Written by Coach D
A couple of times in the past month I have heard a a few of our clients concerned about elbow pain. There are two common elbow injuries that we see that I am going to discuss. These two injuries are Lateral Epicondylitis (Tennis Elbow) and Medial Epicondylitis (Golfer’s Elbow). Two things I would like you to keep in mind as you read this article. One is that these are NOT the only two elbow injuries that one can have, and that some of the signs and symptoms that I discuss are similar to other elbow injuries as well. Two, this is NOT an official diagnosis. This article is meant to give you a background on the signs, symptoms and possible treatments for the two injuries.
Tennis elbow or “lateral epicondylitis” is a condition that causes pain on the outside “bony” portion of the elbow known as the lateral epicondyle. The muscles involved are the extensor muscles which pull the wrist up (Figure 1). Golfers elbow or “medial epicondylitis” causes pain on the medial side of the elbow. The muscles involved in golfers elbow are the flexor muscles on the inside of the forearm (Figure 2). The main cause for both of these injuries is overuse of the muscles.
Both lateral and medial epicondylitis are caused by repetitive movements at the wrist or the elbow. These repetitive movements lead to overuse of the muscles (wrist extensors and flexors) and cause partial or complete tears of the tendons that attach the muscles. Lateral epicondylitis is caused by repetitive forward and backward movement of the wrist. Many tennis players experience this because of the repetitive front to back movement of the wrist on their backhand swing. Medial epicondylitis is caused by repetitive movements involving flexion and pronation of the wrist. Repetitive flexion and pronation of the wrist occurs in a golfer’s swing and a baseball player’s pitch.
Now that we know the location and the cause of the pain, let’s discuss a couple of basic tests that you can perform that will give us an idea of a positive or negative diagnosis. To start, do you have pain on either the lateral or medial epicondyle when placing pressure on those areas? The second is a resisted strength test. To test for lateral epicondylitis the forearm will be face down on a table and someone is going to resist your hand as you try to pull your wrist up (extend). Pain experienced on the outside of the forearm during this test is an indication you may have tennis elbow. To test for medial epicondylitis you will turn your forearm over so that it is facing up, have someone apply pressure to your palm as you flex your wrist. If you experience pain in the medial side of your forearm during this test it is can be an indication of golfers elbow. Keep in mind that this only gives you an idea as to whether or not you may or may not have either condition, see a professional health care provider for an exact diagnosis.
As with any overuse injury, you must rest the muscles. The good ‘ol “RICE” saying is a good one to follow in this case. Rest. Ice. Compression. Elevation. Our first goal is to get the muscles calmed down and get rid of all inflammation. Once we do that we can then begin basic stretching and exercising. Since both are wrist and elbow injuries we will start with your basic wrist extension and flexion stretch. Hold these stretches for :30 and do them 3 times/day.
Along with stretching, there are a couple of basic lightweight (2-5 lb) dumbbell exercises you can perform. These include wrist extension and flexion, wrist pronation and supination, and radial/ulnar deviation. Perform 3 sets of 10 reps of each exercise. Begin with light weight and slowly progress to 5 lb dumbbells.
Its official, you are all now lateral and medial epicondyle specialists. NOT! Remember, I have given you the basics and the basics only. You now know the differences in location of the two, the medial and lateral sides of the forearm. You know that one is caused by forward and backward movement of the wrist (tennis elbow) and one is caused by pronation and flexion of the wrist (golfers elbow). I have given you a couple of very basic tests you can use to evaluate your situation. Lastly, you now know what steps to take if you think you may have one of these injuries. If you take these steps and DO NOT see any progress, see a professional to get an official diagnosis.