COMMON ELBOW PROBLEMS IN SPORTS

Miami Heat Magazine, Vol. IV, No. 2, December 1992

Tennis Elbow

Sports-related elbow injuries are common. The injuries that occur to the elbow are usually caused by chronic repetitive stresses and overuse. The athlete will usually complain of pain in the region of the elbow after a sudden increase in activity. Elbow injuries do occur in basketball-related activities but more frequently result from sports such as tennis, golf, baseball, and weight-training.

The outside portion of the elbow (the lateral epicondyle) is a common site for overuse injuries. This condition, commonly known as tennis elbow, usually results from a sudden increase in tennis-related activites, an increase in string tension of the tennis racquet, or recent racquet change. In some circumstances, the pain in the outside aspect of the elbow can become so severe that the athlete will have pain while shaking hands, opening a door, or even screwing on a light bulb. The site of attachment of the tendon and muscles that allow the athlete to extend the wrist is a common source of the elbow discomfort. Most athletes can be treated with a modification of their activities and a rehabilitation program emphasizing decreasing the pain, soreness and swelling on the outside aspect of the elbow as well as a pain-free strengthening program of the forearm musculature. Occasionally, tennis elbow can be a lingering problem and may require a long period of time to heal. In some cases, it may require more aggressive treatment such as an injection. It rarely requires surgery.

Golfer’s Elbow and Pitcher’s Elbow

Unlike tennis elbow, which is the result of repetitive activites on the outside portion of the elbow, golfer's and pitcher's elbow are the result of increased activity and stress on the inside "medial aspect" of the elbow.  The muscles and tendons that allow the athlete to flex the wrist and fingers and push the palm downward have their origin on the inside aspect of the elbow.

Once again, the athlete may complain of pain after a sudden increase in weight training, hard throwing, or increased time on the golf course and driving range.  These conditions usually respond to a rehabilitation program involving decreasing the pain and improving the strength in the forearm musculature.

Once the athlete has recovered, it is necessary to attempt to prevent recurrence of the painful elbow.  A careful review of the athletes technique while throwing or golfing with corrections by the coach and trainer may be necessary.  Athletes who train regularly with weights may have to further modify their lifting technique.

If a young athlete who is not yet fully grown begins to develop elbow pain on the inside aspect of the elbow, this should also be evaluated by the family orthopedic surgeon.  Unlike adult overuse injuries to the elbow, which usually inolve injury to the tendinous attachment to the bone, little   leaguer's elbow may actually be the result of a defect in the bone itself.   After careful evaluation by the physician, the young athlete may require a rehabilitation program prior to returning to sports related activities or may actually be forced to rest the arm for a period of months.

Injuries to the elbows are very common in the athlete.  Most elbow injuries are with a sudden increase in that activity.   Usually, most elbow problems respond to conservative treatments involving physical therapy and rehabilitation.  If elbow symptoms occur, it is usually beneficial to seek consultation with your physician in an effort to get the problem taken care of as quickly as possible.  This can usually be accomplished while still participating in the sport that the athlete enjoys.

Most importantly, most overuse injuries to the elbow can be prevented by emphasizing proper technique.  Remember, if you increase activity in a sport, do it on a gradual basis.