Physiotherapy and rehabilitation
We will present the most common elbow injuries in detail. Every pathology or elbow injury comes with a description of general facts, causes that led to the development of the injury, characteristics of the symptoms, diagnosis, and the course of treatment.
Tennis elbow (lateral epicondylitis) denotes the pains that appear on the outer side of the elbow. The tennis elbow appears at those attachment points of muscle tendons that extend the wrist and grow attached to the outer side of the elbow, precisely on the lateral epicondyle (a bulge on the outer part) of the humerus.
What kind of an injury is the tennis elbow?
Tennis elbow is an overuse type of injury of the forearm muscle tendons. The overuse causes degenerative changes in the tendon that stimulate the pain receptors; the tendons are oftentimes also in the state of inflammation. Tennis elbow is not exclusively related to tennis and sportspeople. It is also an occupational injury among individuals who overexert their arms – painting, using the computer mouse, using the screwdriver, carrying objects, gardening, experiencing vibrations, weightlifting…
Symptoms of tennis elbow include burning and sharp pain that appears when clenching fists and limits grip strength. The area on the outer side of the elbow is oftentimes tender to the touch; typically, we can cause unpleasant pain by using stronger palpation or manual pressure. What is characteristic of the tennis elbow is that the pain spreads from the elbow down across the entire forearm.
Tennis elbow is mostly caused by poor biomechanics of the wrist, which means that when performing arm movements, the positions of the wrist are incorrect (certain activities overburden the wrong muscle units). A common cause of tennis elbow is poor readiness of forearm muscles to perform activities (the right muscles are overburdened but due to poor training, the overburden happens relatively fast; we speak of poor endurance in terms of strength and poor mobility of the joint). A common direct cause of tennis elbow is muscle imbalance, which means that muscles on one side of the forearm are incomparably stronger or weaker than on the other side of the forearm (the muscles on the front side of the forearm are usually stronger and shorter whereas the muscles in the back tend to be relatively weak).
The symptoms of the tennis elbow usually last from 6 to 16 weeks. If we do not perform conservative treatment, the issues may last continuously for several years or in the shape of occasional outbursts of pain and significantly limit your functionality. We often treat cases where the elbow issues have lasted for several years because the condition was not treated with training, but the main point of focus was pain relief.
Tennis elbow is treated systematically. First, we carry out appropriate diagnostics by measuring muscle characteristics and searching for potential causes of pain in muscle stiffness, muscle imbalance, or poor strength. Once we’ve identified the cause of tennis elbow, we carry out the appropriate number of therapeutic sessions to lessen the acute pain and prepare the body for the further course of treatment with exercise.
Shock wave therapy carried out by an expert physiotherapist, is highly successful in reducing the pain caused by an injury such as the tennis elbow.
The key and the longest stage of treatment of tennis elbow is individual kinesiotherapy, which improves functional muscle imbalance that was diagnosed at first examination and thereby eliminates primary reasons for the development of tennis elbow. What is typical of a pathological condition such as the tennis elbow is that those who do not continue the treatment of causes, that is the phase of muscle strengthening, even after the pain has subsided, develop repetitive elbow issues.
The treatment of the injury does not end once the symptoms – the pain – disappear. The damage is repaired once we finally eliminate the cause of injury.
Golfer’s elbow (medial epicondylitis) denotes the pains that appear on the inner side of the elbow. The golfer’s elbow appears at those attachment points of muscle tendons that flex the wrist and grow attached to the inner side of the elbow, precisely on the medial epicondyle (a bulge on the inner part) of the humerus.
What kind of an injury is it?
Golfer’s elbow is an overuse type of injury of the forearm muscle tendons. The overuse causes degenerative changes in the tendon that stimulate the pain receptors; the tendons are oftentimes also in the state of inflammation. Golfer’s elbow is oftentimes a chronic condition of golfers; however, it is not exclusively related to golf and sportspeople. It also occurs with high frequency among those professions and tasks that overexert the arms (painting, using the computer mouse, using the screwdriver, carrying objects, gardening, experiencing vibrations, weightlifting).
