Sports Chiropractic & Strength Rehabilitation
Elbow & Forearm Pain,
Treated at the Source
Tennis elbow, golfer’s elbow, triceps tendinopathy and stubborn forearm overuse — rebuilt with precise diagnosis and supervised strength rehab.
If gripping, lifting, typing, throwing or swinging has become painful, you are exactly who we treat. Dr. Douglas Cancel, D.C. restores the load capacity your tendons lost — so you return to the work, sport and training you care about.
Start Your RecoveryWalnut Creek, CA · Call (925) 945-1155
A Different Starting Point
Most Elbow Pain Is a Capacity Problem, Not an Inflammation Problem
Tennis elbow and golfer’s elbow are usually called “-itis,” which implies simple inflammation. In reality, persistent cases are far more often a tendinopathy — a tendon whose repair has stalled and whose tolerance to load has dropped below the demands you place on it.
That distinction changes how we approach care. Rest or anti-inflammatory measures may quiet symptoms, but a tendon that has lost tolerance to gripping, lifting, twisting, or pressing usually has to be progressively reloaded before it is ready for those demands again. At Performance Sport Care, the examination is used to identify the tissue that appears involved, reproduce the relevant load, and decide how treatment and rehabilitation should progress. Focused evaluation. A plan built for the work your arm has to do. Targeted treatment and supervised strength rehabilitation, not spinal adjustments alone.
Why cortisone is rarely the answer. Corticosteroid injections can reduce pain in the short term, but randomized trials and systematic-review evidence in lateral epicondylalgia have found higher recurrence and poorer intermediate- or longer-term outcomes. That is why active rehabilitation remains central even when a patient has already tried an injection or another pain-relieving treatment.
Conditions We Treat
Elbow & Forearm Conditions We Evaluate and Treat
We focus on the load-sensitive tendon and muscle conditions of the elbow and forearm — the ones that often benefit from a clear diagnosis and a loading plan matched to the involved tissue and the demands placed on it.
Tennis Elbow
Lateral epicondylalgia — pain on the outside of the elbow from the common extensor tendon (especially the ECRB). Provoked by gripping, wrist extension and palm-down lifting. Common in racquet sports, trades, desk-plus-gripping work and rows/curls/deadlifts.
Golfer’s Elbow
Medial epicondylalgia — pain on the inside of the elbow from the flexor-pronator origin. Driven by wrist flexion, forearm pronation and forceful gripping. Seen in golf, throwing, climbing, pull-ups, heavy curls and farmer’s carries.
Triceps Tendinopathy
Pain at the distal triceps tendon near the point of the elbow, aggravated by pressing, dips, lockout work, skull crushers and overhead throwing. We also screen carefully for partial tendon tears, which are more common in heavier and older lifters.
Repetitive Overuse Forearm Pain
Diffuse forearm or arm pain from muscle overload and fatigue — not always a single focal tendon lesion. Typical after a sudden spike in training volume, high-rep grip work, or long days of keyboard, tool or assembly-line use.
We also evaluate and treat biceps tendinopathy and general elbow joint irritation, and we look up the chain — the wrist, shoulder and neck — because elbow tissue is often overloaded when force is poorly shared across the whole arm.
Who We Help
If Your Hands and Arms Have to Perform, You’re Who We Treat
Elbow and forearm overuse is not just a tennis player’s problem. The highest-risk profile is any active adult — often between 35 and 55 — whose work, sport or training demands repetitive or forceful gripping. We treat people across all of these worlds:
Gym, Strength & Physique Athletes
- Powerlifters and bodybuilders with pain from heavy curls, rows, deadlift grip, skull crushers and close-grip pressing
- Lifters whose elbows flared after a jump in volume, frequency or near-failure sets
- CrossFit and circuit athletes with combined pull, push and carry demands
- Climbers and grip-sport athletes loading the flexors and extensors hard
Sport & Recreation
- Tennis, pickleball and squash players with backhand or serve-related pain
- Golfers managing repetitive wrist flexion and pronation at impact
- Baseball, softball and throwing athletes with flexor-pronator or triceps overload
- Rowers, paddlers and weekend warriors returning after a layoff
Trades & Manual Work
- Electricians, carpenters, plumbers and mechanics using vibrating and gripping tools
- Cooks, butchers, warehouse and assembly-line workers with repetitive grasp-and-twist tasks
- Dental and clinical workers holding sustained, precise grips
- Musicians under repetitive, loaded hand positions
Desk & Everyday Demands
- Keyboard- and mouse-intensive workers with forearm tension and grip fatigue
- Anyone whose pain followed a busy stretch, a new hobby or a sudden change in routine
- People who’ve tried rest, braces or injections and keep relapsing
- Active adults who simply want to grip, carry and lift without pain again
What Makes Our Rehab Different
Supervised Strength Rehabilitation — Built for Real-World Loads
Wrist curls and bands can be a useful starting point, but they do not always reproduce the combined gripping, pressing, pulling, and rotating demands that bring symptoms back during sport, work, or serious training. Our purpose-built strength-rehabilitation facility allows that progression to continue under supervision.
