CNY Orthopedic Sports Medicine, PC: Bodyzone: Elbow

Body Zone: Elbow

From ancestral hunters hurling spears to modern pitchers unleashing fastballs, the architecture of the elbow is responsible for some of the power and precision we bring to the act of throwing. And in sports like golf and tennis, where the club or racket is essentially an extension of the arm, the elbow plays, literally, a pivotal role in delivering propulsive force. For that reason, as many athletes can testify, the elbow is one of our most vulnerable joints.

More than 40 percent of young baseball players sustain elbow overuse injuries each spring. And the consequences can be serious: repeated pulling on the elbow with powerful overhand pitches can actually tear the elbow ligament and tendon away from the nearby bone.

Elbow injuries can also take longer to cure than other overuse injuries - from six to 12 weeks or more--because there are few muscles-to-bring blood and its healing cells to repair damaged tissues. The good news is that most elbow problems can be successfully treated with rest, medication, physical therapy, and simple strengthening techniques can prevent further injuries.

The most common sites for elbow injury are the tendons that attach to the epicondyles (funny bone). Overusing arm muscles, especially by snapping, rolling, or aggressively twisting the forearm can inflame and cause tiny tears in these tendons. Tennis elbow refers to pain near the outer, or lateral, side of the elbow, and golfer's elbow refers to pain on the inner or medial side of the elbow. Injury also commonly occurs at the ulnar nerve when repeated bending of the elbow strains and swells the nerve, sometimes trapping the nerve in its bony tunnel - the cubital tunnel.

Lateral Epicondylitis (Tennis Elbow)
Medial Epicondylitis (Golfer's Elbow)

Harmful Behaviors
  • Relax. Frequent bending of the elbow without rest breaks.
  • Don't over exert. Twisting, rolling, or snapping the forearm with excessive force.
  • Don't get a grip! Too much tension when gripping sports equipment, like a tennis racket or golf club, can be harmful.
  • Inappropriate equipment. A racket that is too heavy, strung too tightly, or with a handle too large, can tire the arm and stresses the elbow.
  • Work out. Lack of exercise weakens the surrounding muscles which stabilize the elbow.

  • Good Practices
  • Warm up. Muscles stretch and more easily absorb strain when they're warm.
  • Take rest breaks. Stretch out the muscles and tendons of the elbow.
  • Take care. Try to avoid excessive activity that requires twisting or snapping of the elbow if you have not been appropriately conditioned or trained to do so.
  • Get good gear. Seek professional advice when choosing rackets and clubs.
  • Work out. Condition your upper body particularly with daily stretching and strengthening exercises.

  • General Conditioning
    To prevent an elbow injury, it's vital to keep your arm muscles strong and flexible. Try regular stretching exercise for the upper body; it will keep your arm muscles elastic and pliable. Strength training exercise at home or at the gym with simple equipment such as light dumbbells builds up your forearm muscles and protects against injury.

    The elbow is a masterpiece of engineering. Three long bones - the bone of the upper arm (humerus), the inner bone of the forearm (ulna) and the the outer bone of the forearm (radius) - meet in the middle of the arm to form a hinge and pivot joint. The elbow allows us to move the arm forward and backward like a door hinge, rotate the forearm 180 degrees, and do it with grace and strength. The rounded edges of the humerus give the elbow its two prominent bumps, called the inner(medial) and outer (lateral) epicondyles.

    Several tendons from the forearm attach to both the inner and outer epicondyles and are particularly vulnerable to injury. Lying over the tip of the elbow, a fluid-filled sac (bursa)cushions the joint and reduces the friction caused by movement of the bones. When you hit your elbow and feel a tingling sensation, you've jolted the elbow's funny bone (ulnar nerve). The ulnar nerve moves down the arm, over the elbow and into the hand, providing sensation to several fingers and powering a number of hand muscles. The triceps muscle on the outer portion of the elbow helps us extend the elbow like a hinge.

     How Badly are You Hurt?
    Get answers to triage questions that will help you decide whether to contact a doctor.

    Product Considerations
    Elbow: Support
    A forearm support bandage, worn just below the elbow, can provide relief from pain. It reduces stress on inflamed or damaged tissues lying above the brace. The elbow support (brace) is not meant to be place directly on the inflamed area. It is designed to be just below to the area so as to relieve the injured portion so that it may heal. In addition, an elbow brace may help relieve swelling. But it is not a panacea and should not take the place of a good exercise therapy program to promote healing.

    Most doctors can fit you with an elbow brace. It's wise to consult your doctor before you buy a brace from a pharmacy or other store. Wearing the wrong kind of brace or wrapping a brace in the wrong way can lead to further injury.

    Hot/Cold Pack
    The use of hot and cold packs to relieve pain and inflammation is a common method of treatment for many conditions. When the soft tissue groups become strained or irritated the rotating application of hot and cold can be beneficial. Cold therapy numbs the nerves to reduce pain and combats swelling by constricting blood vessels and by slowing blood flow to the site of injury. The application of heat to an injury after a few days of cold therapy and after swelling and redness has been reduced promotes the healing process. Heat therapy speeds up healing by increasing the flow of blood to the site of injury. Heat will also restore flexibility, relieve muscle cramping, and arthritic symptoms.

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