The summer injury pattern we see every year in NYC
Try something before you read another word.
Reach your arm out in front of you. Imagine you’re opening a stubborn pickle jar. Give it a little twist. Now picture carrying a golf bag from the trunk to the first tee. A backhand in tennis. A pickleball serve. Shaking someone’s hand. Pouring a pot of coffee.
Did your elbow answer before your brain did?
Maybe it wasn’t a sharp pain. Maybe it was just enough to make you think — huh, you’re still here.
If that’s you, stay with me. Because today isn’t really about elbows. It’s about why one body part sometimes ends up doing everyone else’s work — and what to do about it.
Why Summer Is Elbow Season in New York City
Every summer, almost like clockwork, it starts. Not because something magical happens to elbows in July. Because something magical happens to New Yorkers.
We finally come back outside.
After months of freezing on street corners, walking across avenues with our shoulders up around our ears, wondering if spring was ever going to show up — summer kicks the front door off the hinges. Golf invitations, pickleball leagues, tennis courts, weekend tournaments, long bike rides. Everyone runs outside like third graders racing to recess.
I love that. Movement is worth celebrating.
But every July, my schedule starts telling the same story. And a couple of weeks ago, a recreational tennis player walked into the clinic, tennis racket sticking out of his backpack, and told me he’d looked it up online. “Apparently I have golfer’s elbow.”
I looked at the racket. I looked at him. And quietly smiled — because medicine hasn’t exactly done us any favors with these names.
He looked genuinely confused. “I’ve never golfed.”
Which led to a much more interesting conversation. Not about golfer’s elbow or tennis elbow. About why his elbow had quietly become the busiest employee in the building.
The Naming Problem
Let’s clear this up first, because almost everyone gets it wrong.
Tennis elbow and golfer’s elbow sound incredibly specific — like one belongs to tennis players and the other to golfers. Except they don’t. I’ve treated golfers with tennis elbow, tennis players with golfer’s elbow, CrossFit athletes with both, and office workers who’ve never held a racket in their lives.
So if the names don’t tell us who gets them, what do they tell us?
They describe where the irritated tendon lives. That’s it. Not who caused it, not which sport is responsible. Just geography. Tennis elbow lives on the outside of the elbow — lateral epicondylitis in clinical terms, which isn’t exactly winning any popularity contests. Golfer’s elbow lives on the inside — medial epicondylitis. The names made the diagnoses easier to remember. Unfortunately, they also send a lot of people looking in the wrong direction.
Here’s what the names don’t explain: why does opening a pickle jar hurt? That’s not tennis. Why does carrying groceries make you wince? That’s not golf. Why does shaking someone’s hand feel like you’ve just played five sets at the US Open? And why do I see so many of these cases every single summer in New York City?
The Preparation Problem
Here’s where things start to make sense.
New Yorkers survive winter. Spring barely introduces itself. And then summer arrives like a 300-piece marching band rolling down Fifth Avenue. We go from almost nothing to 18 holes on Friday, pickleball Saturday morning, tennis
Sunday afternoon, and maybe another round on Monday because the weather is perfect and the group chat said so.
Meanwhile, your tendons are still thawing out. Your enthusiasm came back in June. But your tissues are still hanging out somewhere in April.
This didn’t happen because you played golf or tennis or pickleball. It happened because your first weekend looked like your 20th. That’s a preparation problem, not a participation problem.
The Overworked Employee
Now let’s zoom out — because this is where the real story lives.
Think about a small office. Everybody has a job. Sales, accounting, shipping, customer service. Things run smoothly. Then someone stops contributing. Your shoulder gets stiff. Your upper back locks up. Your core takes an extended PTO. Your hips stop rotating quite as well as they used to.
Nobody announces it. Nobody sends a company-wide email. The elbow just quietly starts picking up the slack — answering the phones, packing the boxes, rating customers, running payroll. “I’ve got it, I’ve got it, I’ve got it” — until one day, it doesn’t.
