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Elbow Pain…What The Heck Is The Issue?

Elbow Pain…What The Heck Is The Issue?

The elbow…well, it certainly isn’t the ‘funny/crazy bone’ when we hurt it.

The elbow…when it hurts, it certainly isn’t so ‘funny’ or ‘crazy’.

We treat a LOT of elbow problems in our office.  Why is this?  Well, we have an active patient base and most all we do affects the musculature in our elbows.  It used to be that when you had medial, or inside, elbow pain, that would be called ‘golfer’s elbow’ and when the pain was on the lateral side, or outside, that was called ‘tennis elbow.’  Well, needless to say, times have changed and people in many sports get medial and lateral elbow pain and they certainly are not playing golf or tennis.  For that matter, not all golfers get medial elbow pain and tennis players lateral elbow pain anyway…sometimes, it’s the opposite.  As as far as that ‘funny bone’ issue we’ve all heard about, that occurs when we bang a certain part of the elbow that the ulnar nerve runs through.  The sensation we feel is irritation to the nerve and the distally affected tissues feel ‘funny.’

So, why is the elbow so often injured?  The answer to this is actually quite simple: it is overused…and used some more! I think you get my point.   If your activity involves a lot of gripping (like holding onto a bar when you are at the gym), chances are that you are going to develop an elbow problem.  If you work at a desk and write and type all day long, you, too, are looking at getting elbow problems…and the examples go on.

Elbow pain is soooo annoying because it makes it almost impossible for us to do virtually anything.  Well, when picking up the coffee mug in the morning is painful and you almost drop it, yes, you have a problem. And guess what?  If you do nothing about the problem, it will get

Lateral elbow pain used to just be associated with tennis players but not anymore.

worse with time.  As I’ve alluded to in previous blogs, arthrogenic inhibition is always at play and this means that untreated injuries will tend to get worse.

The pattern for elbow injuries tends to be the same whether we have medial or lateral elbow pain.  The medial side muscles, or the flexors, tend to get too tight and the lateral muscles, or the extensors, tend to get too weak.  This imbalance creates a ripe environment for injury. In fact, in my experience, when this imbalance exists, pain can develop on either side of the elbow.  Think of it this way…do you tend to grip things more or extend your wrist/fingers?   The answer to this is obvious and this is why the flexors tend to be tight and the extensors weak.

We have 6 primary lateral elbow muscles that extend the wrist and fingers.  Four of these muscles coalesce to form the common extensor tendon at your elbow. On the other side, we have five muscles that form the common flexor tendon.  When we damage any or all of the muscles on either the flexor or extensor side, it is possible to tear the associated tendon.  When this occurs, most of the time it can be treated conservatively, but sometimes, if bad enough, it might require surgery.

Early intervention for this condition is imperative.  The earlier we can correct the faulty biomechanics, the better the prognosis.  Treatment has to be geared towards treating the injured area and creating an environment for healing that can only occur when balance is restored to the region (eliminating the dreaded arthrogenic inhibition).

So, if you have elbow pain anywhere, get it checked out as soon as possible.  Failure to do so will lead to a loss of activity level and function and will be harder to correct the longer the condition goes on.  A sports rehabilitation specialist is best trained to deal with these injuries and you should see one before the injury surrenders itself to surgery.

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