Hey guys, I'm coming up to my mid 30's and for the past year I have been getting really bad pain in my right elbow after being in the water for about an hour and a half it really sucks because if the waves are good I just can't stay out any longer because it's really hard to paddle. Does anyone else get this and if so how do you manage it? Lately I have been dosing up on anti inflammatorys and that seems to help.
Look forward to any advice??

Go see a doctor. May just be some tendinitis. Rest, vigorous massage. Strengthening exercises. Then again it may be something more serious and all that just makes it worse.

What the physio say?

Maybe change hands?

Yeah I paddle harder with my left arm haha, will decently go hit up the doctor about it and see what he reckons.

I had exactly the same issue last year. I had some dry needling in my shoulder, forearm and then then the prominent muscle on the outside of the elbow and this seemed to work. They just said that is was due to a poor paddling style where I was putting pressure on my elbow and not through my back and shoulders.

Told me to [paddle with my fingers slightly spread rather than cupped to release the pressure off the elbow and engage other muscle groups. Touch wood I've had no issue since.

Might be worth while asking a physio or osteopath and see if its a similar fix.