Elbow

Typical Causes of Elbow Pain

Typically, elbow pain is caused by injured tendons and is either called tennis elbow or golfer’s elbow. Tendons are connective tissue made out of collagen (a type of protein). Tendons usually attach muscle to bone. Tennis or golfer’s elbow is generally causes by unnatural torque forces on the elbow and forearm. This means that there is no one single cause. It is not usually the result of a direct weightlifting accident but can be. It is rather usually caused by bad or improper lifting form. Obviously you don’t have to play either tennis or golf to be afflicted. Golfer’s elbow is sometimes called thrower’s elbow. Usually, both are caused by some kind of power overload in the forearm attached to the affected elbow. To know which is which, you need to know where on your elbow the pain is located.

Tennis Elbow

The medical term for tennis elbow is Lateral Epicondylitis. Lateral is a term for anatomical position and means the tendonitis is on the outside of the elbow away from your body. Epicondyle is Latin and refers to the end part of the humerus or upper arm bone. Epi means “upon” and condyle means “knuckle.” It hurts where the tendons and muscles attach to the bone area called the epicondyle. There may be a tear or only a strain. Those who suffer from tennis elbow represent about 3% of the population and usually they are between 30 to 50 years of age. The symptoms are pain on the outside of the elbow when having to forcefully grip anything. Sometimes it hurts just to shake hands or use a knife and fork. There may or may not be visible inflammation.

Golfer’s Elbow

The medical term for golfer’s elbow is Medial Epicondylitis. Medial is a term for the anatomical position and means the tendonitis is on the part inside the elbow closest to your body. Medial Epicondylitis is the inside knuckle of the elbow. Pain can be felt when doing such exercises as chins, curls, rowing, dumbbell flys and the like. It is usually felt when the wrist is turned inward with an axial motion. There may be no visible swelling.

Personal Anecdote

I once had a job bending over and lifting many 150 lb. monitors from off a pallet up, over and down into a large box. My back could handle it well enough; it was like doing a combination row-and-deadlift with a twist to the side. My hands and forearms were about 4 feet from each other to grip and press the side handles of the monitors in a very unnatural fashion. The pressure it put on my elbows, however, was enough to give me golfer’s (thrower’s) elbow. This was very painful and I consequently could not do weight chins without pain, especially on the inside of my right elbow. It got better only after not lifting anything heavy for awhile and abstaining from weighted chins.

Immediate Treatment

Initial treatment should be first aid known as R.I.C.E.

Rest – Stop using the afflicted part.
Ice – 10 minutes on, 10 minutes off for an hour (or whatever feels comfortable).
Compress – Wrap a compression bandage around the injury. This may keep down the swelling.
Elevate – Keep the injured part propped up and elevated above the level of your heart. This may help keep down the swelling.

Clinical Treatment

Most people will get better with rest and using Nonsteroidal Antiinflammatory Drugs (NSAIDs). Your doctor may inject Corticosteroids in the tender area where the tendon attaches to the humeral epicondyle (elbow knuckle bone). You may have a couple follow up injections along with 2 or three months of prescribed rest. Corticosteroids are powerful anti-inflammatory drugs. The problem is that they sometimes work so well that the athlete thinks he is already healed and then goes out stressing the injured part to the max only to make the injury worse than before. The possible side effects indicate they are only to be used short term. There are studies that show long term use may cause symptoms to re-occur to where you’re back at the beginning again. A conservative rehabilitation program is usually the best. If your doctor says you need surgery, research this well and perhaps get a second opinion.

Prevention and Care

Always keep at least a slight bend in your arm when lifting—especially with heavy weights.
Lighten up on the weights.
Perform exercises with strict form. If a lift doesn’t feel natural then don’t do it.
After healing, avoid those exercises completely that give you pain or at least do them only partially in a safe way with a lighter weight.
Do gripping exercises on a regular basis.
Stretch your forearm extensors. This is a passive stretch: Extend your right arm straight out with palm down. With your left hand, pull your right hand down and back so your right palm faces you. This will stretch your right forearm extensors. Hold for 7 to 10 seconds. Repeat.
Ask your doctor if an elbow compression strap will work for you. This is a strap that wraps around your forearm about 2 to 3 centimeters down from your elbow. It puts pressure on the tendons at the compression point thus somewhat relieving the pressure on tendons at the elbow joint. It works on the same principle as that of putting finger pressure on a guitar string. The pressure on the string is relieved above the fret point.

We can avoid weight training injuries with simple common sense. Unfortunately, elbow injuries last for a long time and may never completely go away. Prevention is the most important thing.