Symptoms of golfer’s elbow include burning and sharp pain that appears when clenching fists and limits grip strength. The area on the inner side of the elbow is oftentimes tender to the touch; typically, we can cause unpleasant pain by using stronger palpation or manual pressure. The characteristic of the golfer’s elbow is that the pain spreads from the inner side of the elbow down across the inner side of the forearm.
Golfer’s elbow is mostly caused by poor biomechanics of the wrist, which means that when performing arm movements, the positions of the wrist are incorrect (certain activities overburden the wrong muscle units).
A common cause of the golfer’s elbow is poor readiness of forearm muscles to perform activities (the right muscles are overburdened but due to poor training, the overburden happens relatively fast; we speak of poor endurance in terms of strength and poor mobility of the joint). A common direct cause of a golfer’s elbow is muscle imbalance, which means that muscles on one side of the forearm are incomparably stronger or weaker than on the other side of the forearm (the muscles on the front side of the forearm are usually stronger and shorter whereas the muscles in the back tend to be relatively weak).
The symptoms of golfer’s elbow usually last from 6 to 16 weeks. If we do not perform conservative treatment, the issues may last continuously for several years or in the shape of occasional outbursts of pain and significantly limit your functionality. We often treat cases where the elbow issues have lasted for several years because the condition was not treated with training, but the main point of focus was pain relief.
Golfer’s elbow is treated systematically. First, we carry out appropriate diagnostics by measuring muscle properties and searching for potential causes of pain in muscle stiffness, muscle imbalance, or poor strength. Once we’ve identified the cause of golfer’s elbow, we carry out the appropriate number of therapeutic sessions to lessen the acute pain and prepare the body for the further course of treatment with exercise.
Shock wave therapy carried out by an expert physiotherapist, is highly successful in reducing the pain caused by an injury such as the golfer’s elbow.
The key and the longest stage of treatment of golfer’s elbow is individual kinesiotherapy, which improves functional muscle imbalance that was diagnosed at first examination and thereby eliminates primary reasons for the development of the golfer’s elbow.
What is typical of a pathological condition such as the golfer’s elbow is that those who do not continue the treatment of causes, that is the phase of muscle strengthening, even after the pain has subsided, develop repetitive elbow issues. The treatment of the injury does not end once the symptoms – the pain – disappear. The damage is repaired once we finally eliminate the cause of injury.
Climber’s elbow denotes the pains that appear on the inner side of the elbow. The climber’s elbow is a chronic inflammation of the attachment points of elbow flexors, most often that is the muscle group brachialis that is attached to forearm tuberosity and less often the muscle group biceps that is attached to the radial tuberosity. In both cases, we can sense significant pain on the front or inner side of the elbow.
Climber’s elbow is an overuse type of injury of the upper arm muscle tendons. Golfer’s elbow and climber’s elbow are not the same pathological conditions, even though both are a case of tendinopathy. The golfer’s elbow is an inflammation of the muscle tendons that flex the wrist, whereas the climber’s elbow is an inflammation of the muscle tendons that flex the elbow. In both cases, the pains appear on the inner or front side of the forearm, except that with the golfer’s elbow, they are located a bit higher, and the pain is more superficial, whereas with the climber’s elbow they are located a few centimetres lower and deeper. The overuse causes degenerative changes in the tendon that stimulate the pain receptors; the tendons are oftentimes also in the state of inflammation.
Climber’s elbow is oftentimes a chronic condition of climbers; however, it is not exclusively related to climbing and sportspeople. It also occurs with high frequency among those professions and tasks that overexert the arms (painting, using the computer mouse, using the screwdriver, carrying objects, gardening, experiencing vibrations, weightlifting).
Symptoms of the climber’s elbow include burning and sharp pain that appears when clenching fists, lifting burdens, and pulling with the arms; it also limits grip strength. The area on the inner side of the elbow is oftentimes tender to the touch; typically, we can cause unpleasant pain by using stronger palpation or manual pressure. The characteristic of the climber’s elbow is that the pain spreads from the inner side of the elbow down across the inner side of the forearm.
