The elbow seems like a simple joint, right? Generally the elbow bends and straightens; however, it also has accessory motions that help us to use our hands. To complicate matters, a significant number of muscles cross the elbow that come from the forearm and the hand. The elbow gets injured in two key ways: 1) trauma, and 2) overuse. Trauma based injuries are from high force such as accidents, falls, a fight, or sports. The majority of elbow injuries are caused by overuse, whether that overuse comes from years of doing a task or simply and increase in a task that is not your normal. Some basic repetitive tasks are: wrenching, hammering, weed pulling/whacking, throwing, swinging a tennis racket. Due to the repetitive nature of some tasks, the muscles, ligaments, and tendons of the elbow can be over-stressed and will lead to pain. What makes the elbow even more difficult, is that we are always using our hands; thus, the healing process can take much longer than we expect.
There are numerous injuries that are classified for the elbow, but we will focus on the two most often seen for physical therapy: lateral elbow pain (tennis elbow) and medial elbow pain (golfer’s elbow, throwers elbow). Additionally, elbow pain can arise from the neck, arthritis, neuropathy, nerve entrapment, osteophytes, avulsion fractures, and post surgical conditions (1).
When the pain comes from chronic and repetitive activities, we have have to find a means to reduce the stress and strain to allow the structures to heal properly, then follow up with the correct loading strategies to allow the ligaments and muscle tendons to take accept the stress.
