3 Steps to Fixing Your Elbow Pain for Good
Has elbow pain been making lifting, climbing, or golfing less enjoyable? Have you spent months, or even years, trying every kind of brace, tape, injection, medication, and exercise with only short term results? The following 3 step process will help provide a simple solution to get you out of pain and back to performance, without any of the confusion or “too good to be true” gimmicks found online.
1) Calm it Down
The most common elbow conditions experienced by athletes are Tennis Elbow (lateral epicondylitis) and Golfer’s Elbow (medial epicondylitis). These conditions are typically caused by overuse of the muscles that cross both the wrist and the forearm in sports that involve lots of gripping, heavy lifting, or swinging, leading to irritation at the point where the tendons originate at the elbow.
The biggest low hanging fruit that many practitioners will recommend is to stop your activity entirely. But oftentimes, that is neither realistic nor desirable. Nobody wants to put their passions on hold in order to get symptom relief. Additionally, what often happens when athletes stop their sport entirely is that their muscles and tendons become deconditioned, making them more susceptible to these types of injuries in the future when they return to their sport. The more realistic and effective option, then, is to get creative to find a less intense version of the aggravating activity while symptoms are at their worst.
For gym-goers, this could mean reducing sets, reps, or weights. It could also mean picking some slightly different exercises that are less painful for the time-being as things heal.
For golfers and tennis players, this could mean limiting your swing count or decreasing your distance.
For climbers, this could mean spending your time on easier problems and routes, taking a step back to focus on technique.
The most important takeaway here is the principle of active recovery. The modification allows the tendons some room to breath (so long as pain stays <3/10) while still maintaining some degree of musculotendinous strength and resilience when the time comes for full participation.
This is also the stage where some good old TLC can be beneficial. Massage, ART, cupping, dry needling, and wrist bracing can all have value in bringing symptoms down to a more tolerable level. What is important to note, however, is that these strategies provide temporary relief and are not to be confused with a permanent fix.
You can find an example of an easy self-massage ART technique here.
2) Build it up
Speaking of permanent fixes, this is where the “build it up” phase comes in. Once the symptoms have been reduced to a more manageable level with the strategies listed above, it’s time to address some of the root causes that have led to these issues in the first place.
Where many athletes and providers go wrong is they put too much focus on the above strategies without honing in on all of the potential root causes that can lead to elbow pain. Additionally, many exercise programs focus excessively on the elbow itself or the wrist in the form of wrist curls, and forget some of the other muscle groups that are equally important, such as:
Finger flexors/extensors. Many of the muscles that are responsible for gripping, curling, and extending your fingers also travel upward and cross the elbow joint. By strengthening the finger flexors/extensors, you are A) helping to take the load off of any one tendon or muscle that may be carrying the tendon team during your sport and B) building resilience in those tendons in the event that they are part of the problem, making the injury less likely to pop up in the future.
You can find an example of a finger extension exercise here.
Shoulder girdle. By strengthening the shoulder girdle, you are bringing just another crucial player onto the squad to take up some of the load. By building strong shoulders, especially the rotator cuff and scapular stabilizing muscles, you will help decrease the amount of demand being placed on the elbow attachments.
Check out one of our favorite shoulder exercises here.
3) Make It Last
The “make it last” phase is all about weaning gradually back into your prior level of activity while maintaining some degree of participation in your “build it up” exercises to maintain elbow resilience.
The word “gradually” is crucial here, as many people jump right back into their prior level of activity without allowing their tendons time to recalibrate to their sport.
Take it slow, and progress 10-25% each week. Prioritize sleep and nutrition to minimize stress on the system. Continue strength training to build up the supporting muscle groups.
And while this approach may seem simple in principle, recovery is rarely linear; there will likely be ups and downs and transitions to/from each stage. Stay patient, stay the course, and if need be, seek help from a provider who understands your sport.
Dr. Brooks Kenderdine
PT, DPT, CSCS, USAW-1
Co-owner | The PATH Rehab & Performance
