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October 18, 2021 4 min read

Earth Fed Elite Athlete and certified PA, Matt Shaw gets you the most simple guide to healthy, pain-free elbows.

You may be experiencing an elbow injury without even knowing it.

Injury terms like tennis elbow and golfer’s elbow are often used as blanket terms for overuse injuries of the elbow, but what do these phrases actually mean? Tennis elbow, also referred to as lateral epicondylitis, is inflammation on the outside of the elbow

Golfer’s elbow, also referred to as medial epicondylitis, is inflammation on the inside of the elbow. While these specific sport names are associated with each condition, both can be caused by a variety of activities including weight training and throwing/racket sports.  Often a job or even hobbies may be to blame for pain when done repetitively without proper care for oneself!

Anatomy 101

Time to nerd out and take a brief anatomy lesson. The elbow joint is made up of three bones: humerus, radius and ulna. Multiple ligaments, including ulnar collateral ligament, radial collateral ligament and annular ligament, hold these bones together. The biceps and triceps are the powerhouse muscles responsible for flexion and extension, respectfully. The biceps has an additional role in supination, or turning the palm towards the ceiling, while the pronator teres and pronator quadratus are responsible for pronation, turning palm down towards the floor.

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elbow anatomy

In addition to these muscles, there are also attachments of wrist flexor and extensor muscles. The flexors not only flex the wrist, but also aid in closing the fist. The extensors, on the other hand, extend the wrist and work to resist wrist flexion. In the case of Tennis elbow, the extensor tendons, attached to the lateral epicondyle, become inflamed and painful. Conversely, in Golfer’s elbow, the flexor tendons, attached to the medial epicondyle, become inflamed and painful. When these conditions are new, the body recognizes something is wrong and initiates a healing process. If symptoms are ignored, the condition may become chronic and no longer identified by the body as an injury in need of repair. 

Treatment

What now? How can this problem be resolved to return to regular training and activity without pain, right away? If you are simply told rest or try anti-inflammatories with maybe even a cortisone injection please find yourself an experienced provider that actually wants help for their patients. While these remedies might improve your immediate symptoms they're doing nothing about strengthening connective tissue where it matters - at the site of injury itself.

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Let’s go down a different path; one of healing, strengthening and success. If symptoms are severe with basic tasks, a short period of rest would be beneficial. Once tolerated, a series of rehab exercises and stretches will not only assist in healing the current injury, but it will also build up muscle and tendon strength to be able to tolerate the movements or exercises that caused the condition in the first place.

 Golfer’s Elbow:

  • Stretches: “L” stretch with palms facing each other (goal is to getwrists to 90 degrees), using opposite hand to pull fingers back, aim for at least 30 second holds
  • Isometrics:  position forearm on edge of table or bench with palm facing up holding dumbbell and preventing wrist extension (30-60 seconds x 3-5 rounds), farmer or suitcase carries holding dumbbell or kettle bell
  • Strengthening: wrist curls with dumbbell or barbell, arm curls gripping dumbbell or barbell with palms facing the floor, stress ball or grip squeeze device, pronation and supination resistance (can be done holding handle of hammer and rotating palm to sealing and back to floor), Good rep ranges would be 8-12 for 3-5 sets. Start low and build over time. Focus on form and quality of repetition

Tennis Elbow:

  • Stretches: “L” stretch with back of hands facing each other (goal is to get wrists to 90 degrees), using opposite hand to assist wrist flexion, aim for at least 30 second holds
  • Isometrics:  position forearm on edge of table or bench with palm facing down holding dumbbell and preventing wrist flexion (30-60 seconds x 3-5 rounds), farmer or suitcase carries holding dumbbell or kettle bell
  • Strengthening: wrist extensions with dumbbell or barbell, arm curls gripping dumbbell or barbell with palms facing the floor, towel twist, stress ball or grip squeeze device, pronation and supination resistance (can be done holding handle of hammer and rotating palm to sealing and back to floor), Good rep ranges would be 8-12 for 3-5 sets. Start low and build over time. Focus on form and quality of repetition

Wrap up:
I hope this dive into the world of Tennis Elbow and Golfer's Elbow helps expand your knowledge about elbow injuries. Symptoms generally result from overuse of gripping or forearm dominant exercises or activities. The goal in treatment is to establish the correct diagnosis and commit to a consistent rehab program to resolve symptoms and prevent recurrence of injury. If symptoms fail to improve or worsen with time, please consult your Sports Medicine or Orthopedic provider. As always, do not neglect proper sleep, diet and hydration. Our friends at Earth Fed Muscle do an excellent job providing a clean line of supplements to help stay on top of our game. In this particular scenario, I would recommend The Keystone Collagen Superprotein. Tendons are primarily made of collagen and this may aid in growth and repair.  Until next time my Friends! Feel free to suggest a topic to dive into.


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