Elbow Pain: Hurting your funny bone isn't quite so humerus!

Welcome to Back2Front's latest blog by Ruth Bowe, our Senior Physiotherapist, where we dive into the intricate world of elbow pain. Whether you're an athlete, office worker, or fitness enthusiast, elbow discomfort can be a persistent challenge. In this insightful guide, we'll explore the common causes behind that nagging pain, share expert tips on prevention, and unveil effective strategies for recovery.

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Who experiences Elbow injuries?

Absolutely anyone can suffer from an elbow injury! Elbow pain can begin due to a chronic overload involving the tendons surrounding your elbow or due to an acute traumatic injury which can involve the bones, cartilage, tendon and ligament structures surrounding your elbow.

Types of Elbow Injuries:

·      Tennis Elbow (also known as Lateral Epicondylitis)

Tennis elbow is caused by an overload of the tendon on the outside of the elbow (extensor carpi radialis brevis if we want to get technical) resulting in a sharp pain and inflammation on the outside of the elbow. It is most diagnosed between the ages of 30- 60 years old with both men and women being equally affected. It is caused by repetitive gripping, with your hand in a raised and slightly twisted position (such as the wrist position when typing on a laptop). It gets it's name because of how a tennis player grips their racket but it is certainly not limited to just tennis players.

·       Golfers or Baseballers Elbow (Also Known as Medial Epicondylitis)

Golfers Elbow is also caused by an overload of the tendon (common flexor tendons to be technical) on the inside of the elbow resulting in symptoms of sharp pain and inflammation on the inside of the elbow. Again, this can affect people between the ages of 30-60 with men and women equally affected. It results from repetitive wrist flexion movements like when a golfer swings their golf club but anyone who takes part in similar movement patterns are also at risk such as anyone who has hobbies such as writing, painting or gamers. Other individuals who are at risk may be because of their current job, a factory worker who twists handles tightly or anyone who works in a manual job or using machinery with controllers.

·       Elbow Strains and Sprains

An elbow strain is an injury to the muscles or tendon of the elbow where as an elbow sprain is an injury to the ligaments of the elbow. The most common ligament injury is to the ulnar collateral ligament on the inside of the elbow. This may lead to instability of the medial elbow joint. Common movement patterns that make you more prone to sustaining an elbow sprain is a sudden force to the inside of the forearm pushing it in an outward direction. A strain to the muscles can either be from overuse or a traumatic force to the elbow or forearm.

·       Elbow Joint Fractures and dislocations

This is a break to one of the bones that make up the elbow joint. The elbow joint includes the humerus, radius, and ulnar bones. Fractures can vary in severity from a hairline fracture to a more complex and multi – directional break. Elbow dislocations can be partial or complete dislocations. Both elbow fractures and dislocations can occur from a fall on an outstretched hand, falling directly onto the elbow, traumatic accidents and may occur in high-risk sports. Younger children are also at high risk of elbow dislocations and subluxations due to the bone formation at this stage of their physical development. The most common type of dislocation is a posterior dislocation.

Symptoms of Elbow Injuries:

There are many various symptoms for elbow pain depending upon the cause of the injury. Some common symptoms can include:

·       Swelling and bruising, but not always, around the elbow

·       Instability and giving way of elbow joint

·       Weakness in the affected arm

·       Pins and needles, numbness, sharp electric shock symptoms

·       Tenderness and sharp pain to touch

·       Difficulty gripping with an associated weakening of your grip

Treatment Options for Elbow Pain:

·       Rest: Some elbow injuries may require a period of complete rest such as a fracture/dislocation however for tennis elbow, golfers elbow and sprains and strains we will need to reduce the activities that exacerbate symptoms, but that does not mean complete rest. We call this Optimal Loading. This is actually beneficial for the healing process; promoting blood flow and maintaining and improving muscle strength.

·       Ice and compression: This is applied in order to manage the swelling around your elbow and to provide some local analgesia to the area. A combination of ice and compression has been found to be more beneficial than either in isolation.

·       Rehabilitation: As mentioned above, optimal loading is the key to the management of elbow injuries. You will need to complete exercises that will reduce symptoms and strengthen the involved muscles and tendons at the correct stage of your healing process.

·       Reducing the instability: Strengthening the muscles and tendons around the unstable ligaments can give the elbow more support through range of motion.

·       Reduce stiffness: Stiffness is very common following a period of immobilisation following a fracture or dislocation. We want to get you moving the elbow as soon as possible in order to reduce the restriction. There are four main ranges of movement that the elbow is involved in, flexion, extension, pronation, and supination. All of these are affected when your elbow remains immobilised.

·       Onward referral from physiotherapy: Is further intervention needed? If physiotherapy is unsuccessful you may require an injection or surgery on your elbow. These interventions are not always needed and if the injury is treated earlier rather than waiting for it to become more severe, onward referral and intervention can often be avoided. I'd like to stress that the majority of elbow injuries can be cured with physiotherapy only.

Conclusion

Elbow injuries can be challenging to rehabilitate, however elbow injuries are best resolved with early intervention. Elbow injuries once correctly diagnosed can be resolved with a specific and individualised rehabilitation plan. Rehabilitation is not the same for every elbow injury and can vary in content depending on the stage of healing, the severity of the injury, the mechanism of injury and how long ago the injury was sustained. If you are experiencing any form of elbow symptoms, pain or have sustained an injury, I would suggest seeking the advice of a physiotherapist or another healthcare practitioner.