If you love fishing, you might have heard of “fishing elbow.” It’s a common problem that causes pain on the outside (or sometimes inside) of your elbow, similar to tennis elbow. Doctors call it lateral epicondylitis (or medial epicondylitis). It happens when you do the same arm motions over and over, like casting or reeling in a fish. People can also get this with other sports, or in jobs like construction. These movements can cause tiny tears in the tendons that connect your forearm muscles to your elbow bone. This makes your elbow hurt, feel tender, and can even weaken your grip, making fishing less fun and super painful. I ended two tournaments early because the pain got too intense.

I’ve had this condition since about August of 2024 and have been trying to rehab it without success. Haven’t fished since the very beginning of October to rest it and doing home physical therapy, but it hasn’t worked.

Usually, rest, ice, physical therapy, and wearing a brace can help, according to the internet. After a cortisone shot, that didn’t work, my doctor recommended needle tenotomy. I very recently underwent this procedure and am healing up and then will begin rehab. I’m hopeful to be ready in time for the 2025 tournament season – but that’s not guaranteed. Because it has been a pain, literally, for me…I wanted to share more about this procedure with other anglers.

What’s Needle Tenotomy?

Needle tenotomy (also called dry needling or percutaneous tenotomy) is a procedure that helps damaged tendons heal. Instead of cutting you open like in surgery, doctors use a needle to fix the problem. Here’s how it works:

• Starts Healing: The needle makes tiny, controlled injuries in the hurt tendon to create damage and bleeding. This tells your body to start healing itself and build new, stronger tendon tissue.
• Breaks Down Scar Tissue: When your elbow hurts for a long time, scar tissue can build up in the tendon. This scar tissue makes it hard for the tendon to work right and causes more pain. The needle helps break down this scar tissue so blood can flow better and the tendon can heal.
• Relaxes Muscles: Sometimes, tight muscles around your elbow can make the pain worse. The needle can help relax these muscles, taking pressure off the tendon. Too early to tell if this was a problem for me that was fixed, but I suspect so.

What Happens During the Procedure?

Needle tenotomy is done in a doctor’s office, I had it done by my orthopedic doctor. Here’s what to expect with a procedure:

1. Numbing the Area: The doctor numbs your elbow with a shot so you don’t feel much. Ha! This was pretty painful for me, the worst part of the procedure.
2. Inserting the Needle: Using a special ultrasound machine to see exactly where to go, the doctor puts a thin needle into the damaged tendon.
3. Making Tiny Punctures: The doctor moves the needle around to make lots of tiny holes in the tendon. This is what starts the healing process. Oddly, it didn’t hurt but I could feel the needle scraping or whatever against tendons…felt crazy weird.
4. Putting on a Bandage: After, they just put a small bandage on the spot where the needle went in and that was able to come off the next day.

The whole thing only takes a few minutes.

What Happens After?

Your elbow might be a little sore and bruised where the needle went in. Your doctor will tell you what to do, which might include:

• Resting Your Arm: Not doing anything too hard with your arm for a few days.
• Using Ice: Putting ice packs on your elbow to help with swelling and pain.
• Taking Pain Medicine: You can take over-the-counter pain medicine if you need it.
• Physical Therapy: You might have to do some exercises with a physical therapist to make your elbow stronger and more flexible.

Most people feel a lot better within a few weeks, but it can take a few months for the tendon to completely heal. For me, I wore a sling for a day to rest the arm and to keep myself from doing anything stupid by accident. Then i started working out the soreness but being very careful. Definitely had some pain as the Lidocaine wore off.

Is This Right for You?

If you have really bad “fishing elbow” that hasn’t gotten better with other treatments, needle tenotomy might be an option. You need to talk to your doctor to see if it’s right for you – I AM NOT A DOCTOR, AND NOT YOUR DOCTOR. They’ll check your elbow and ask you questions to decide. My doctor recommended this approach over another solution called platelet-rich plasma (PRP) is an option, another angler recapped his experience with PRP here. I chose the tenotomy because it was covered more by insurance and the doc recommended it for what he was seeing in my ultrasound.

Good Things About Needle Tenotomy:

• Not a big surgery
• Doesn’t take long
• Done in a doctor’s office
• Quicker recovery than surgery (anywhere from 4-8 weeks)
• Can really help with pain

Possible Problems:

• Pain and bruising where the needle went in (Yes!)
• Infection
• Damage to nerves or blood vessels

A detailed article about the needle tenotomy procedure can give you more specific information on how the procedure is executed.

The Bottom Line:

Needle tenotomy may be an option for people with long-lasting “fishing elbow.” It helps the body heal itself and can make the pain go away so you can get back to fishing. At this point I haven’t fully recovered from the procedure and will do a follow up in a few weeks to share how it went.

Important: This article is just for information. Always talk to a doctor before making any decisions about your health.