Therapy Time: Elbow pain and a case study.
I’ve heard quite frequently these days of those who are new and old to training having elbow pain. Lateral epicondylitis, or tennis elbow, and Medial epicondylitis, or golfer’s elbow, are two possible causes of elbow pain in the athlete.
Tennis elbow occurs when there is some sort of overuse or trauma to the lateral elbow musculature, or that which helps extend the wrist. It can be painful to touch as well as painful to grip, actively extend the elbow, or eccentrically contract the extensor musculature. You don’t actually have to play tennis to get this but those who repetitively stress their wrist extensors or grip heavy when they’re not ready tend to end up with tennis elbow
Golfer’s elbow is very similar, but to the inside of the elbow and is more troubled via wrist flexion.
These two conditions can be significantly painful early on and can persist for long periods of time.
Things I tend to see in people who come to me with one of these conditions is pain with pressing on the area, pain in resisting the motions noted above, weak scapular stability on the side of the pain, and sometimes a decrease in cervical (Neck) movement patterns.
Things you can do to help yourself:
1. Light self massage with a tennis ball around the area.
2. Isometric and eccentric strengthening of the movement that is painful. Isometric means that you contract the muscle against resistance but not moving the body part and eccentric means starting in the “top” position of the movement and slowly lower down until the muscle is fully stretched.
3. Take the self neck assessments from our previous post and complete 10-15 retractions with side bend towards the side of pain and see if there is any improvement.
LINK: Cervical screen
4. Begin to focus strengthening on the scapular area.
And now for the case:
I recently saw a manual laborer who came to see with with Tennis elbow like symptoms. He had weakness throughout the scapula stabilizer area and his grip strength was significantly weaker. Like 50 lbs weaker than his right and it also had 8/10 pain.
I performed a physical therapy thoracic manipulation (as opposed to a chiropractic manipulation) and retested his grip. He “gained” 60 lbs in strength on his injured arm, but it was also 0/10 pain at that point. Now you don’t increase your strength by 100% in 5 seconds, he had the strength but his pain was preventing him from being able to use it. A quick pain modulation (manipulation) technique and now we’re stronger, pain free, and able to complete a full session of physical therapy.
This kind of result can occur relatively frequently, but the instant pain free doesn’t always last. A true tendonosis problem like a later state tennis or golfer’s elbow can take time and consistency in order to fully improve. If you get on top of it quickly, you should be able to fend off further problems down the road.
As always, if you have questions or want to get that elbow checked out feel free to shoot me a message and we can take a look and give you a plan on how to approach it.