Response Physio | 26.05.22
Your elbow lets you do a whole range of activities from throwing, lifting, swinging to hugging. You can do all this because it’s not a simple joint. But that means there are a lot of ways things can go wrong with the elbow.
Your elbow’s a joint form where three bones come together — your upper arm bone, the humerus, and the ulna and the radius, the two bones that make up your forearm. Each bone has cartilage at the end, which helps them slide against each other and absorb shocks. They are held in place with tough tissues called ligaments and your tendons connect your bones to muscles to allow you to move your arm in different ways. If anything happens to any of these parts, not to mention the nerves and blood vessels around them, it can cause you pain.
Elbow pain does not always occur in isolation. Other structures (body sites) can refer pain to the elbow and can contribute to the development of elbow pain and dysfunction. For example, we can feel pain in the elbow region due to problems in other structures like the shoulder, neck and upper back regions. Elbow pain is not as straight forward as you would think!
Here are some common elbow injuries we treat in physiotherapy:
Sprain injuries – a stretching or tearing of the ligaments. Ligament problems can occur in any of the ligaments located in the elbow joint. Ligament sprains may be the result of trauma or overuse and can cause pain, swelling, bruising and limit the ability to move the elbow joint
Strain injuries – an injury to a muscle or a tendon. Minor injuries are caused by overstretching a muscle or tendon, while more severe injuries may involve partial or complete tears in these tissues. Depending on the severity of the injury the symptoms can cause pain or tenderness, swelling, bruising, limited motion and muscle weakness. Strains injuries may be the result of trauma or overuse.
Olecranon bursitis – occurs in the olecranon bursa, a thin, fluid-filled sac that is located at the back of the elbow, called the olecranon. The bursa act as a cushion between bones and soft tissues, such as tendons, muscles and skin. It contains a small amount of lubricating fluid that allows the soft tissues to move freely over the underlying bone.
If the olecranon bursa becomes irritated or inflamed, more fluid will accumulate in the bursa and bursitis will develop. Usually the result of direct trauma (such as a fall onto the outstretched elbow) or repetitive activities. The symptoms usually are swelling, tenderness, pain and possible redness over the back of the elbow.
Tennis elbow and golfer’s elbow – are both types of tendinopathy, which means you have damage in the tendons around your elbow, usually from overuse. You do not need to play tennis or golf to develop tennis elbow or golfer’s elbow, you can develop the same injury from doing different activities. The main difference between the two is that tennis elbow affects the tendons on the outside of the elbow, while golfer’s elbow affects the inner tendons in the elbow. The symptoms are mainly pain and weakness.
A pinched nerve (nerve entrapment) – in or near the elbow can cause elbow pain, numbness, tingling, or weakness of the arm, wrist, or hand. The nerve that most commonly gets pinched in or near the elbow is the ulnar nerve. It is located in the elbow area, on the little finger side when the palm is facing up. This usually occurs with repeated motions.
Dislocated elbow – When one of the bones that form the elbow gets knocked out of place, you have a dislocated elbow. An elbow dislocation typically results from falling on an outstretched or extended arm, often as a result of a contact sport or fall from a height. Usually, a dislocated elbow causes extreme pain and distortion. If you think you or someone have a dislocated elbow, call your doctor right away.
Fractured elbow –If one of your arm bones breaks at the elbow, you have a fracture. Fractures of the elbow usually occur due to a fall on an outstretched arm. Also, it commonly causes acute pain, swelling, bruising and potential joint deformity. You’ll need medical attention if you’ve fractured your elbow
Stress fractures – are tiny cracks in a bone due to repetitive stress or impact like in athletes who throw a lot. Stress fractures are therefore an overuse injury. The main symptom is pain that usually starts at a specific spot and decreases during rest. Also, you could have swelling around the painful area.
Rheumatoid arthritis – is a chronic inflammatory disorder that can affect more than only your joints. In some people, this condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. It can affect the elbow causing inflammation, pain, and stiffness in and around the joint that can eventually result in bone erosion, reduced mobility and joint deformity.
Osteoarthritis – is a condition that affects the cartilage, a type of connective tissue found in the joints. Also causes this tissue to wear down and become damaged. This can happen because of a previous injury such as elbow dislocation or fracture. Most commonly, however, it is the result of a normal wearing away of the joint cartilage from age and activity. The main symptoms, as a result, are pain, stiffness, tenderness, reduced mobility and swelling.
Physiotherapy Exercises for elbow pain relief.
The exercises and tips below can be done to help prevent your elbow from getting painful or help you recover if you have developed some elbow pain.
Wrist flexors stretch
Extend your arm in front of you with your palm up. Use your other hand to bend your wrist pointing your fingers toward the floor until you feel a mild to moderate stretch and hold for 30 seconds. Repeat 8-10 times each day.
Wrist extensors stretch
Extend the arm in front of you with your palm down. Use your other hand to bend your wrist pointing your fingers toward the floor until you feel a mild to moderate stretch and hold for 30 seconds. Repeat 8-10 times each day.
Wrist flexion strengthening exercise
Resting your forearm on the table with your wrist and hand over the edge of the table with your palm facing the ceiling. Without a weight or holding a lightweight in your hand lift/flex your wrist up so that your palm moves towards the ceiling. Once your wrist is fully flexed, hold the position for a few seconds. Then, slowly lower your hand back to the initial position. Your forearm should remain on the table. Repeat 8-10 times each day.
Wrist extension strengthening exercise
Resting your forearm on the table with your wrist and hand over the edge of the table with your palm facing down. Without a weight or holding a lightweight in your hand and slowly lift your hand so the back of your hand moves towards the ceiling. Your forearm should remain on the table. Once your wrist is fully extended, hold the position for a few seconds, then slowly lower your hand down. Repeat 8-10 times each day.
You can also add some simple changes in your daily routine that may help.
For more exercises and advice follow our YouTube channel. If you are suffering elbow pain that isn’t going away and would like to see a physiotherapist, please visit our contact page and find a physiotherapist near you.
What are the most common swimming injuries, and how can physiotherapy help them? Read our latest blog