An advanced, performance-informed loading system
Dr. Cancel has developed a rehabilitation method that adapts resistance tools originally engineered for elite arm-wrestlers into a precisely scalable clinical system. Used at controlled, low-to-moderate intensities, these tools train loading directions that are relevant to many elbow and forearm demands: gripping with pronation, resisted supination, wrist extension under grip, ulnar/radial deviation and elbow flexion-extension through the full kinetic chain.
It is not “arm-wrestling training for injured people.” It is an integrated hand-to-shoulder loading system that bridges the gap between basic therapeutic exercise and a confident return to demanding sport, work and strength training.
Pain-limited isometrics, light grip engagement and gentle pronation/supination.
Slow concentric-eccentric loading, controlled forearm rotation and endurance sets.
Heavier grip-integrated, multiplanar loading with velocity and perturbation.
High-load tolerance and fatigue resistance for your specific sport or job.
While direct trials on arm-wrestling-derived tools are still limited, the approach is fully consistent with established principles of progressive tendon loading, grip-strength restoration and task-specific return-to-function care. It is an adjunct to evidence-based conservative treatment — not a replacement for it. This pairs naturally with our strength & bodybuilding rehabilitation work.
Our Evidence-Based Framework
How We Build Your Recovery
Every plan is individualized, but the clinical hierarchy is consistent and grounded in the best available research for elbow and forearm tendinopathy.
Know What You’re Loading
The examination is used to identify the involved tissue, reproduce the loads that matter, and distinguish common tendon problems from joint, nerve, or more serious injury presentations.
Load management
We temporarily reduce the aggravating volume, grip width, tempo or range while keeping you as active as safely possible — then reintroduce load progressively.
Supervised progressive strengthening
The core of recovery. Isometric, eccentric, heavy-slow and grip-integrated loading rebuild tendon and muscle capacity — dosed and supervised to avoid flare cycles.
Manual therapy as an adjunct
Soft-tissue work, mobilization-with-movement and joint mobilization reduce pain and improve pain-free grip — used to enable loading, never as a stand-alone cure.
Kinetic-chain & postural correction
We address the shoulder, scapula, wrist and pressing/throwing mechanics that overload the elbow when force is shared poorly.
Nutritional support
Practical guidance on protein, energy and micronutrient sufficiency to support tendon healing — a sensible adjunct, not a substitute for loading.
Why Performance Sport Care
The same standard runs through every condition we treat — and through our overall approach to care.
◆A Professional-Athletics-Inspired Standard
Dr. Douglas Cancel brings more than four decades of clinical experience to a model inspired by high-level professional athletics, where evaluation, treatment, rehabilitation, and return to performance are connected. The goal is to identify the tissue and loading pattern that best fit the presentation, then build the plan around what your arm has to do again.
◆Purpose-Built Strength Rehab
A dedicated, supervised facility — including our arm-wrestling-derived loading system — that rebuilds the capacity generic rehab leaves behind.
◆Evidence-Based Methodology
Care grounded in current tendinopathy research, prioritizing active rehabilitation over passive quick-fixes with poorer long-term outcomes.
◆Honest, Ethical Referral
If your case needs imaging, injection or surgical input, we say so — and coordinate it — without unnecessary delay.
A straightforward note on fit. Many common elbow and forearm problems are good candidates for conservative care. Complete tendon rupture, substantial neurologic involvement, major trauma, or other concerning findings may require imaging or specialty evaluation, and we refer when the examination points in that direction. Either way, you leave your first visit with a clearer understanding of what the examination supports, what may still need clarification, and what Dr. Cancel recommends next.
Let’s Get You Gripping, Lifting and Living Pain-Free
Tell us what hurts and what you’re trying to get back to. We’ll give you a clear assessment and a practical, evidence-informed plan to rebuild the capacity your elbow needs for work, sport, and training.
Request an AppointmentSelected References
- Bisset L, Paungmali A, Vicenzino B, Beller E. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med. 2005;39(7):411–422.
