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Thursday, December 3, 2015

That damn lateral elbow pain

    In the sports performance and sports injury management, we study the mechanism of injury as well as the most popular injuries that occur in that sport: Baseball:shoulder, runners:ANYTHING below the knee can be affected!, swimmers:shoulder, football:knees, . You get the idea. Well I can officially say that the most popular injury in the sport/hobby of weight training is the elbow. Yes. The elbow. I know what you are thinking, "what about the shoulder". True. But shoulder complaints can come from poor mechanics at the, you guessed it, the elbow!

     The condition is called  Lateral epicondylitis or in layman's terms 'tennis elbow'. It afflicts many athletes especially in sports where grip strength is required. This area of the arm is often neglected because we don't think about it being  a major contributor to overall arm function. My first patient out of grad school had symptoms so severe she had to the ripe old age of 31! (oh yeah....BOTH elbows were affected)! In fact, she needed help just pumping gas! So it is a pesky overuse or microtraumaitc injury that can really be a 'drag' on performing high level lifts. Just consider the amount and frequency of setting up your lifting stations, doing the lift, stripping the weight off, etc.  You get the picture.There is constant compression at this joint. This compression, ironically, increases stability of the elbow;whenever you make a fist this happens. 

     Moreover techniques require 'fist' like grip to perform kettlebell work, 'kips', now combine that with any free weight dumbbell work that involves elevation through abduction and flexion, advanced Olympic lifts, serious volume throughout the week etc. Consider the amount of grip strength that it requires. Those muscles originate at the elbow. Specifically the lateral elbow. That group of  muscles is responsible for pronation, supination and the eccentric control of both of those movements. Lets face it, unless you know this you won't know how to prevent it. The radius(thumb side) articulates with the distal humerus: radio humeral joint. This region of the elbow gets stressed often, not only with weight training, but also with repetitive use ie operating your 'mouse' on your computer. You don't have to be in the gym to get this ailment!

    Our prevention strategy at  BODY SPECS varies. It varies depending on when our clients inform us! The typical rule for healing time is commensurate with the onset of symptoms e.g. 2 weeks onset, 2 weeks healing time;typically. Nevertheless check out these successful strategies below:
  • Cryomassage: Ice cube rubbed over lateral elbow joint above and below. Whether you have symptoms or not. Prevention is key!
  • Reverse dumbbell curls. The key is to lower the weight slowly. So get a dumbbell no heavier than 10#. Rest forearm on thigh, palm down with weight in hand. Raise weight but lower with a 3 count i.e. "1 1thousand, 2 1 thousand" etc.  3X7 per side, even if asymptomatic {no pain] expect mild discomfort;this is normal
  • My fave is a combination of analgesic pain and inflammation control: Aspercream[has lidocane] and BIOFREEZE type gel or PERFORMANCE SPORTS gel. A dallop of each in your palm and rub together then apply to affected elbow-EVERYDAY!;before you leave the house and before bed till symptoms subside or till you use up both products whatever comes from first. 
  • Another common practice is use of a compression elbow sleeve or Hex sleeve. I like these as a maintenance tool but NOT as a treatment modality. Use above strategy along with bracing. 
  • I will use a tried and true technique I used as a clinician called muscle energy. It is a manual technique that requires resistance concentrically, eccentrically in multiple planes of motion from shoulder to wrist. Great results with this. STRONGLY recommend finding a qualified person ie, ATC, PTA, PT, instead of YOUTUBE to do this!