If you’ve been dealing with persistent pain on the inside of your elbow, especially when paddling, gripping your board, or doing other activities that load your forearm, you might be experiencing Surfer’s Elbow.
This condition is medically known as medial epicondylitis and involves irritation or degeneration of the tendons that attach to the inner elbow.

As a physiotherapist, I often work with surfers and active people who’ve had this pain for months, despite doing all the right things, rest, hands-on treatment, strengthening exercises, and load management yet they still aren’t getting the relief they hoped for.

So what’s next when conservative treatment hasn’t worked?

A recent 2024 clinical trial offers some helpful insights. It compared two regenerative treatment options that can support tendon healing when progress has stalled:
✔️ Platelet-Rich Plasma (PRP)
✔️ Extracorporeal Shockwave Therapy (ESWT)

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What Did the Study Look At?

The trial included 54 people with chronic medial epicondylitis (pain lasting more than 3 months). Participants received either:

• A single ultrasound-guided PRP injection, or
• Three weekly sessions of shockwave therapy (ESWT)

Researchers tracked pain and function over 24 weeks to see which treatment worked best.

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What Were the Results?

• Both PRP and ESWT helped reduce pain and improve elbow function
• PRP was more effective overall, with greater pain relief and improved use of the elbow at 12 and 24 weeks
• PRP’s benefits were longer-lasting, especially for people with stubborn symptoms

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Why Might PRP Work Better?

PRP uses your own blood platelets to promote tissue repair. By injecting concentrated platelets into the affected tendon, it helps stimulate:

• Collagen production
• Blood flow
• Tendon regeneration

ESWT, on the other hand, uses sound waves to trigger healing responses. It’s effective too—but often offers more short-term relief.

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What Does This Mean for You?

If you’ve had Surfer’s Elbow for more than 3 months and your symptoms aren’t resolving with standard physio care, PRP or shockwave therapy could be worth considering:

✔️ Choose PRP if you want longer-lasting results and are comfortable with injection-based therapy
✔️ Consider shockwave if you prefer a non-invasive option or want to trial another approach before considering injections

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Need Guidance?

These aren’t first-line treatments, but they can be helpful when the usual strategies haven’t worked. If you’re still struggling with elbow pain, talk to your physiotherapist or sports doctor. We’ll help you make an informed choice based on your symptoms, goals, and preferences.

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Reference:
Singh, S. A., Singh, A. J., Singh, Y. N., et al. (2024). Effectiveness of ultrasound-guided PRP injection vs ESWT in medial epicondylitis: A randomized controlled trial. International Journal of Advances in Medicine, 11(4), 338–343. Retrieved from Boston Sports & Biologics