The elbow joint is a commonly injured area especially among sportspeople and manual workers.
The most common cause of elbow pain is overuse with tasks of repetitive nature (e.g. racquet sports, throwing, weight lifting, repetitive use of screw driver to name a few!).
Tendons, ligaments and muscles work synergistically around the elbow to allow functional movement, however when subjected to repetitive stress with without adequate time for the tissues to rest and heal, irritation and pain and manifest.
Common injuries in the elbow include:
- Tennis elbow (Lateral Epicondylalgia)
- Golfer’s elbow
- Osteoarthritis
- Nerve entrapment (radial nerve)
- Ligament sprain (ulnar collateral ligament)
- Radiohumeral bursitis
- Referred pain from the cervical spine
Overuse injuries represent a large proportion of elbow injuries with Tennis elbow being the most common presentation we treat at the clinic.
Despite the name, this injury can occur as a result of a range of physical activities – racquet sports, rowing, weight lifting, hockey as well as repetitive work tasks throughout various occupations.
Clinical symptoms include diffuse pain which radiates from the lateral aspect of the elbow (common extensor origin), as shown in the image below), into the forearm extensor muscle mass.
Occasionally the pain may be more localised.
The onset of pain may be either acute or insidious over a period of time.
It is often revealed on examination that there is a change in training/work load and frequency or changes in use of equipment in sports or work.
The severity of pain ranges from trivial to incapacitating pain that may keep you up at night.
Certain movements, usually those involving extension of the wrist or gripping will aggravate pain.
Common causes of elbow overuse injuries:
- Poor technique during sporting activity putting excessive strain on the elbow joint
- Inappropriate equipment (i.e. heavy racquet or small grip)
- Rapid changes in training/work load
- Lack of strength or flexibility in the forearm muscles
- Lack of strength or flexibility in the shoulder muscles resulting in overload to the elbow
- Other factors such as neck symptoms or nerve irritation
The management of overuse injuries often involve consideration of many factors which may have contributed to the elbow pain.
These may include:
- Relevant biomechanics and technique during sports/work to reduced strain on elbow
- Progressive strengthening of the muscles and tendons in the elbow through a gym/home based exercise program (respecting tendon pathology). From a muscle restoration and conditioning perspective, wrist eccentric extension, forearm pronation and supination, and looking proximally at the biceps/triceps and shoulder muscles are all important to consider.
- Addressing contributing factors such as neck pain or nerve tightness
- Effective load management (sports/work)
- Soft tissue techniques to improve flexibility of the muscles surrounding the elbow
- Taping/bracing to off the injured structures in the elbow
At myPhysioSA we are skilled at treating overuse injuries of the elbow and have a particular emphasis on long-term solutions.
We evaluate and consider all factors which may be causing your elbow pain and provide a detailed rehab plan for your recovery.
Kevin Doan, myPhysioSA & SANFL Physiotherapist
