Elbow
Elbow Pain and Injuries
Elbow your pain! Get back to doing what you enjoy! Address it now!
What is the elbow?
The elbow is a hinged joint made up of three bones, the humerus, ulna, and radius. The ends of the bones are covered with cartilage and held together with ligaments that form the joint capsule, while tendons connect your bones to muscles to allow you to move your arm in different ways.
We use our elbows extensively in daily life, such as activities that involve throwing, lifting and swinging. Elbow injuries/pain often occur from trauma (e.g. sporting injuries, road traffic accidents, breaking a fall with an outstretched hand). These high energy injuries can result in fractures, dislocations and sprains/strains of the elbow. On the other hand, the elbow is also prone to wear and tear over time from repetitive overuse, causing injuries such as inflamed tendons (i.e. tennis/golfer’s elbow). Certain medical conditions such as arthritis and lupus can cause pain and swelling over the elbow as well.
Elbow pain can happen to anyone — whether you’re very sedentary, very active or somewhere in between. But your risk may be increased by participating in contact sports, doing repetitive work and carrying heavy loads. Here are some common causes of elbow pain that require prompt medical attention and care.
A well-functioning elbow is essential for upper limb use in sports. Elbow injuries may even interfere with an athlete’s everyday activities. Tennis was the classic cause of elbow pain, but the double-handed backhand has reduced the prevalence of ‘tennis elbow’ dramatically. Elbow pain remains a problem in golf and in sports such as volleyball and handball, which involve forceful elbow hyperextension.
Common Elbow Injuries & Causes of Elbow Pain
The outer side of the elbow is the most common site of elbow pain. Some diagnoses that should be considered are lateral elbow tendinopathy i.e. tennis elbow, referred pain from the neck or upper back, synovitis of the radiohumeral joint, radiohumeral bursitis, osteochondritis dissecans of the capitellum and radius, posterolateral elbow instability or a combinations of these problems
Referred pain from the neck i.e. cervical radicular pain (nerve dysfunction or irritation)
Nerve dysfunction refers to either an inflamed or irritated nerve in the spine. Injuries often cause radiculopathy or radicular pain, but it can often occur without cause. Symptoms can include numbness or weakness in the arm and hand, pain running down your arm, a tingling sensation in your arm, and pain after long periods of being sedentary, looking arm or just by turning your neck.
Sometimes, this may present as pain in the outer aspect of your arm when you move your neck in a particular direction.
Golfer's elbow a.k.a flexor/pronator tendinopathy
This condition is not as common as its lateral equivalent, accounting for 9–20% of all epicondylalgia diagnoses.56 It is seen especially in golfers (‘golfer’s elbow’) and in tennis players who use a lot of topspin on their forehand. The pain occurs on the inner aspect of the elbow.
Tennis elbow a.k.a lateral epicondylalgia
Manual tasks that require wrist stabilisation, such as gripping, wringing a towel, or that require wrist extension movements, place considerable load on the extensor tendon. The highest stresses occur in this tendon is when the elbow is straighten and the forearm turned to face down — the most provocative position to reproduce your pain.
Rehabilitation & Exercise Programme for Elbow Pain
At The Rehab Centre, we do not believe in stop-gap solutions to treat your pain and we don’t take shortcuts. After we’ve assessed your symptoms and uncovered the root problem, we’ll put together a customised rehabilitation programme just for you.
As you might have read above, the cause of your elbow pain could be due to a myraid of reasons. Is the pain coming from your elbow or is your elbow pain a result of referred pain from your neck? Understand the source of the pain is important as this will allow your Physiotherapist to prescribe specific exercises to address your concerns.
A typical session with your Physiotherapist might look like a time of understanding your pain, having a thorough assessment of your neck and elbow and after, prescribing specific exercises that will address your concerns.
Electrotherapeutic modalities such as laser, extracorporeal shockwave therapy (ESWT), TENS and ultrasound are often used for these conditions despite mixed evidence on their effectiveness. However, specific manual therapy applied to the joints or soft tissues of the elbow and forearm is beneficial for tennis elbow pain. There is evidence of benefit with elbow mobilisation with movement, in combination with exercise, and with the addition of cervical and thoracic spine treatment to elbow treatment.
Look no further! Allow our Physiotherapists to deploy effective preventative and management strategies to assist and empower you to reduce the incidence, recurrence and consequent burden of your elbow pain!
Common Treatments for Elbow Pain
Here are some common treatments and rehabilitation approaches might use for your elbow pain:
Golfer's Elbow
If you are experiencing pain from a Golfer’s elbow, we focus our rehabilitation programmes on:
- Education. We want to help you understand how you might have sustained the injury and how the exercise you will be prescribed will help address your pains.
- Assurance. Our bodies are resilient. It is imperative that you understand what brought you to us, learn it and be assured that it will get better. Trust the process.
- Manual Therapy. Manual therapy can include massage or joint / soft tissue mobilizations. It can help relieve stiffness and improve range of motion. It may be used in conjuction with a series of exercises that will be prescribed.
- Electrotherapeutic Agents. Agents like TENS (transcutaneous electrical nerve stimulation) may be used but with caution since there are mixed evidence on their effectiveness.
- Gradual Movement within Comfort Levels. We’ll slowly introduce gradual movements and exercises within your level of comfort to get your elbow back to 100%, or as close as possible.
- Return to Activity. Our ultimate goal is to get you back to the daily and extracurricular activities you love – pain free.
Tennis Elbow
Tennis elbow can be a result of a sudden overuse or trauma. If you’re experiencing pain from a tennis elbow, we aim to:
- Advise & educate. We want to help you understand how you might have sustained the injury and how the exercise you will be prescribed will help address your pains. Helping you understand that a certain activity might have cause the extensor tendon to be overloaded and hence cause pain.
- Assurance. Our bodies are resilient. It is imperative that you understand what brought you to us, learn it and be assured that it will get better. Trust the process.
- Manual Therapy. Manual therapy can include massage or joint / soft tissue mobilizations. It can help relieve stiffness and improve range of motion. It may be used in conjuction with a series of exercises that will be prescribed. As mentioned above, your therapist may choose to utilise mobilisation with movement which has been shown to be effective when used in conjunction with exercises.
- Electrotherapeutic Agents. Agents like TENS (transcutaneous electrical nerve stimulation) may be used but with caution since there are mixed evidence on their effectiveness.
- Gradual Movement within Comfort Levels. We’ll slowly introduce gradual movements and exercises within your level of comfort to get your elbow back to 100%, or as close as possible.
- Return to Activity. Our ultimate goal is to get you back to the daily and extracurricular activities you love – pain free.
Grip strength test
Grip strength test by hand therapist at The Rehab Centre
Wrist strengthening
Wrist strengthening by hand therapist at The Rehab Centre
Shoulder flexion with weights
