Elbow Pain

Elbow Pain

Epidemiology (sports)

• Elbow injuries are common in sports and life and can affect performance and cause elbow pain in daily life.
• With sports, elbow injuries commonly occur in throwing and overhead sports, for example, cricket, baseball, and tennis, but can also occur in contact sports such as rugby and basketball. 
• As with most injuries, early communication from the athlete and early diagnosis and planning treatment plus return to sport is key to a good outcome! 

Mechanism Of Injury

• Elbow injuries can be both acute or chronic in nature.
• Acute injuries can occur through trauma, for instance, during a rugby tackle, taking a charge in basketball, or having a mountain bike crash. These acute injuries can also occur suddenly with throwing, involving an injury to the medial ligament of the elbow.
• Chronic injuries are more common, often due to overuse and improper loading. Tennis elbow (lateral or outside of the elbow) and golfers elbow (medial, or inside of the elbow) are chronic elbow injuries. These fall under the category of tendinopathies. They can occur in many sports such as rock climbing, weight lifting, golf, or tennis.
• Depending on your issue, pain in the elbow can arise from the neck or upper thoracic spine.

Key assessments required

• A thorough history will be taken to determine the diagnosis and causative factors relating to your issue.
• Determining whether the neck and thoracic spine is involved in your elbow issue will be a key part of the initial assessment.
• If acute, ligament testing may be indicated with possible imaging required.
• If chronic, we often don’t require imaging (x-ray or ultrasound). Instead, we look at a series of tests to look at muscle/tendon load tolerance, plus other factors relating to arm use and movement.

Evidence-based Treatment/Management Required

• Acute injuries may require sports doctor or orthopaedic surgeon input. Your physio will guide you early in the rehabilitation process with regard to possible referral.
• Chronic injuries, such as tendon-based injuries, will often need correct loading and strengthening programs.

Return to play and activity; prognosis

• Return to play is variable and based on the injury presenting
• Chronic injuries may be returned sooner and managed with graded loading over time.
• Acute injuries with periods of healing required often need strengthening and buildup. This can take 3-6 months post-surgery on some occasions.