The elbow is straightforward to assess and easy to get wrong, because pain there is not always from there.
What I test: resisted wrist extension and grip for tennis elbow, resisted wrist flexion for golfer\u{2019}s, and palpation of the exact attachment point. Then the neck, because C6 and C7 refer to this area and a proportion of "tennis elbow" that has not responded to anything is coming from the neck. Then the shoulder blade and shoulder, because the whole arm chain loads through the elbow.
I also check for the things that are not tendon: a hot swollen joint, which needs a doctor; locking or catching, which suggests something inside the joint; numbness or weakness in the hand, which points at a nerve; and a specific tearing incident, which is a different injury.
What I then prescribe is loading, and I write it down: which exercise, how many, how often, how uncomfortable it is allowed to be, and when it increases. Most days for months. That is the treatment. Needling and manual work are what I use to make it tolerable and to get someone through a working week, and I say that rather than implying the needles are doing the repair.
Then the cause: grip, tool, desk, racquet, and what changed in the weeks before onset. If nothing changes there, it comes back. The clinic is in Lane Cove, opposite the library, and I re-test at four weeks rather than asking how it feels.
