Elbow Health 101

You don’t usually pay much attention to your elbow–until it starts to hurt. The elbow joint facilitates many of our daily movements, from lifting objects to typing on a keyboard. Due to the elbow’s many uses and intricate structure, the joint is susceptible to overuse injuries that can significantly impede our daily routines.

Chronic elbow pain is relatively common in the general population, particularly in recreational sports and occupations that require highly repetitive movement. Elbow injuries can cause pain, impair function, reduce productivity, and even keep you from work. Collegiate and youth athletes are highly susceptible to elbow injuries, particularly in sports with overhead movement, like throwing or swimming.

Here, we’ll explore some of the most common injuries and prevention strategies to ensure the longevity and optimal function of the elbow joint.

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Common Injuries of the Elbow

The elbow is a hinge joint where three bones meet (the ulna, radius, and humerus). The joint is responsible for the flexion and extension of the arm, allowing for essential movements like lifting, pushing, and pulling. It also contributes to wrist and hand movements through rotation (supination and pronation) of the forearm, making it a linchpin in various activities ranging from sports to daily chores. Here are some of the most common injuries to the elbow.

Golfer’s elbow (medial epicondylitis): Golfer’s elbow occurs when inflammation, pain, and discomfort develop around the inside of the elbow (at the bony landmark called the medial epicondyle). While this overuse injury does impact golfers, other adults can develop golfer’s elbow through repetitive stress on the joint, like holding heavy objects or baseball pitching. The medial epicondyle is also where the ulnar collateral ligament originates. With enough overuse of these movements without appropriate recovery, the UCL may tear over time.

Tennis elbow (lateral epicondylitis): Similar to golfer’s elbow, tennis elbow describes inflammation of the tendons attached to the bony knob on the outside of the joint (the lateral epicondyle). While you can get tennis elbow from playing tennis, it also develops from jobs or activities that involve repetitive arm motions. Lateral epicondylitis is more common than medial epicondylitis in the general population. It occurs in 1 to 3% of adults, with up to 50% of recreational tennis players developing the condition at some point in their careers.

Olecranon bursitis: A bursa is a fluid-filled sac that provides a cushion between bones or soft tissue. A bursa covers the olecranon process, the bony aspect of the elbow, protecting the bone and the skin. Olecranon bursitis develops with sudden trauma, like a fall, or prolonged pressure, such as leaning your body weight on your elbows for an extended period. Elbow bursitis causes acute swelling, pain, and tenderness to the touch.

Cubital tunnel syndrome: The ulnar nerve is one of the primary nerves of the arm that runs from the neck to the hand. Ulnar nerve entrapment happens when the nerve becomes compressed within the inside of the elbow, known as cubital tunnel syndrome. The nerve irritation can cause numbness and tingling in the hand and fingers.

Osteoarthritis (OA): OA is an age-related breakdown of articular cartilage that lines the surface of the bones, providing protection and fluid movement. The slow degeneration of this tissue in arthritis causes pain, stiffness, and reduced range of motion. OA typically affects weight-bearing joints. However, a previous injury or wear and tear over time in individuals who perform repetitive elbow movements can result in OA later in life.

Habits for a Healthy Elbow

Elbow injuries can disrupt our daily lives and hinder our ability to engage in activities we enjoy. Understanding prevention strategies is a crucial step toward maintaining elbow health. Here are some ways you can keep your elbow moving pain-free.  

1. ‍Progress overtime: Many elbow injuries are incurred by highly repetitive movement when the elbow is in a non-neutral position, like volleying in tennis or hammering a nail repeatedly. We often don’t realize these movements impact the elbow, so be cognizant when doing an activity you’re not accustomed to, and avoid increasing your volume of work sharply. Try to increase your intensity, duration, or frequency slowly and steadily to avoid overuse injuries. ‍
2. Build upper body strength: One of the best ways to prevent elbow injury is to strengthen the upper arm and forearm muscles to support the joint. Some research suggests focusing on the eccentric phase of the exercise (the way down, when your muscle is lengthened) can help with prevention and recovery. Monitor your movement techniques, particularly in overhead actions, to ensure you transfer force appropriately–your back and chest muscles are larger and more resilient to stress than the smaller, more intricate elbow muscles. ‍
3. Stop while you’re ahead: There’s a reason why pitchers come out of a baseball game around a specific pitch count. It’s easy to ignore pesky elbow pain when it arises, but doing so could result in overuse injuries that take longer to heal. When performing repetitive work, take breaks and rest before you feel fatigued. This recommendation also goes for computer work. Staying in the same position can strain the small muscles controlling wrist and hand movements and, in turn, affect the elbow. ‍
4. Recover smarter: If you are already dealing with elbow pain, look to the PEACE & LOVE protocol for soft-tissue injuries for a speedier, more efficient recovery. Be sure to follow the recommendations and stay consistent with the home exercise program provided by your healthcare practitioner.

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