A persistent neck ailment turned into a bulging disc while Elliot was playing for the New Zealand Maori in Canada, and he briefly lost feeling from the chest down.
Surgery to repair two vertebrae involved fusing a piece of his hip bone to his neck and left Elliot facing a lengthy lay-off and a mental battle before he could again pack down in the scrum.
But the former All Black overcame both challenges and will take his place at QBE Stadium tomorrow, an occasion bound to be moving for the Chiefs' player and coaches alike.
"Isn't it a great story?" said assistant coach Andrew Strawbridge. "When he ran out for his first trial game [against the Waratahs last weekend] he was really emotional, and I imagine it's going to be exactly the same.
"It's emotional for all of us and it's wonderful to have him back. He's a wonderful man and has worn this jersey proudly for a long time. It's a bonus for us to have him back."
That final point is salient for the Chiefs' title chances. Hooker was something of a problem position for Dave Rennie's side last season, when three men played more than 400 minutes but none truly nailed down the No 2 jersey.
Mahonri Schwalger led the way, playing in 13 games. Nathan Harris (12) showed enough promise to earn an All Blacks call-up and Rhys Marshall (9) rounded out the trio.
Schwalger's retirement combined with Harris' long-term injury - suffered while he was away on international duty - opened the door for Elliot's return, although Marshall and new recruit Quentin MacDonald also battled for game time.
Elliot won that initial battle and, while his steady hand should help allay the lineout woes that plagued the Chiefs' previous campaign, the hooker's character appears to be another valuable addition.
"I think Hika would readily admit that he's matured a lot," Strawbridge said. "You get confronted by these sorts of things in life and you're forced to take stock and you're forced to think about what your priorities are.
"Also, I imagine you can see how quickly your rugby career could be over. He's become a far more balanced character, I believe, and I'd say it's been a significant part of growing up for him."