Elbow Injury
mvpboxing  |   May 04, 2017, 12:05PM

Tennis Elbow
  1. Definition and Occurrence
    1. Also known as lateral epicondylitis, the muscle tendons that attach to the outside of the elbow function in extending the wrist. This action helps to position the arm for functions that require grip strength, such as holding a tennis racquet.
    2. Overuse of the tendons to extend the wrist can lead to inflammation and pain at the outside of the elbow, improper muscle strength and repetitive movement of the wrist and elbow where the tendons at the elbow become stressed due to poor mechanics.
    3. Although this is a common tennis injury, it can occur with overuse of the muscles in a lot of different sports, as well as in normal everyday function.
    4. Weakness in the shoulder muscles can contribute to improper lifting mechanics which can lead to overuse of the wrist extensor tendons.
  2. Signs and Symptoms
    1. Localized pain with resisted wrist extension and passive wrist flexion
    2. Tenderness with deep pressure on outside part of elbow
  3. Treatment
    1. Rest, Ice Massage, NSAID’s to decrease inflammation and give tendons time to heal
    2. Can initiate pain-free shoulder strengthening to help correct lifting mechanics after the tendons heal
    3. Gentle soft tissue mobilization and ice massage
    4. Stretching of extensor tendons
    5. Thermal or electrical modalities may be used to decrease inflammation in order to promote tissue healing.
    6. Splinting of the wrist may also be utilized to rest the muscles around the elbow during this time of healing
    7. After pain has subsided, initiate strengthening of wrist extensor tendons
  4. Prehab (prevention)
    1. Encourage proper lifting mechanics using the shoulder instead of the elbow.
    2. Proper positioning at computer desk with neutral wrists
    3. Tennis elbow can be difficult to relieve if mechanics/strength issues are not addressed.
    4. Proper backhand stroke in tennis without being making contact with the ball after neutral.
Ulnar Nerve Injury
  1. Definition and Occurrence
    1. The ulnar nerve travels in a small tunnel on the inside of the elbow. The path of the ulnar nerve can be felt each time the “funny bone” is hit and the pain sensation travels down the arm and into the hand. With overuse of the muscles that flex the wrist, inflammation can result that crowds the tunnel and decreases the amount of space that the nerve needs to function properly. This can lead to compression of the nerve and symptoms down the arm and into the hand.
    2. This injury can commonly occur with baseball players who pitch sidearm and place a lot of stress on the inside part of the elbow
  2. Signs and Symptoms
    1. Pain (shooting, numbness, tingling) down the outside of the arm and into the fourth and fifth fingers. Often times, tapping of the tunnel which contains the nerve can bring on these symptoms
    2. Swelling on inside part of elbow
    3. Pain with resisted wrist flexion
  3. Treatment
    1. Rest, Ice, NSAIDs, and activity modification
    2. Soft tissue massage of muscles that may be crowding the space where the nerve runs
    3. Shoulder strengthening to encourage proper lifting mechanics of the arm
    4. After pain subsides, strengthening of muscles that flex the wrist
    5. Stretching of wrist flexor muscles
  4. Prehab (prevention)
    1. Proper shoulder strengthening to encourage proper lifting mechanics
    2. Proper form during striking and pitching to decrease likelyhood of overuse of muscles attaching to inside part of elbow.