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 everything about treatment. Rest and anti-inflammatories may quiet the pain for a while, but they don’t rebuild what the tendon actually lost: capacity. That is why so many people feel better, return to their old routine, and flare right back up. At Performance Sport Care we diagnose precisely, then progressively restore the tendon’s ability to handle gripping, lifting, twisting and pressing — the loads that matter to your life. Focused evaluation. Definitive diagnosis. Targeted treatment and supervised strength rehabilitation, not spinal adjustments alone.
Why cortisone is rarely the answer. Corticosteroid injections can provide short-term relief, but the research consistently shows poorer long-term outcomes and higher recurrence compared with active, exercise-based care. We treat the mechanical cause rather than masking the signal — a deliberate contrast to adjustment-only chiropractic that never addresses tendon capacity.
Conditions We Treat
Elbow & Forearm Conditions We Resolve
We focus on the load-sensitive tendon and muscle conditions of the elbow and forearm — the ones that respond best to accurate diagnosis paired with supervised, progressive loading.
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, older and chemically-assisted 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
Most elbow rehab stops at wrist curls and bands. That’s a fine start, but it rarely reproduces the combined gripping, pressing, pulling and rotating that caused the problem — so people stall the moment they return to heavy or repetitive use. Our purpose-built strength-rehabilitation facility is designed to close exactly that gap.
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 the exact force vectors behind elbow and forearm pain: 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.
Precise diagnosis first
A thorough exam pinpoints the involved tissue and the loads that provoke it — structural, muscular or functional — so treatment is targeted rather than generic.
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.
◆Pro-Sports Diagnostic Depth
Led by Dr. Douglas Cancel, D.C., with 30+ years treating athletes and active adults. We diagnose the actual tissue and mechanism — not a vague “-itis.”
◆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. The large majority of elbow and forearm pain responds very well to the conservative care we provide. A smaller number of cases — for example a complete tendon rupture or significant nerve involvement — need imaging or a specialist, and we’ll identify that quickly and point you in the right direction. Either way, you leave your first visit with a clear answer about what’s wrong and what to do 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 precise diagnosis and a clear, evidence-based plan to rebuild your elbow for good.
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.
- Frydman A, Johnston RV, Smidt N, et al. Manual therapy and exercise for lateral elbow pain. Cochrane Database Syst Rev. 2018.
- Keogh JWL, Winwood PW. The epidemiology of injuries across the weight-training sports. Sports Med. 2017;47:479–501.
What conditions cause elbow pain that a chiropractor can treat?
Dr. Cancel treats tennis elbow (lateral epicondylalgia), golfer’s elbow (medial epicondylalgia), triceps tendinopathy,
biceps tendinopathy, repetitive forearm overuse pain, and general elbow joint irritation. These are typically caused by
repetitive strain, overload or a sudden spike in activity, and most respond very well to manual therapy and
progressive, supervised strengthening.
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 it’s not really inflammation, why does my tennis elbow keep coming back?
Persistent tennis elbow is usually a tendinopathy — stalled tendon repair and reduced load tolerance — not simple
inflammation. Rest, braces and cortisone can ease symptoms temporarily but don’t rebuild the tendon’s capacity, so
pain returns when you resume activity. Lasting recovery requires progressively restoring the tendon’s strength, which
is the core of our approach.
How long does it take to recover from tennis elbow or golfer’s elbow?
Many patients experience improvement of their symptoms within their first few treatment sessions. However, more
meaningful improvement in terms of load-related symptom reactivity requires a few weeks of active, supervised care.
Fuller recovery — in the form of symptom-free, pre-injury load-bearing capacity — may require a couple of months or
more. Timelines depend on how long the problem has been present, the load demands you’re returning to, the state
of tendon degeneration, if any, and how consistently your treatment plan is followed. Dr. Cancel gives you a realistic,
individualized timeline at your first visit.
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?
Yes. The large majority of elbow conditions — including tennis elbow, golfer’s elbow and tendinopathy — respond
very well to conservative care built around manual therapy and progressive loading. Surgery is rarely necessary
when the right rehab is followed. If your case ever needs imaging or a specialist, Dr. Cancel will identify that and
coordinate the referral
Do I need to stop training while being treated for elbow pain?
Usually not. Complete rest tends to weaken the tendon further. Dr. Cancel identifies which movements are safe to
keep, which to modify, and which to pause for now — then progressively reloads them. Staying active within tolerable
limits typically speeds recovery rather than slowing it down.
How do I know if my elbow pain is serious or could be a torn tendon?
Warning signs include a sudden ‘pop’ with rapid swelling or bruising, marked weakness, numbness or tingling, or pain
that’s severe and not improving. Triceps tendon tears, though uncommon, are more likely in heavier and chemically-assisted lifters. Dr. Cancel performs a thorough orthopedic exam and refers for imaging or surgical input
when the findings warrant it.
Where is Performance Sport Care located?
We’re located at 1776 Ygnacio Valley Road, Suite 106, Walnut Creek, CA 94598. We serve patients from Walnut
Creek, Concord, Pleasant Hill, Lafayette and surrounding East Bay communities.
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!