- Hoogvliet P, Randsdorp MS, Dingemanse R, Koes BW, Huisstede BMA. Does effectiveness of exercise therapy and mobilisation techniques offer guidance for the treatment of lateral and medial epicondylitis? A systematic review. Br J Sports Med. 2013;47(17):1112–1119.
- Southerst D, Yu H, Randhawa K, et al. Multimodal care for the management of musculoskeletal disorders of the elbow, forearm, wrist and hand: a systematic review by the OPTIMa Collaboration. Chiropr Man Therap. 2016;24:8.
- Wallis JA, Bourne AM, Jessup RL, et al. Manual therapy and exercise for lateral elbow pain. Cochrane Database Syst Rev. 2024;5(5):CD013042.
- Keogh JWL, Winwood PW. The epidemiology of injuries across the weight-training sports. Sports Med. 2017;47:479–501.
- Coombes BK, Bisset L, Brooks P, Khan A, Vicenzino B. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. JAMA. 2013;309(5):461–469.
- Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Lancet. 2010;376(9754):1751–1767.
What elbow problems do you evaluate and treat?
Dr. Cancel evaluates and treats tennis elbow, golfer’s elbow, triceps and biceps tendinopathy, repetitive forearm overuse problems, and other musculoskeletal elbow complaints when conservative care is appropriate. Many are related to repetitive loading or changes in activity, but the diagnosis should come from the history and examination rather than the symptom location alone.
What’s the difference between tennis elbow and golfer’s elbow?
Tennis elbow causes pain on the outside of the elbow and involves the wrist-extensor tendons, aggravated by
gripping and wrist extension. Golfer’s elbow causes pain on the inside of the elbow, involves the flexor-pronator
tendons, and is aggravated by wrist flexion, forearm rotation and forceful gripping. Both are load-related tendon
conditions that respond to the same progressive-loading principles.
If tennis elbow is not simply inflammation, why does it keep coming back?
Persistent tennis elbow is usually better understood as a load-sensitive tendon problem than as simple short-lived inflammation. Symptoms may settle before the tendon is ready for normal gripping, lifting, or sport demands. Progressive loading is therefore a central part of rehabilitation for many patients.
How long does tennis elbow or golfer’s elbow take to recover?
The timeline varies with symptom duration, tendon irritability, work or sport demands, and how the area responds to progressive loading. Symptoms can improve before full load tolerance returns. Dr. Cancel gives you an initial estimate after the evaluation and updates it as the tendon’s response becomes clearer.
Can you help elbow pain from lifting weights or strength training?
Yes — this is one of our strongest areas. Lifters often develop elbow pain from heavy curls, rows, deadlift grip, dips,
skull crushers and pressing volume. We use a supervised, grip-integrated loading system — including tools adapted
from elite arm-wrestling — to bridge the gap between basic rehab and a confident return to heavy gripping, pressing
and pulling.
Can a chiropractor treat elbow pain without surgery?
Many common elbow tendinopathies are managed conservatively. A complete tendon rupture, substantial neurological involvement, major traumatic injury, or persistent functional loss may require imaging or specialty evaluation. Dr. Cancel refers when the findings indicate that conservative treatment is not the appropriate next step.
Do I need to stop training?
Not necessarily. Dr. Cancel identifies which movements can continue, which should be modified, and which should temporarily pause. The objective is to maintain useful activity when appropriate while progressively rebuilding the load tolerance needed for full training.
How do I know if my elbow pain could be a serious tendon injury?
Warning signs include a sudden pop followed by rapid bruising or swelling, a visible change in the muscle or tendon contour, marked loss of strength, significant numbness or tingling, or severe or worsening pain after trauma. Those findings may warrant prompt imaging or surgical evaluation.
Where is Performance Sport Care located?
Performance Sport Care is located at 1776 Ygnacio Valley Road, Suite 106, Walnut Creek, CA 94598. Call (925) 945-1155. We serve Walnut Creek, Lafayette, Danville, Concord, Pleasant Hill, and greater Contra Costa County.
The office is a short walk from John Muir Medical Center, next door to the Walnut Creek Tennis Club, and just steps from Heather Farm Park, with convenient on-site parking. Ygnacio Plaza and Sports Basement are directly across the street.
Don’t let elbow pain hold you back from the activities you love. Contact us today at (925) 945-1155 or click the Request An Appointment button to schedule a consultation. Experience how Performance Sport Care can transform your recovery journey with compassionate, effective, and expert care. Schedule your consultation today!