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Management of Elbow Pain

In this post we are going to discuss two of the most common sites and causes of elbow pain. Pain at the outside (lateral) and inside (medial) of the elbow joint is very common in people of all ages. Two common diagnosis are medial and lateral epicondylitis (golf and tennis elbow).

Pain at these sites can be quite acute and really impact our sport, work and daily life activities. In fact, these activities are usually what bring on the pain over time. Most often pain arises here from repetitive strains - meaning the tendons of the muscles have been overwhelmed on a small scale repetitively for a long time and finally began to send pain alarms.

We have many layers of muscles in our forearms and many of them have common insertion points at the elbow. Any action that involves these muscles could contribute to strain and injury. As we perform actions such as hitting a tennis ball, opening jars, typing, or

carrying bags, forces are transmitted up through the muscles towards this common insertion point. These isolated area take a beating and injury can arise.

If the muscles are extra tense, or the bones and joint of the elbow are restricted, even more forces will hit the area without being evenly distributed and sharing the forces. Biomechanics pertaining to your work or sport can also contributed to your arm and elbow doing more work than it needs to. All things that will be examined in a proper elbow assessment.

First Steps for Acute Pain

Rest/Activity Modification - The most important thing you can do is to give the tissues a break. Try to identify aggravating or causal factors and limit them as best you can to give the body a chance to heal and not be bombarded with strain anymore. Those that ignore this and try to work through it, often struggle to see pain reduction.

Ice - control inflammation in the area and help modulate or decrease pain by icing for 10min, 3-5x/day in the acute painful stage.

Gentle Movement - Gentle stretching and activity as tolerated. Using pain as a guide to keep tissues moving but not re-injuring.

Bracing - forearm braces can help distribute forces away from the common insertion point allowing the injured site more opportunity to rest and heal. These can sometimes get people back to sport or work earlier with less pain.

Modalities - Some patients get relief from using modalities for the pain such as Ultrasound, Acupuncture, or TENS/IFC.

What's Done Next

As pain begins to subside, your therapy should focus around a gradual return to strengthening. We need to strengthen these injured tendons to make them more resilient to these forces than they once were. This is a key part to making sure the pain doesn't return.

A Physiotherapist or Chiropractor can guide you through these exercises progressions in a safe and effective way to get you back to work or back on the court!

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