The Elbow's Connected to... Pain

Here we are, in the swing of high school spring sports and athletes competing in baseball, softball, tennis, golf, and field events like discus and shot put are putting their arms to the test. The elbow joint can be at risk in these athletes, because of the stress caused by the repetitive motions of throwing an object like a softball or swinging a tennis racket. The most common elbow injury lateral epicondylitis, also known as tennis elbow, affects tennis players, as well as throwing athletes. Tennis elbow is initially an inflammatory reaction in the muscles that extend the wrist, where they attach to the knobby part of the bone just above and on the outside of the elbow (the lateral epicondyle). A less common injury is to the opposite side of the elbow, called medial epicondylitis, often known as little league elbow or golfer's elbow. Medial epicondylitis commonly occurs in pitchers and golfers. The cause of these injuries is a combination of factors. One problem is imbalance in the muscles of the wrist, elbow or shoulders, such as very strong biceps and very weak triceps. Poor posture or improper throwing or swinging mechanics often contribute to the problem. Weakness in the core muscles may be the cause of poor throwing mechanics. Lack of off-season training or over-training at the beginning of the season can also result in elbow pain. Let's take a closer look at the elbow: - Symptoms include pain with wrist extension and tenderness over the outside of the elbow (lateral epicondylitis) or pain with gripping and wrist flexion and tenderness on the inside of the elbow (medial epicondylitis). - Preventing elbow injuries consists of: 1. Pre-season strength training that includes all muscle groups of the shoulder, elbow, and wrist. 2. Pre-season core strength training for lower abdominals, gluteals, and low back muscles. 3. Stretching of the wrist flexors or extensors 4. Instruction in proper mechanics for throwing or swinging. This includes making sure that the athlete uses their entire body in the motion, getting power and momentum from the hips, not the shoulder or elbow. - Treatment of an elbow injury can include: 1. See your athletic trainer initially; see your physician for follow-up if the pain does not resolve in one or two weeks. 2. Rest from the activity. 3. Ice (cold pack wrapped on the elbow for 15 minutes 2-3 times per day). 4. Remedial strengthening, stretching, core strength training and body mechanics analysis and correction. 5. Anti-inflammatory medications as prescribed by your physician. 6. Use of a counter-force brace for activity and/or a wrist splint at night. 7. Gradual return to sport following a functional progression (a one-two week program that starts with easy sports skills and progresses to harder skills as able without return of the pain). - Chronic elbow pain that does not resolve with the above treatments may be due to a buildup of scar tissue in the tendons of the affected muscles. This type of problem is difficult to treat, but there is a new type of treatment offered at St. Francis Sports Medicine and Physical Therapy called Augmented Soft Tissue Mobilization (ASTYM). ASTYM uses special tools to stimulate healing of the affected areas, and is most affective on active athletes who need to recover quickly and get back to their sports. For more information about ASTYM, contact the author by e-mail (melanie.pennington@ssfhs.org) or go to the ASTYM web site www.astym.com. And remember, when it comes to elbow injuries, an ounce of prevention is worth a pound of cure. Train smart, get enough rest and play hard.