Climber’s elbow is mostly caused by poor biomechanics of upper arm muscles, which means that when performing arm movements, the positions of the wrist and the elbow are incorrect (certain activities overburden the wrong muscle units). A common cause of the climber’s elbow is poor readiness of forearm muscles to perform activities (the right muscles are overburdened but due to poor training, the overburden happens relatively fast; we speak of poor endurance in terms of strength and poor mobility of the joint). A common direct cause of a climber’s elbow is muscle imbalance, which means that muscles on one side of the forearm are incomparably stronger or weaker in comparison to the other side of the forearm (the muscles on the front side of the forearm are usually stronger and shorter whereas the muscles in the back tend to be relatively weak).
The symptoms of the climber’s elbow usually last from 6 to 16 weeks. If we do not perform conservative treatment, the issues may last continuously for several years or in the shape of occasional outbursts of pain and significantly limit your functionality. We often treat cases where the elbow issues have lasted for several years because the condition was not treated with training, but the main point of focus was pain relief.
Climber’s elbow is treated systematically. First, we carry out appropriate diagnostics by measuring muscle characteristics and searching for potential causes of pain in muscle stiffness, muscle imbalance, or poor strength. Once we’ve identified the cause of climber’s elbow, we carry out the appropriate number of therapeutic sessions to lessen the acute pain and prepare the body for the further course of treatment with exercise.
Shock wave therapy carried out by an expert physiotherapist, is highly successful in reducing the pain caused by an injury such as climber’s elbow.
The final, most important and longest stage of treatment of climber’s elbow is individual kinesiotherapy, which improves functional muscle imbalance that was diagnosed at first examination and thereby eliminates primary reasons for the development of climber’s elbow. What is typical of a pathological condition such as the climber’s elbow is that those who do not continue the treatment of causes, that is the phase of muscle strengthening, even after the pain has subsided, develop repetitive elbow issues. The treatment of the injury does not end once the symptoms – the pain – disappear. The damage is repaired once we finally eliminate the cause of injury.
Bursitis is an inflammation of the bursa or synovial membrane, small sacs that are located between bone and tendon. Bursae reduce friction between tendons, muscles, and other structures of the joint and they also improve joint mechanics; the movement is, therefore, smoother. Elbow bursitis is also called olecranon bursitis. It causes the area behind the elbow where the elbow bursa is located to fill up with fluids. Elbow bursitis grows more common with age, and it usually affects the male population on their dominant upper extremity.
The cause of elbow bursitis is not known; one of the risk factors is chronic physical overload and traumatic injuries to the elbow joint. The acute form of elbow bursitis usually appears after straining the arm or after putting a specific burden on it. Chronic elbow bursitis that lasts for several months usually refers to former repetitive traumatic injuries to the elbow.
The symptoms of elbow bursitis include a mushroom-like swelling on the back of the elbow. The swelling oftentimes seems to appear out of nowhere or you do not remember when exactly the external symptoms first started to appear. The inflammation of the elbow bursa can be accompanied by pain, swelling, and tenderness in the affected joint. Discomfort and pain usually appear during stretching or putting a burden on the elbow joint or directly when hitting it or pressing on the back side of the elbow. Chronic elbow bursitis can lead to arthrofibrosis and limit the joint’s mobility.
A reliable diagnosis can be obtained by puncturing the swollen bursa and analysing the fluid inside of it once we’ve excluded the possibility of an infection and crystal deposits in the elbow. X-ray imaging is used to exclude bone fractures. Magnetic resonance imaging (MRI) is not necessary in case elbow bursitis is suspected, unless some atypical symptoms are present and there is uncertainty regarding the diagnosis.
Treatment includes therapy with non-steroidal anti-inflammatory drugs and systematic individual physical therapy. It is necessary to avoid activities that overburden the elbow, getting hit, and putting pressure on the back side of the elbow.
It is recommended to follow conservative management that includes special exercises to get rid of elbow muscle imbalance and therapeutic techniques such as friction massage, laser therapy, and magneto-therapy. In some rare cases, steroid injections are also used, as is surgical treatment with advanced forms of elbow bursitis. If we do not treat elbow bursitis, then, in the long run, this leads to calcium depositions in soft tissues and therefore permanent joint damage. With appropriate conservative physical therapy, the symptoms improve in the period of 6 to 10 weeks for the majority of patients.
