Navigating Elbow Tendinopathy
As a physical therapist, I have encountered various elbow injuries throughout my career, and I understand the challenges they pose for active individuals. Elbow tendinopathies are the most common and can cause significant pain and discomfort, affecting one's ability to perform daily activities and participate in sports. Understanding different elbow tendinopathies and their respective treatment options is crucial for effective management and recovery. In this blog post, we will explore two of the more common elbow conditions.
Assessing Elbow Pain: We carefully assess elbow pain through a thorough evaluation, including understanding the onset, location, and aggravating factors. Palpation and specific tests help determine the affected tendon and the severity of the injury.
The Importance of Shoulder and Neck Screening: Elbow pain is often linked to issues in the shoulder and neck regions. Poor posture, muscle imbalances, and movement dysfunctions can lead to compensatory patterns, overloading the elbow tendons. Therefore, screening the shoulder and neck is essential to identify and address contributing factors to the elbow injury.
Understanding Elbow Tendinopathies: Elbow tendinopathies are repetitive stress injuries. The most common is lateral epicondylitis by a 4:1 ratio compared to medial epicondylitis.
Tennis Elbow (Lateral Epicondylitis): Tennis Elbow is an overuse injury that involves inflammation or micro-tears in the tendons that attach the forearm muscles to the bony bump on the outside of the elbow. Despite its name, it can occur in individuals who do not play tennis. Symptoms include pain, tenderness, and weakness on the outside of the elbow and forearm.
Golfer's Elbow is characterized by inflammation or micro-tears in the tendons that attach the forearm muscles to the bony bump on the inside of the elbow. It commonly occurs due to repetitive gripping, swinging, or throwing motions. Symptoms include pain, tenderness, and weakness on the inside of the elbow and forearm.
Management of Tendinopathy: The management of elbow tendinopathies involves a multifaceted approach. Rest, activity modification, and ice can help reduce inflammation. However, a more comprehensive treatment plan includes:
Load Management: Gradual loading of the affected tendon is crucial. Patients should avoid excessive stress on the injured area while progressively increasing the load over time.
Manual therapy with soft tissue treatments or joint mobilization is used to restore muscle imbalances and reduce tension that is perpetuating the stress to the elbow. This might be aimed at the trunk, shoulder, or arm depending on what was gleaned during the assessment.
Eccentric Strengthening: Eccentric exercises have shown promising results in promoting tendon healing. Slowly lowering a weight in a controlled manner helps stimulate collagen synthesis and tendon repair. The Flexbar allows one to perform eccentrics with a combined motion that even more closely replicates the stress applied by tennis or golfer’s elbow and has evidence to support its use.
Bracing or Splinting: Wearing a brace or splint to provide support and relieve stress on the tendons.
Tips for Active Individuals: For active individuals seeking to prevent or manage elbow injuries, I offer the following tips:
Warm-Up: Always warm up adequately before engaging in physical activities to prepare the muscles and tendons for the workload ahead.
Proper Technique: Pay attention to proper technique during sports and exercises to minimize stress on the elbow.
Cross-Training: Incorporate cross-training activities to reduce repetitive strain on the elbow and promote overall fitness.
Listen to Your Body: If you experience persistent elbow pain, don't ignore it. Seek professional advice and avoid pushing through the pain.
As is the case with most tendinopathies, elbow injuries share common treatment principles aimed at reducing pain, inflammation, and promoting healing. In all cases, a combination of conservative measures such as rest, activity modification, physical therapy, and sometimes medications form the initial line of treatment. It's crucial to consult a healthcare professional to accurately diagnose the condition and develop an appropriate treatment plan tailored to the individual's specific needs. With proper management, most individuals can expect significant relief and a return to normal functioning.For active individuals, understanding the importance of prevention and early intervention can significantly impact recovery and long-term function.
