Elbow injuries are most often classified as repetitive strain or overuse injuries. Various activities and sports can cause an overuse elbow injury, such as typing at a keyboard, tennis and golf. Symptoms that may be associated with elbow pain include difficulty lifting, opening jars, turning door handles and carrying and gripping objects.
Lateral Epicondylalgia (Tennis Elbow)
Lateral epicondylalgia (or epicondylitis) refers to pain on the outside of the elbow. It is often due to tendinopathy of the extensor tendons and more commonly referred to as tennis elbow. The most common cause is repetitive strain through actions that involve the elbow and wrist, for example tennis, typing, painting, cutting, digging or other activities that involve gripping. Pain is often associated with weakness of the arm and wrist. Other causes of lateral elbow pain may include referred pain from the cervical or upper thoracic spine.
Resting from aggravating activities can often ease the pain. Adjusting gripping technique and fixing the wrist, arm and upper body posture can also reduce the load placed through the elbow. Seeking help from your physiotherapist to modify your techniques with problem activities and having a workstation assessment can be beneficial.
Your physiotherapist can implement a specific exercise program targeted to your function and goals. It is important to thoroughly rehabilitate this injury to prevent recurrence.
Medial Epicondylalgia (Golfer’s Elbow)
Medial epicondylalgia (or epicondylitis) refers to pain on the inside of the elbow. It is more commonly referred to as golfer’s elbow or thrower’s elbow. Golfer’s elbow is similar to tennis elbow, except it involves the flexor muscles of the forearm. It is often a result of overuse or overloading of these muscles during activities such as a golf swing or tennis forehand involving a lot of topspin. Those involved in throwing sports may also experience medial elbow pain, often as a result of straining the ligaments in the elbow joint.
As with many overuse injuries, rest is required to reduce the pain and symptoms. Improving technique and gradually increasing your load with specific exercises as guided by your physiotherapist can help to return you to your normal level of activity.
Radial Tunnel Syndrome
Radial tunnel syndrome refers to a compression of the posterior interosseous nerve below the elbow. Compression of the posterior interosseous nerve is commonly associated with repetitive gripping and activities that involve repeated supination of the forearm. Symptoms of radial tunnel syndrome include altered sensation in the hand and forearm, such as pins and needles or numbness, and vague forearm and wrist pain. In more severe cases there may be weakness of the wrist and fingers. Your physiotherapist can assist you with a range of exercises and manual treatment to help improve your symptoms.
Fractures & Dislocations
Fractures of the elbow are most often caused by an acute injury, such as a fall onto an outstretched hand or direct trauma in contact sports. The fracture may be to either or both bones of the forearm (ulnar and radius) or to the upper arm bone (humerus). Often a period of immobilisation is required in either a sling, splint or cast.
Following this period of immobilisation, the elbow joint may be stiff with limited range of motion, and the arm will be weak. Your physiotherapist can help guide you through the appropriate exercises and provide you with manual therapy to help regain your range of motion and strength. Your physiotherapist can also assist you with a safe and gradual return to sport or high level activity.
Bursitis
Bursae are small sacs of fluid that are found around areas of friction, such as where a tendon runs over a bone. They provide cushioning around a joint and allow for smooth movement of the muscles and tendons. Olecranon bursitis (inflammation of the bursa), is the most common bursitis in the elbow joint and is found at the back of the elbow. It is often caused by repetitive trauma to the triceps tendon as occurs when throwing/pitching or from frequent leaning on your elbow. It can also occur secondarily to an acute injury, such as a fall onto the elbow or during contact sports.
Symptoms of olecranon bursitis include pain and swelling at the back of the elbow, pain with leaning on your elbow or pain when fully straightening or bending your elbow.
Ice can help reduce pain and swelling and refraining from aggravating activities is important. Physiotherapy treatment often involves soft tissue massage, strengthening and alteration of biomechanics.
Ligament Sprains
Elbow ligament sprains are normally a result of high force being applied sideways though the joint. The ligaments can be sprained, meaning they are overstretched or overloaded. Tears to part of the ligaments or acute rupture may be the result of a very high stress injury of the elbow. Your physio will be able to help determine the extent of ligament injury during an assessment and implement a treatment program.
