Dugal , that would sound plausible , along with the other highly credentialled arguments alluding to protein and cartilage breakdown, presence of chemical irritants etc etc , what I'm saying is however that in the period during which I have managed so called LE, ( more than twenty years ) since I stopped treating the elbow and became alert to the neuralgic events , my success rate with this otherwise perplexing issue has risen to near 100 percent . All without touching the elbow at all. One to three treatments, all to the relevant facet behaviour, some to dural length if indicated, but esssentially no exercise at all . Results are immediate, at the time of treatment, prove to be very long term ( years ) and able to be learned by anyone with the willingness to think beyond pathology and become alert to neurology and its relationship to hypomobile Wikipedia reference-linkfacet joints.