Golfer's Elbow--Or Is It?

A baseball pitcher throws a fastball. After the game, he notices his elbow is sore. He grabs an ice pack, placing it on the inside of his elbow and heads out the door.
A phone salesman wins an award for the most sales in his department. He gets in his car to drive to his favorite restaurant to celebrate, shrugging off the pins and needles sensations in his ring and small fingers and the sharp pain at his inner elbow.
When a golfer makes contact with the ball, he winces from pain in his elbow, causing him to drop the club. He grabs his arm, wondering what could be wrong.
What do all of these situations have in common? They all have pain at their inner elbow. So they all have the same diagnosis, right?
Wrong! Like the rest of your arm, the anatomy in this region is complex and intricate, so many structures can cause pain at the inner elbow. Bend your elbows to a 90 degree angle and place them next to your body. The part touching your sides is the inner, or medial elbow. This article discusses three of the most common causes of elbow pain at this location.
The baseball pitcher is suffering from a medial collateral ligament (MCL) strain, a result of repetitive torque and stress to the elbow during pitching. Small tears and overstretching of the ligament occurs, leading to laxity and instability at the elbow over time. See a physician if you suspect you have this condition. Early treatment should include a throwing analysis by an experienced occupational or physical therapist. They can pinpoint biomechanical problems and offer suggestions to correct technique. If ignored, MCL strains can progress to the point that surgery may be required.

Cubital tunnel syndrome is the likely culprit causing the salesman's symptoms. It occurs when pressure is placed on the ulnar nerve, which is located behind the bony knob on the inner elbow. Remember the last time you hit your funny bone? Well, that pain was the result of you hitting your ulnar nerve, which feels anything but funny! In the early stages, you will feel soreness at the inner elbow and may notice pins and needles in you ring and small fingers. This condition can also progress if ignored, so it's important to make an appointment with your doctor if you have these symptoms. Treatment includes splinting and stretching but focuses on modifying the activities that are aggravating the nerve. Again, ignoring these symptoms for long periods can require a surgery to remove pressure from the nerve.

The golfer does indeed have the characteristic "golfer's elbow," which is caused by inflammation of a tendon at the medial elbow. This tendon attaches the muscles that bend your wrist and fingers to the bony knob at the inner elbow. Seeking treatment in the early stages of this condition is also best because healing times are slower when any tendonitis becomes chronic. Identifying the aggravating activities and learning how to modify them can help to decrease your pain and stop the symptoms from becoming worse. Treat Yourself Therapy has a comprehensive exercise video that includes the education you need to get through your day with less strain on your elbow. It also contains hints on returning to tennis and golf! Learn more at www.TreatYourselfTherapy.com/golfers-elbow. Surgery is rare for this condition, even in chronic stages, but can be a last resort option.
The above examples have shown you that inner elbow pain can be the result of damage to a ligament, a nerve, or a tendon. The take home message is to seek advice from your doctor in the early stages to prevent the condition from becoming worse!

Shoveling Snow with Tennis Elbow

Shoveling snow is a reality of winter for many Americans. Although we haven't had much snow this year in Utah, I'm sure mother nature has a few surprises in store for us before the daffodils appear in spring! There's a lot of information on the web on proper body mechanics to avoid back injuries while shoveling snow. What I haven't seen is helpful hints for anyone who happens to be recovering from tennis elbow, and there are some things to know before grabbing your shovel and heading outside. So, if you are recovering from tennis elbow, and have no other options for getting your sidewalk or driveway cleared, read on!

First of all, shoveling snow is a strenuous activity, so be sure your back, heart and arms are up to the task before even considering shoveling your sidewalk. Warm up your muscles before getting started. Specifically with tennis elbow, it's important to do forearm stretches. Holding your arm out in front of you, with your palm down, place your other hand on the back of your hand, and apply gentle pressure, bending the wrist towards the floor, stretching the forearm extensor muscles. Hold this position up to 30 seconds, and repeat 3 times. Now rotate the extended arm so the palm is up, and apply pressure through the palm with your other hand, again bending the wrist towards the floor, and hold 30 seconds. Repeat 3 times. These stretches are good to do when you've finished shoveling as well.

Now, let's take a look at shovels. The lighter the shovel, the less stress on your arm and back. Curved handles help to keep your back straighter, enabling you to generate power through the legs and core. There are also shovels that have a "U" shaped handle, allowing you to push the show, using both arms equally, thus distributing the force between both arms. With tennis elbow, it's important to keep your elbows bent and as close to the body as possible. This lessens the stress to the elbows compared to pushing the shovel with the elbows straight. Also, keep your grip light. The lighter the grip, the less strain at the elbow.

Take small scoops when shoveling, especially if the snow is wet and heavy. Break the job up into small sections, and take frequent breaks, doing a few forearm stretches. If you have a forearm strap, or band, wear it when shoveling. Remember to keep your core strong, engaging shoulder, and shoulder blade muscles, which are larger and stronger than forearm muscles.

One thing you NEVER want to do is chip away ice. This is extremely aggravating to the elbow. The forceful gripping, lifting, and jarring actions are a deadly combination if you have tennis elbow.

When you're finished shoveling, if you have any elbow soreness, apply a cold pack, or put some snow in a baggie, wrapped in a pillowcase, to your elbow for 8 to 10 minutes. This helps decrease inflammation.

For more tips, and a 4 phase exercise program for treating yourself for tennis elbow, check out TreatYourselfTherapy.com/tennis-elbow.

Treat Yourself Therapy, LLC provides innovative and inexpensive do-it-yourself videos for people unable to attend hand therapy. These videos were developed by Jessica Karge, OTR, CHT and Kathleen Papi-Baker, OTR,CHT, both certified hand therapists who have over 40 years of combined clinical experience. To learn more, visit www.TreatYourselfTherapy.com.