Mrs. P was a 49 year old female who presented with a 3 week history of constant right lateral elbow pain which was worsening in nature. This was the 3 major episode within a year of the same elbow pain and the worst so far. She had not previously sought out treatment and the pain usually resolved within a few days. When I met Mrs. P two things stuck me immediately; her kind compassionate persona and her inability to extend her arm to shake my hand. She tried to support her elbow with her left arm and I knew as her hand was limply placed in mine that a firm handshake was completely out of the question.