A Common Cause of Pain For Fitness Oriented People And Athletes Alike

by Peter Chiang DC, CCSP

Tennis elbow or Lateral epicondylitis is inflammation, soreness, or pain on the outside of the upper arm near the elbow.  Golfer’s elbow or Medial epicondylitis is pain and inflammation on the inner side of your elbow.

How the injury occurs:

Both of these injuries are caused by repetitive use of extensor and/or flexor muscles of the forearm.  Over time, inflammation, scar tissue, and small tears develop in the origin tendon of the muscle, which leads to irritation and pain when the muscle is used.

Lateral epicondylitis occurs in weightlifters usually due to wrist extension during pressing exercises such as barbell press, where the hands are stabilized, but the elbow has the tendency to move if technique is poor.  Medial epicondylitis can occur with improper and/or excessive curling of the wrist during a bicep exercise.  Both can also occur in occupation with consistent wrist rotation; like construction, painters, keyboard and mouse use, plumbers, and many more.

Symptoms:

For a Tennis Elbow, pain is usually present when you extend your wrist; the pain may or may not radiate from the elbow to your forearm.  Occasionally, numbness and/or weakness may be associated.  A lifter may notice it more when performing a barbell exercise.  There is also some tenderness within the elbow when you press on the area.

For golfer’s elbow, pain is present when you flex your wrist, squeeze your hand, swing a club, plus many more.  Tenderness may also be present.  The skin may also feel warm to the touch for both conditions.

Diagnosis:

Usually, your medical history and physical exam will provide enough information for a diagnosis of epicondylitis.

An X-ray can be helpful to rule out other possible causes of elbow pain.

Treatment:

  • Rest:  Stop performing activities that will aggravate the pain, it takes time for the tears to heal.   Premature return to activity may prolong the symptoms.
  • Ice:   Apply an ice pack to the affected area for 15 to 20 minutes, 3-4 times per day for several days.  Use a thin towel to protect the skin.
  • Over the counter (OTC) pain reliever:  Try ibuprofen, naproxen, or acetaminophen, these will help to lower the inflammation.
  • Injection:  Cortisone or similar injection can also reduce the pain and swelling.
  • Myofascial Release:  Active Release Technique (ART), Graston, FAKTR-ISTM, Kinesio Tape, have proven to help in reducing inflammation and pain with little to no side effects.
  • Tennis or Elbow Brace:  Purpose of the brace is to reduce pressure on the injured tendon by creating a temporary muscle origin.  Apply the brace 3 to 4 inch from the tip of the elbow, you may need to wear the brace for up to 6 weeks.

It is not uncommon for elbow pain to last 6 to 12 weeks.  With treatment, the pain may resolve faster.

Prevention:

These types of elbow injuries can be a part of a bigger picture, what appears to be an elbow injury may start from weak core stability and lack of strength.  For a lifter, it means to take a step back and see the overall picture, when attempting more weight do you feel that your core is stable?   Are the elbows stable and not flailing around?  Are the wrists in severe flexion and extension?

Once the injury is healed, consider incorporating core stabilizing exercises and gradually increase the weight of a lift to emphasize form and technique.   Weight train with a wrist wraps to limit flexion and extension.   Also train using oversized grip (Fat Gripz).