Elbow

Tennis elbow is a common condition that causes pain in your forearm and around the outside of your elbow. Despite its name, most people don’t get it from playing tennis. It’s usually caused by repeated movements such as gardening or typing. It is often due to overuse of a group of muscles in your forearm which attach to the outside point of your elbow where the tendon attaching the muscles to the bone develop tiny tears and then thicken and swells causing pain and tenderness. Pain is usually worse when you bend and straighten your elbow and your wrist. It can also progress to getting pain when gripping or twisting your hand. The pain can vary from mild discomfort to severe pain that keeps you awake at night. Often when rest can be helpful to reduce the pain but pain then reappears when you start doing the same movements as was previously painful. Because of this it is useful to see a physiotherapist who can help prescribe exercises to restore function and reduce pain.

Golfers elbow is where pain develops on the inside of the elbow where muscles of your forearm insert to your elbow. Ironically most people who have this condition do not play golf. Symptoms include focal pain and sometimes widespread pain that originate from the inside of the elbow, pain and weakness when opening jars or gripping items and struggling to fully straighten your elbow. The majority of people who develop these symptoms have recently increased their level of activity or slightly changed their routine for example an increase in gardening, typing or an increase in resistance training. You can develop symptoms at any age but commonly people are between 40-60 years old. Factors that increase your risk of developing this condition are if you have diabetes (type 1 and 2), if you smoke, have high cholesterol levels, prone to a sedentary lifestyle, overweight and eat fatty foods on a regular basis. Reassuringly after a clinical diagnosis is made there is strong evidence that symptoms can improve over time with an individualised physiotherapy plan.

The elbow has three ligaments that assist with stabilising the joint, they can be injured by trauma or overuse activities. Common injuries are falling on an outstretched arm, forced twisting of the arm and during sports such as volleyball and tennis. Symptoms include dull aching pain, swelling around the injured site and pain during movement. Physiotherapists can assess the joint stability and help manage pain, restore movement and address any secondary complications such as strength deficits. The level of injury will determine the recovery time and the amount of rehabilitation you will require. In rare occasions surgery is required to reconstruct the ligament where rehabilitation is key in order to return to previous function or sports.

Cubital tunnel syndrome is a nerve irritation syndrome that is caused by repetitive over stretching of the elbow or by direct trauma to the elbow. Symptoms will include pain, numbness and pins and needles from the elbow joint down.

People at risk of developing these symptoms are those over 40 years old, people who complete overhead throwing activities (javelin), people who rest their elbows on hard surfaces constantly or people who rest the elbow in prolonged bent arm positions (holding telephone). With physiotherapy a range of strategies, mobilisations and exercises have been shown to improve 90% of cases in 2-3 months.