This is why when someone comes into my clinic with elbow pain, I’m rarely looking at just the elbow. I’m looking at how they rotate, how they reach, how they grip, how they generate force, and how they transfer force through the chain. Because your body doesn’t care what hurts. It cares how you move.
Think about a baseball batter stepping into the box. If he tries to hit a fastball using only his arms, the bat still moves — but those smaller muscles around the forearm and elbow have to generate almost all of the force. Now add the hips providing the power, the trunk rotating, the core connecting and transferring that energy forward, the shoulder blade gliding. Suddenly the bat moves faster and with far more power. Same bat, same hitter. The whole team showed up.
That’s what your elbow wants. Teammates.
What Tendons Actually Need
Tendons have earned a bad reputation they don’t deserve. I think of them like the shock absorbers in a car — incredibly strong, built to absorb force, store energy, and release it over and over again. That’s why you can swing a racket or hit a golf ball thousands of times across a lifetime.
But they’re slow learners. Muscles adapt quickly. The heart and lungs adapt fairly quickly. Tendons take their time. And they don’t hate activity. They hate surprises. Ask them to gradually do more, give them time to adapt, and they’ll usually rise to the occasion. Ask them to go from winter hibernation to three hours of pickleball because your friend texted on a beautiful day — that’s a different conversation. Your tendons aren’t punishing you. They’re simply saying: I’m not ready for that yet.
One of the most common myths I encounter: “I just need to stretch it.” I understand the instinct. Stretching feels productive, like you’re doing something. But you can’t stretch away tissue that isn’t tolerating load. That’s like trying to fix worn-out brakes by washing the car.
What tendons respond to is progressive loading — the right amount at the right time, repeated consistently. That’s how they remodel. That’s how they become resilient again. For stubborn cases that aren’t responding the way we’d expect, Shockwave therapy can become a valuable part of the conversation — not because it’s magic, and not because it replaces exercise. But the research over the past several years has become increasingly encouraging. When we combine progressive strength training with Shockwave therapy, we can often create an environment that helps stubborn tendons restart the remodeling process. In my clinic, it’s never either/or. It’s both — helping the tissue calm down while simultaneously teaching it to tolerate life again.
3 Things You Can Start This Week
Adjust the dose — don’t stop. Nine holes instead of eighteen. One pickleball match instead of six. A shorter tennis session before the weekend tournament. Your goal isn’t to prove how much you can tolerate today. It’s to build what you can tolerate next month. Meet your tissues where they are.
Warm up the whole team, not just your wrist. A few minutes of shoulder movement, some upper back rotation, wake up the hips, get the core involved. A handful of practice swings before the first real one. Remember — we’re hiring the staff back. Your elbow shouldn’t be running the entire office by itself.
Train your grip for life, not just sport. Carry the groceries instead of making two trips. Farmer carries. Controlled wrist strengthening. Dead hangs if they’re appropriate for you. Tendons don’t become resilient by being protected forever. They become resilient by being challenged gradually, consistently, over time.
And if your elbow is still quietly saying “hey, I’m still here” — don’t ignore it. That’s not weakness. That’s information.
What We’re Really Protecting
Very few people walk into my clinic worried about an elbow. They’re worried about the Saturday morning doubles match. The annual golf trip. Beating their son at pickleball. Carrying their granddaughter’s suitcase through the airport. Helping someone move without wondering if they’ll pay for it tomorrow. Looking outside on a perfect summer morning and saying — yeah, I’m in.
That’s what we’re really protecting. Capability. The freedom to keep saying yes.
The goal isn’t to avoid getting older. The goal is to become the kind of person who keeps showing up for life because they’re prepared for it. Not perfectly. Just consistently.
Your body doesn’t need perfection. It needs practice. Your elbow isn’t asking you to stop playing. It’s asking you to prepare like the athlete you are.
This content is from Episode 18 of Cue The Burn — listen to the full episode wherever you get your podcasts.
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