The elbow is one of the most common areas for pain in sports and overuse syndrome. Although it may seem like a relatively simple area, the elbow is the origin for the tendons of many of the wrist, hand and forearm muscles. When you think of the numerous functions the hands and forearms perform, it is no wonder that repetitive, excessive or new activities can inflame this area.
The majority of elbow problems fit in two distinct groups. In the first group, pain is located on the outside of the elbow near a bony prominence called the lateral epicondyle. To find this area, bend your elbow and put your opposite hand on the pointiest part of the elbow (the part that would rest on a table if you rested your chin in your hands and put your elbows on a table.)
Now slide your hand 1-2 inches to the outside of that point. You should find another bony point. This is the lateral epicondyle. It hurts when you have “tennis elbow” or lateral epicondylitis, although you don’t have to play tennis to get pain there. Pain at the lateral epicondyle usually signals an overuse of muscles that extend the wrist and turn the forearm palm up.
To test this, turn your palm down and rest your forearm on the armrest of a chair. Now raise the back of your hand toward the ceiling, keeping your forearm on the armrest and keeping your palm facing down. You should feel the muscles contract in the lateral epicondyle area. Resisting this movement with your opposite hand will usually bring on pain if you have tennis elbow.
So the types of activities that bring on tennis elbow include the backhand stroke of any racquet sport, excessive gripping activities in which your wrist is kept straight or extended, and especially activities in which your are repetitively turning your palm up, such as turning screws with a screw driver. In a severe case of tennis elbow, turning the key in the ignition or your car or shaking hands can prove very painful.
In the second group of common elbow problems, the pain is on the inside of the elbow in an area called the medial epicondyle. Slide your hand toward the inside from the bony point of the elbow. This is the origin of muscles that typically flex the wrist. To test this, place your forearm on the armrest of a chair and turn your forearm and hand palm up. Now, raise your palm toward the ceiling, keeping your forearm on the armrest. You should feel the muscles in the medial epicondyle tighten. Pain in this area from muscle overuse is typically called “golfers elbow” or medial epicondylitis. Though not as common as lateral epicondylitis, activities such as golfing, lifting or unscrewing bolts or screws can cause pain in this area.
Treatment for both of these inflammations includes rest and ice. If the problem persists, see your doctor. Your physician will often recommend physical therapy, which can significantly hasten your recovery by reducing inflammation. Using manual therapy, a physical therapist can often quickly relieve the tension patterns in the muscles and fascia in inflamed areas. In severe and recurrent cases, if no relief is achieved with these approaches, your physician may opt for a cortisone injection.
Knowing the causes of tennis and golf elbow is the first step in reducing its severity. Your body will usually tell you when you have overdone a particular activity. The problem typically occurs when you ignore the warning signs and continue the activity for several days. Be aware of your body. “Listen” to it. Be practical and play it safe.