Dr. O'Donnell treats elbow injuries in throwers, lifters, racquet-sport players and working adults: tennis and golfer's elbow, distal biceps and distal triceps ruptures, UCL injuries in baseball and softball players, cubital tunnel syndrome, olecranon and distal humerus fractures, and elbow arthritis. Patients come from University of Miami teams and from Coral Gables and Miami workplaces where gripping, lifting and typing have made the elbow painful.
Most elbow problems are treated without surgery, and the treatment is specific. Epicondylitis follows a 12-week eccentric loading program, not a cortisone injection, which relieves pain briefly and weakens the tendon. Low-grade UCL tears are rested from throwing for 6 to 12 weeks while the shoulder, hip and core are strengthened, with an ultrasound-guided PRP injection offered for partial tears. Cubital tunnel syndrome starts with a night splint that keeps the elbow straight and changes to how the arm rests during the day. The exceptions are the injuries that do not heal in place: a complete distal biceps or triceps rupture is repaired within 2 to 3 weeks, and a displaced fracture is fixed within days. When surgery is needed, Dr. O'Donnell uses the smallest approach that does the job, including arthroscopic release for lateral epicondylitis and internal-brace repair for suitable UCL tears.
After surgery, motion, bracing and loading follow Dr. O'Donnell's written protocols for each operation, with lifting and throwing restrictions lifted on criteria. Procedures are outpatient at Bayside Surgery Center; out-of-town patients can send imaging through mymedicalimages.com and use telemedicine consults and post-operative visits.
When to see a specialist
Elbow pain from a weekend of tennis or a new lifting program usually improves within two to three weeks of relative rest. See a specialist promptly for any of the following:
- A pop at the front or back of the elbow during a lift or a fall, followed by weakness turning the palm up or straightening the arm
- A change in the shape of the upper arm muscle after that pop
- Inability to fully straighten or bend the elbow after an injury, or a visibly deformed or swollen elbow
- Numbness or tingling in the ring and little fingers, or weakness of grip and pinch
- Inner elbow pain during throwing, loss of velocity or control, or tingling into the hand while pitching
- Outer or inner elbow pain that has not improved after 6 weeks of rest and a brace
How Dr. O'Donnell decides between rehab and surgery
Two questions decide treatment: does the injured structure heal on its own, and how much does the patient need from that arm. A complete distal biceps tear does not reattach, so in anyone who lifts, works with their hands or plays sport it is repaired, and the timing is set by the tissue: within 2 to 3 weeks the tendon reaches bone without tension; after 6 to 8 weeks a graft may be needed. The same logic applies to a complete distal triceps tear. Non-operative care for these is a deliberate choice to accept the strength loss, reasonable for low demand on a non-dominant arm.
Overuse conditions go the other way. Tennis and golfer's elbow improve in most patients with 12 weeks of eccentric loading, and release surgery is offered only after 6 to 12 months of correct treatment, including a PRP injection, has failed. A UCL injury is graded on MRI: low-grade partial tears are rested and rehabilitated; a complete or mid-substance tear in a thrower who wants to keep pitching is reconstructed, and an avulsion with healthy tissue in a younger athlete can be repaired with an internal brace, which recovers faster.
Elbow conditions we treat 8
Elbow procedures 5
Rehabilitation protocols
Dr. O'Donnell's written physical therapy protocols for this joint, shared with your therapist and progressed on criteria rather than dates.
Frequently asked questions
Does a distal biceps tear need surgery?
A complete tear does not reattach on its own and leaves about 40% less supination strength and some flexion weakness. For anyone who lifts, does manual work or plays sport, repair is recommended, ideally within 2 to 3 weeks. Partial tears involving less than about half the tendon are rested and rehabilitated first. Same-week appointments are kept for this injury because the window matters.
Will a cortisone shot fix my tennis elbow?
It relieves pain for a few weeks, but patients who receive it do worse at 6 and 12 months than those who do not, and repeat injections weaken the tendon. The treatment that works is a 12-week eccentric loading program with a counterforce brace. For a tendon still painful at 3 to 6 months, an ultrasound-guided PRP injection is offered; release surgery is reserved for the small group who fail that.
How do I know if my elbow pain is a UCL injury?
Inner elbow pain that builds during throwing, loss of velocity or control, and sometimes tingling into the ring and little fingers are the typical pattern. In clinic, the moving valgus stress test reproduces the pain, and an MRI, ideally with contrast, grades the tear. Low-grade tears are rested for 6 to 12 weeks; complete tears in throwers are treated with repair or reconstruction.
Can I be seen the same week after an elbow injury?
Yes. Same-week appointments are held for acute elbow injuries, and any suspected tendon rupture or fracture is seen within days. If you have been to an emergency department, bring the X-rays or upload them through mymedicalimages.com. The hook test for a biceps rupture and an X-ray for a fracture are done at the first visit, and an MRI is arranged the same week when it would change the plan.
