Re: Elk River, TN
I live in Huntsville, AL, and the Elk is the closest trout water to me. Don't expect a Hiwassee, Holston, Watauga type tailwater. The river is fairly narrow, and cannot be fished if TVA is generating any water. When the water is off, there are a few good runs that can be worked, but nothing in the sense of classic trout water.
The main public access points are at the Dam at Tim's Ford, Ferris Creek Bridge, and Old Dam Ford. Most of my success has come at the dam, probably because that's where most of the fish are stocked. There's a bridge that crosses the river at the dam, maybe Hiway 53? below the bridge is a gravel bar with about a 100 yard pool. People stack up on this bar and it gets lots of pressure. If you walk down the river about 1/4 mile, you will come to a big turn hole in the river. It's deep and generally holds better fish. After you go around the turn, the river rapidly becomes deep and difficult to fish.
Do a search on Google for Tim's Flies and Lies. This is a fly shop in Lynchburg. He posts a fishing report every month or so.
In my limited experience, two flies have been the biggest producer: (1) olive woooly bugger; and, (2) small (size 22 or smaller) midges. I've caught plenty of fish on other flies, but these have been the best producers.
I once paddled from the dam to Ferris Creek Bridge. At points the water was very still, very deep and very clear. We could see some nice size trout as we paddled over them.
Good luck and let me know how you do.