Check the elbow's inside
My engine was overheating and the mechanic had a good idea why. He said those elbows often occlude completely preventing the exhaust water from exiting with enough volume. I could seem small amounts of steam coming out the exhaust by the sternWhen he pulled it, there was only a pin hole left open in the middle. If you haven't ever replaced it, or know that it has, it's a "must check" item. You need to pull it to check it, but it's worth it.