Elbow Tendinopathy: A Closer Look at Golfer’s Elbow and Tennis Elbow Justin Cormier and Brendan Gates of Champion Physical Therapy & Performance
Have you ever felt a sudden twinge in your elbow after a game of golf or tennis? Do you feel like your elbow hurts with just simple tasks, like grabbing your coffee or water bottle? Does your grip feel weak? You’re not alone! These are common complaints from patients who struggle with medial and lateral elbow tendinopathy, also known as “golfer’s elbow” or “tennis elbow”, respectively. (And NO, you don’t need to play tennis or golf to have these problems.)
What is Elbow Tendinopathy?
In simple terms, tendinopathy is when there is damage to a tendon in your body. Tendons connect your muscles to your bones and ultimately help us move. (Not the same as a ligament! Ligaments connect bones to bones.) Tendinopathy can occur in many ways, from one specific injury or from overuse after repetitive movements. When these tendons are overworked or strained, it can cause acute and long-lasting pain in the inflamed areas.
The Tale of Two Elbows: Golfer’s Elbow and Tennis Elbow
To differentiate the two common types, a golfer’s elbow is pain on the INNER side of the elbow, while tennis elbow affects the OUTER side of your elbow. Despite their names, these conditions aren’t confined to just sports enthusiasts! They can occur due to any repetitive motion that strains the elbow joint, such as; prolonged computer use, repetitive lifting, repetitive gripping/manual labor or even playing a musical instrument. They can also be the result of compensatory movements due to range of motion deficits at the shoulder or wrist.
A Multi-Modal Approach to Treatment
When it comes to treating elbow tendonitis, a one-size-fits-all approach won’t do the trick. There are many reasons why someone may develop this problem and having a thorough evaluation done to find the root cause is key. With that being said, everyone should be treated differently and there are a lot of interventions that can be used to assist someone’s recovery.
Soft Tissue Work and Massage
Soft tissue work (massage) can be a starting point for alleviating pain. By working on the muscles and tendons around the elbow, massage can promote blood flow and decrease muscle tension, which will reduce some discomfort and promote healing.
Dry needling, which involves inserting a thin needle into the painful area to trigger a twitch response and stimulate an inflammatory response, has been shown to assist in healing. Sounds nerdy, but this can be very effective! In a nutshell, the inflammatory response, caused by the needle itself, can reduce muscle tension, alleviate pain, and expedite the healing process by promoting blood flow.
In addition to these therapies, introducing local strength work to your whole arm and wrist should be a priority! Tendons crave resistance and resistance training can actually help with the healing of the tendon itself (through a process called “tissue remodeling”). In a nutshell, resistance training causes micro-tears in the muscle fibers, triggering a healing response. This involves the removal of damaged tissue and the synthesis of new proteins to repair and reinforce the area. Depending on what led to their pain, each person should have a personalized program to incorporate resistance training to remodel the inflamed tissue and increase strength in the supporting musculature.
Blood Flow Restriction Training
Blood Flow Restriction (BFR) training is a novel approach gaining traction in rehabilitation. It involves reducing the blood flow to a muscle group while performing high volume, low-intensity exercise. This unique combination triggers a hormonal response that promotes muscle growth and enhances recovery, without placing undue strain on the affected tendons. Imagine getting the same gains as lifting heavy weights but with way less weight?! This is very helpful in a tendinopathy situation as patients typically can’t lift heavy weights due to pain.
Wrapping It Up
Elbow tendinopathy, be it golfer’s elbow or tennis elbow, can be a real pain in the butt (or elbow, ha ha ha). It typically lasts a long time for people and many just wait for it to go away. But, you don’t need to! You can help expedite that process with a comprehensive and personalized approach to treatment. Just as you wouldn’t build a house with only one tool, the best outcomes are seen with many tools (soft tissue work, dry needling, resistance exercises, isometric training, and blood flow restriction training) employed in a comprehensive combination.
It’s essential to remember that while these modalities can significantly help, they should be undertaken under the guidance of a trained healthcare professional. This ensures your safety and helps you achieve optimal recovery. It’s time to say goodbye to elbow pain and reclaim the activities you love.
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