip pain within the first session.

Forearm Flexor Release (Golfer's Elbow)

The same approach applies to the flexor side. Your provider targets the flexor carpi radialis, pronator teres, and flexor digitorum superficialis with protocols designed for each muscle. You'll flex and extend your wrist and pronate/supinate your forearm during treatment.

Supinator and Pronator Release

The supinator and pronator muscles rotate the forearm (turning your palm up and down). Adhesions here are common in both tennis and golfer's elbow and are frequently missed by other treatments. They contribute to pain with gripping, twisting, and turning movements. ART addresses them specifically.

Wrist and Hand Protocols

In chronic elbow cases, adhesions often extend into the wrist and hand — particularly in the extensor retinaculum and the intrinsic hand muscles. We check and treat these structures when they're involved, because leaving them untreated can limit your recovery.

Proximal Assessment: Shoulder and Neck

The nerves that supply the forearm muscles originate in the cervical spine and pass through the shoulder. In some cases, nerve irritation higher up the chain amplifies the pain at the elbow. We assess the cervical spine, scalene muscles, and shoulder for contributing factors and treat them if needed.

Why ART Outperforms Conventional Treatments for Elbow Pain

Elbow braces (counterforce straps) reduce stress on the tendon by compressing the muscle belly. They can help manage symptoms during activity, but they don't treat the adhesions. When you take the brace off, the dysfunction remains.

Rest reduces acute inflammation but doesn't break apart scar tissue. Most patients who "rest" their elbow for weeks or months find that the pain returns as soon as they resume their normal activities.

Cortisone injections are powerful anti-inflammatories, but research increasingly shows they may actually slow tendon healing over the long term. They provide short-term relief but don't address the mechanical cause.

Physical therapy exercises — especially eccentric loading protocols — can be effective, but they work best when the adhesions have been released first. Trying to strengthen through an adhesion is like trying to stretch a knotted rubber band — the knot takes all the strain.

ART removes the adhesions, restores muscle function, and allows the tendon to heal properly. When combined with corrective exercises, it produces faster and more complete resolution than any single treatment.

Who Gets Tennis Elbow and Golfer's Elbow?

These conditions are surprisingly common in the Greenville area:

Golfers — Greenville's many courses and year-round golf season make golfer's elbow a frequent complaint
Tennis and pickleball players — both sports involve repetitive forearm loading
CrossFit and weightlifting athletes — heavy barbell and dumbbell work, pull-ups, and kettlebell training
Tradespeople — carpenters, plumbers, electricians, and mechanics who grip tools for hours daily
Office workers — prolonged mouse use and typing create low-grade but constant strain on forearm extensors
Musicians — guitarists, drummers, pianists, and string players
Parents — repetitive lifting and carrying of young children

What to Expect

Elbow and forearm assessment. We test grip strength, wrist range of motion, and specific provocation tests for lateral and medial epicondylitis. We palpate the forearm extensors and flexors to identify exactly where the adhesions are and how extensive they are.

ART treatment at the first visit. We treat every adhesion we find — in the forearm, wrist, and elbow — during your first appointment. Most patients feel a measurable reduction in pain within the session.

Progressive loading guidance. We prescribe specific eccentric exercises calibrated to your condition and activity level. These exercises work synergistically with ART — the ART releases the adhesions, and the exercises stimulate healthy tendon remodeling.

Activity modification recommendations. We'll help you identify which activities are contributing most to your elbow pain and give you practical strategies to reduce the load without stopping your life.

How Many Sessions Does It Take?

Most cases of tennis elbow and golfer's elbow improve significantly within four to eight ART sessions. Mild cases sometimes resolve in two to three visits. Chronic cases (present for six months or more) may take longer, but patients typically notice improvement within the first two visits.

We'll set clear expectations at your first appointment and track your progress with grip strength testing and pain assessments at every visit.

Stop Gripping Through the Pain

Elbow tendonitis won't resolve on its own if you keep using the arm — and you have to keep using the arm. ART is the treatment that lets you address the root cause without stopping your life, your sport, or your work.

📞 Call Popwell Scota Spine Center at (864) 244-2220 or schedule your appointment online. We're located at 107 Pelham Commons Blvd, Greenville, SC 29615.

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FAQs — ART for Elbow Pain

How do I know if I have tennis elbow or golfer's elbow?

Tennis elbow causes pain on the outside of the elbow and is aggravated by gripping and wrist extension. Golfer's elbow causes pain on the inside of the elbow and is aggravated by gripping and wrist flexion. Some patients have both. Our evaluation will identify exactly which structures are involved and which type you have.

Can I keep playing golf (or tennis, or lifting) during treatment?

In most cases, yes — with some modifications. We may recommend reducing intensity or volume temporarily, adjusting your grip or technique, or warming up differently. Our goal is to keep you active while we resolve the problem.

I've had elbow pain for over a year. Is it too late for ART?

No. Chronic elbow tendonitis takes longer to resolve than acute cases, but it still responds to ART. The adhesions are more developed, so it may take more sessions, but patients with longstanding elbow pain routinely get significant relief through ART.

Do I need imaging before starting ART for elbow pain?

In most cases, no. Our clinical evaluation is sufficient to diagnose tennis elbow or golfer's elbow and begin treatment. If we suspect a more serious condition — such as a ligament tear or fracture — we'll refer you for imaging before proceeding.