• Over 1.3% of the general population suffer with elbow pain
• More than 15% of these are amongst activity specific groups
• About 7 in every 1000 GP visits are in regards to elbow pain
• There are 26 different lesions described and over 19 sources of pain in this area
What can cause elbow pain?
• Lack of strength or flexibility in the forearm muscles
• Lack of strength in the shoulder muscles
• Instability of the elbow joint
• Poor technique and overuse during sporting activities that put too much strain on the elbow joint
• Inappropriate sporting equipment, such as using a heavy tennis racquet or having the wrong sized grip on a tennis racquet or golf club
• Repetitive movements of the hands and arms, such as gardening, painting, using computer mouse, lifting, carrying
• Other factors such as neck symptoms or nerve irritation
Two common elbow complaints are ‘tennis elbow’ (lateral epicondylitis) and ‘golfers elbow’ (medial epicondylitis). They typically result from overuse of the elbow.
Tennis elbow is classified as pain on the outside of the elbow joint, and caused by overuse of the forearm muscles involved in gripping, extending the wrist and extending the elbow (the backhand motion in tennis). Golfers elbow presents as pain on the inside of the elbow, and is caused by overuse of the forearm muscles involved in gripping, flexing the wrist and flexing the elbow (golf swing).
The tendon which attaches the muscles to the bone is damaged and can develop micro-tears. There is a poor blood supply to this area so it can take a long time to heal.
Symptoms can include:
• Elbow pain on the outside or inside of the elbow, possibly radiating down the forearm to the wrist
• Elbow pain with lifting or bending the arm, gripping or activities such as lifting a cup, opening a door or turning a tap as well as during rest
• Weakness in the wrist
• Difficulty straightening the arm
• Occasionally swelling and sensation changes around the elbow
What a physiotherapist can do?
• Treatment may include ice and anti-inflammatory measures to decrease pain and swelling, soft tissue release techniques to the forearm muscles as well as specific strengthening exercises to stimulate healing. Dosages of these exercises in combination with resting periods are crucial during recovery and are guided by your Physiotherapist.
Other physiotherapy techniques such as mobilisation, taping, dry needling, stretching, ultrasound and nerve stretches may also be used.
An elbow strap for tennis/golfers elbow can be very helpful to offload the tendon attachment and allow healing to occur.
Your Physiotherapist will be able to guide you through graded exposure back into previously aggravating activities whilst avoiding exacerbation during and after exercise. Regular reviews will facilitate maintenance of correct form and posture during exercises which will then be progressed as tolerated until best recovery is reached.
• Always warm up and cool down thoroughly when playing sport
• Make sure you use good technique and proper equipment when playing your chosen sports and other activities
• Do strengthening exercises with hand weights – your physiotherapist can prescribe the correct exercises for you
• Regularly stretch relevant muscles before beginning any potentially stressful activity. Your physiotherapist can prescribe the correct exercises for you.
• Avoid or modify work tasks that put excessive pressure on muscles of the forearm or that include the use of fingers, wrists and forearms in repetitive work involving forceful movement, awkward postures and lack of rest.
Elbow pain is a very common injury that is seen on a day to day basis by Physica Physiotherapists. Please call to make an appointment with your physiotherapist to have your elbow pain accurately diagnosed and treated