Elbow pain causes, symptoms and treatment
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Lately, I have had a few people ask about pain that has developed on either the inside or the outside of the elbow.
Their symptoms were pretty common such as tenderness on the inside or outside of the elbow and pain during any grasping, pulling or pushing of objects such as the following:
- Shaking hands
- Writing
- Lifting objects
- Holding objects
- Steering a car etc.
Depending on the location, those people were suffering from either Golfer’s Elbow or Tennis Elbow. Golfer’s Elbow (also known as Medial Epicondylitis) is pain located along the inside of the elbow. Tennis Elbow (also known as Lateral Epicondylitis) is pain located along the outside of the elbow. You don’t have to play either sport to develop one or the other. While I am not a physician, tenderness and pain located on either side resulting from any of above items are your typical symptoms of Golfer’s/Tennis Elbow.
The second question that is usually asked after given an idea of the problem is, “how did this happen?” Before we get into causes, you have to understand how the elbow works. Your elbow is a hinge joint that can only flex and extend. In medical terms, the elbow is known as your humeroulnar joint (the connection between your humerus, the long bone in your arm, and the ulna, the part of your forearm that runs along your pinky). Just below the elbow is your forearm, also known as the radioulnar joint. This joint consists of your radius (thumb side) and ulna (pinky side). Along your forearm you have several muscles that will help to flex and extend your wrist (think wrist curl and reverse wrist curl movements). The muscles that help to flex your wrist will attach on the palmar side of your hand whereas the muscles that extend your wrist will attach along the dorsal side of your hand (your back hand). The other attachment point for the wrist flexors will be along the medial epicondyle whereas the other attachment point for the wrist extensors will be along the lateral epicondyle. To know where these areas are on the body, simply feel on the inside of your arm towards the inside crease of the elbow. Do you feel a bump? If you do (and you should), that is your medial epicondyle. The bump on the outside of your elbow is the lateral epicondyle.
How this pain occurs is that those wrist flexor and extensor muscles that help move the wrist are strained and inflamed. When you look at it closer, it is those same muscles that are attached along either the inside or outside of the elbow that are damaged. One also has to understand that your wrist flexor/extensor muscles aren’t one muscle but rather three muscles. There are three muscles that flex the wrist and three that extend it. For example, all three muscles that flex the wrist converge together and attach onto medial epicondyle while the three muscles that extend the wrist attach onto the lateral epicondyle.
What causes the inflammation of those muscles? The number one cause to this kind of elbow pain is overuse. People who play constant tennis, painting, typing, golfing, gardening, pitching … anything that will constantly flex and extend the elbow … can lead to overuse issues which will in turn inflame the wrist flexors or extensors. In the weight lifting culture, having an arm day three days a week or just doing too much volume can cause serious issues and pain. And speaking of pain, the pain can be unbearable for some, tolerable for others. The pain can be so bad that you may have a hard time flexing and extending the arm. One thing to keep in mind though is that while these are the common causes, there are some uncommon causes of this as well. A client developed tennis elbow while jet skiing. When he hit a wave and landed, he jarred his elbow which led to all of the signs and symptoms of tennis elbow. Another thing to keep in mind is that the re-occurrence of either issue will differ from person to person. One client couldn’t hold a pair of dumbbells at his side so he had to bend his elbows and rest the weights on the tops of his shoulders. Another client would have a flare up if the did neutral grip (palms facing in) pull ups.
How do you fix it? Because there is constant usage of the elbow and forearm, muscles often become tight. Every time you hold on to an object, your wrist flexors and extensors will contract. Not understanding that concept? Look at your forearm palm side up. Make a fist as hard as you can and repeat that several times. You should see muscles contracting all along the forearm. Outside of resting it, icing, elevating and compressing you will want to stretch your wrist flexors and extensors. Assuming that pain is minimal, straighten your arm out in front of you, palm side down. Take your free hand and pull the fingers back on the opposite hand. You should feel a stretch going all the way down your forearm. Do the same thing but this time with the palm facing up. Close the fingers, but don’t grasp and pull the hand in.
You will also want to strengthen your forearms by performing simple wrist flexion/extension exercises. Seated, rest your forearm on your thigh and your hand (palm side up) should be hanging off of your leg. Make a fist (but not a tight fist) and perform a wrist curl nice and controlled. Turn the palm down, make a fist and perform a reverse wrist curl nice and controlled as well. You can progress to weights if needed. Perform two to three sets of 15-20 reps. You can also strengthen the fingers by extending (or straightening) your fingers, hold for about five seconds, make a small fist and then repeat. Once that gets easy you can wrap a rubber band around the fingers to add tension.
These are a few ideas to help alleviate the pain caused by Golfer’s and Tennis Elbow. While they can prevent a person from working out or just function normally, these are some small tips to help you alleviate the problem but more importantly understand what is going on within the body. You can also do these stretches and exercises at the end of a workout or for 15-30 minutes at home a few times a day.
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