Non-drug treatment for tennis elbow

As a specialist in treating sports injuries without drugs, I see many patients with tennis elbow, otherwise known as lateral epicondylosis. Many of these patients have already tried conventional medical treatment, including prescription anti-inflammatory drugs, such as naprosyn or celecoxib, and cortisone shots. They come to me because drugs don’t help and can make the condition worse. In fact, cortisone shots are no longer recommended as a treatment because they are harmful in the long run.

I work with my patients to relieve their pain and get them back on the tennis court using a two-pronged approach: Soft-tissue treatment and nutrition.

For the soft tissue treatment, I rely on two very successful modalities: Active Release Technique (ART) Injury Care, combined with low-level laser therapy.

Over-used muscles (and other soft tissues) change in three important ways:

  • Acute conditions: Pulls, tears, collisions, etc.

  • Accumulation of small tears: Micro-trauma

  • Not getting enough oxygen: Hypoxia

Each of these factors can cause your body to produce tough, dense scar tissue in the affected area. This scar tissue binds up and ties down tissues that need to move freely. As scar tissue builds up, muscles become shorter and weaker, the tension on tendons causes tendonitis, and nerves can become trapped.

ART Injury Care uses precise techniques to resolve soft-tissue injuries by removing the adhesions and restrictive tissues that are laid down when the tissue suffers repeated trauma. In the case of tennis elbow, the result is pain and reduced range of motion. Sometimes, a nerve becomes trapped in the tissue, leading to more pain, tingling, numbness and weakness. Because repeated trauma is usually the root cause of tennis elbow, ART can be extremely effective for restoring full function and movement. When I work with patients using ART, I use my hand or thumb to evaluate the problem area and guide the patient to move that part of the body through a specific range of motion. The process helps break up scar tissue and lets the area move freely again. I find ART gets my patients back in the game quickly, usually after only six to eight 15-minute office visits.

I like to combine ART with Low-Level Laser Therapy (LLLT). This treatment works by exposing the injured tissue to coherent light at specific wavelengths—in other words, laser light. The light passes through the skin and reaches the damaged soft tissue painlessly and with no sensation of heat. The stimulation from the light triggers a biological response that switches on the healing process. The injured area is stimulated to produce a cascade of natural chemicals, such as anti-inflammatory enzymes, that reduce pain and improve mobility in the joint. LLLT treatments are quick, usually taking less than five minutes. It’s so effective that the prestigious British Journal of Medicine includes LLLT in its clinical evidence recommendations for tennis elbow.

I’ve found that when I combine ART and LLLT, my patients feel pain relief in the arm and elbow very quickly. Within a few weeks, their pain is usually entirely gone and they are back to playing with no restrictions.

To keep tennis elbow from recurring, I often recommend some dietary changes to my patients. I’ve found that tennis elbow and a diet high in refined carbohydrates—junk food and processed foods—often go hand-in-hand. Part of the solution to re-injury is changing your diet to:

  • Eliminate sugar and foods with added sugar

  • Eliminate processed carbohydrates

  • Avoid foods with gluten

  • Avoid foods with soy

  • Avoid dairy products

  • Avoid fried foods

  • Avoid foods you are sensitive to

  • Reduce or eliminate the consumption of alcohol

In addition to removing these foods from your diet as much as possible, increase your intake of fresh fruits and vegetables, nuts, whole grains and fatty fish, such as salmon.

Editor's note: Silverman will be speaking at the annual Integrative Healthcare Symposium on February 23-25, 2017 in New York City. This article is part of’s IHS Preview Series, a collection of articles and media where we give you a sneak peek of the sessions offered at this year’s event. This article originally appeared in New York Tennis Magazine.


About the Author

Robert G. Silverman, DC, MS, graduated Magna cum Laude from the University of Bridgeport College of Chiropractic and has a Masters of Science in human nutrition. Dr. Silverman is a diplomate with the American Clinical Board of Nutrition and diplomate with the Chiropractic Board of Clinical Nutrition. He has a full-time successful private practice in White Plains, NY, where he specializes in the treatment of joint pain with innovative, science-based, non-surgical approaches and functional medicine. Dr. Silverman is awarded the “2015 Sports Chiropractor of the Year” by the ACA Sports Council. Dr. Silverman can be reached at his office: 914.287.6464; [email protected]