A pain in the elbow

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ImageIn the past few weeks I’ve seen a lot of clients coping with the pain and the elbow.  The 2 conditions associated with the elbow are tennis elbow and golfer’s elbow.  The former affects the outside of the elbow joint and is called ‘lateral epicondylitis’ or ‘lateral elbow tendinosis’. By contrast, golfer’s elbow affects the inside joint of the elbow and is called ‘medial epicondylitis’

Tennis elbow can be traced back to it’s first description in 1873, when it was described as writer’s cramp and later washer women’s elbow. Golfer’s elbow is associated with the repetitive nature of the golfer’s swing, but has also been called little league elbow or climber’s elbow.

Both conditions are caused by an inflammation of the tendons attaching at the epicondyles of the humerus bone at the elbow.

Causes

Both conditions are the result of repetitive movements that result in overuse of the extensor muscles of the forearm running down to the wrist.  Actions such as repeatedly striking a golf ball or the back swing of tennis are good examples of how overuse can occur, but such movements are not specific to either of these sports.  The majority of people suffering with either of these conditions do not play either sport, it is the repetitive movement that lead to the overuse.

What are the symptoms?

For tennis elbow there is pain at the outside of the forearm (the lateral side) which can radiate towards the wrist.  Sometimes pain can also be experienced in the upper arm.  Golfer’s elbow will feel pain on the inside of the forearm (the medial side).  There will be a weakness in the wrist, which will make carrying objects (even if they are light) or carrying out simple activities.

Treatment and complications

There are 3 phases to the healing process for elbow tendinitis. The acute inflammation phase; a collagen and ground substance production phase (beginning of healing process); and a maturation/remodeling phase (as the healing takes hold). You should seek advice from your GP as necessary.

It can take anything from 2 weeks to 2 years to recover from tennis elbow and 6 to 12 months for golfer’s elbow. The injured area should be rested and movements that trigger pain should be avoided. The application of heat and ice can also help.

Rehabilitation

An early rehab exercise is a wrist extensor stretch.  Use a table or other flat surface to support the forearm, so that the wrist is hanging over the edge, The wrist should be facing palm down (you can progress to holding a weight if there is no pain in the movement).  Extend your wrist downwards slowly.  Pause at the bottom of the movement for 15-20 seconds and return to the starting position.  Repeat 5-6 times.

21 April 2016