Elbow Pain

Elbow pain can have serious consequences when it comes to daily function...

The elbow is a highly functional joint used for a wide variety of tasks throughout the day whether it be as simple as reaching for an object, or something more strenuous like getting through your workout. As such, any sort of elbow pain can have serious consequences when it comes to daily function, even when there doesn’t appear to be a single event that triggered the pain. In this article, we will provide information about treating elbow pain, with a focus on some of the more common conditions that can cause elbow pain, such as tennis elbow, golfer’s elbow, and bursitis...

Common Questions About Elbow Pain

What causes tennis elbow and golfer’s elbow?

Tennis elbow and golfer’s elbow are painful conditions that are most commonly caused by repetitive strain to the tendons that cross the elbow and attach to the bony bumps just above the elbow joint. The fact that these conditions result from repetitive strain to the tendons is why you may hear it described as an overuse injury. While the main culprit involved in these conditions are the tendons, it is important to know that tendons connect muscle to bone, so the forearm/wrist muscles that these injured tendons blend with are also highly involved. Therefore, combined movements of the wrist and elbow that are repetitive in nature can make a person more vulnerable to developing tennis elbow or golfer’s elbow.

The repetitive actions of swinging a tennis racquet or swinging a golf club are prime examples of movement patterns that can lead to these conditions, which is how we end up with the names for these elbow conditions. That said, other repetitive actions that may be more occupational, such as swinging a hammer or using a paintbrush every day, can sometimes also lead to these same conditions as well.

What is the difference between tennis elbow and golfer’s elbow?

Tennis elbow and golfer’s elbow are both conditions that affect tendons, which connect muscle to bone. Tendons are primarily composed of a protein called collagen, and these collagen fibers provide structural integrity to the tendons. When you have deterioration and subsequent disorganization of these collagen fibers, you can end up with a condition called tendinopathy.

Tennis elbow and golfer’s elbow are two forms of tendinopathy. Tennis elbow is a more common term for tendinopathy of tendons that cross the outside of the elbow, and you may see this referred to as “lateral epicondylopathy” in medical resources. Similarly, golfer’s elbow is a more common term for tendinopathy of tendons that cross the inside of the elbow, so you may see this referred to as “medial epicondylopathy” in medical resources.

So why can tendinopathy lead to elbow pain? When the collagen fibers in a tendon deteriorate and become disorganized, the body orders a biochemical response to that area. This response can affect nerves in the area that are associated with our perception of threat, damage, and pain, so the body will ultimately recognize this as an injury. In other words, the body recognizes the tendons as being in a constant state of damage, and if left untreated, any sort of additional stress on these tendons, such as movement, can amplify the pain.

What other conditions can cause elbow pain?

Tennis elbow and golfer’s elbow aren’t the only conditions that can lead to elbow pain. Other common conditions can include bursitis, ligament sprains, arthritis, and direct trauma to the joint (for example, fractures, dislocation, or bruising).

Elbow bursitis can appear in many forms, but the most common variation is called olecranon bursitis. “Olecranon” refers to the bony part of the elbow that pokes out when you bend your elbow. A “bursa” is a fluid-filled sac that reduces friction for other structures as the elbow bends and straightens. “itis” refers to inflammation. Altogether, this means inflammation of the bursa that is located at the tip of the elbow. This condition can occur when there is a direct impact to the elbow, such as falling and landing on the elbow. Smaller and more repetitive impacts to the elbow may also lead to olecranon bursitis. Your elbow may become very swollen and painful to move, in which case it is important to seek care in a timely manner from a physician or physiotherapist to rule out an infection and to ensure you get the appropriate treatment for your elbow.

In terms of ligament sprains, the most commonly sprained ligament in the elbow is the UCL, which stands for ulnar collateral ligament. This ligament crosses the inside, or medial aspect, of the elbow joint, and helps keep the bones that form the joint from separating. The UCL is commonly injured when there is a lot of stress placed on the inside of the elbow in a quick manner, especially if that stress is repetitive. For example, UCL sprains are very common in baseball players, especially pitchers, when compared to the general population. Treatment for this type of injury may or may not involve surgery, and physical therapy will involve protecting the area to allow the ligament to heal, and then when ready, movement and strengthening exercises to regain function of the elbow and help prevent any future injuries.

Arthritis can also affect the elbow, and may either be inflammatory (for example, rheumatoid arthritis), or non-inflammatory (for example, osteoarthritis). Due to the highly variable nature of arthritis, the approach to treating this condition will likely involve multiple healthcare professionals, including doctors, physiotherapists, and potentially pharmacists and specialist doctors.

The other traumatic conditions mentioned above, such as fractures and dislocations, will likely be handled by doctors and/or surgeons at first, but then as the elbow recovers, physiotherapists will again play a large role in the rehab process, ultimately getting you back to your functional activities.

How do you treat tennis elbow and golfer’s elbow?

Tennis elbow and golfer’s elbow can be treated successfully with a targeted exercise program!

Both tennis elbow and golfer’s elbow respond very well to an exercise program that includes stretching of the muscles and tendons, as well as specific forms of strengthening that provide the tendons with an opportunity to replace and re-organize their collagen fibers appropriately. 

For these conditions, physiotherapists are well suited to customize your treatment process, especially when it comes to the stretching and strengthening portion of therapy, which is the most effective way to treat this form of elbow pain.

Additionally, physiotherapists can offer hands-on support to further assist in your recovery. Examples of this can include soft tissue release, intramuscular stimulation (needling), joint mobilizations, deep transverse friction massage to affected tendons, ultrasound, and electro-therapeutic tools such as TENS and IFC.

General physicians or pharmacists can provide better advice regarding the role of medications in alleviating your symptoms.

What exercises are best for elbow pain?

This may depend on the exact nature of your condition, so this question is best answered with the help of a physiotherapist.

First, the physiotherapist will be able to help identify the cause of your elbow pain, and subsequently, will be able to design an exercise program that is specific to your individual condition.

In the case of tennis elbow and golfer’s elbow... this will likely include specific stretching of the affected muscles and tendons, strengthening of the affected muscles and tendons in a stationary position (isometric strengthening), and strengthening of the affected muscles and tendons while allowing them to stretch at the same time (eccentric strengthening). Your physiotherapist can help guide you through these exercises so you have as much control as possible over your recovery.

Let's get you back to normal!

Common elbow pain conditions have a high success rate when being treated with physiotherapy. If you are experiencing elbow pain, we would suggest booking a visit for further advice on how to best treat your specific condition...

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10 Convenient Locations in Calgary. All Physiotherapy clinics have morning and evening appointments available to meet the demands of your busy schedule. Saturday appointments are available at select locations.
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Panther Sports Medicine and Rehabilitation Centres are a network of ten clinics, physiotherapist operated, serving Calgary and surrounding areas. Our team offers a wide range of services including physiotherapy, massage therapy, and sports injury rehabilitation to help our clients reduce pain and recover from injuries. Panther Sports Medicine has been proudly serving our community for over 30 years.
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