Elbow Pain
There are a few reasons why your elbow may be hurting after a night of dodgeball. Throwing sports, like dodgeball, cause a common elbow injury call medial epicondylalgia. Some of you may know this as Golfer’s elbow or Pitcher’s elbow or Little League elbow, as it is most commonly found in athletes who play golf and baseball.
Some background info…
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Figure A. The medial epicondyle and the wrist flexor muscle group. Adapted from http://www.orlandparkorthopedics.com/patient-education/golfer%E2%80%99s-elbow-medial-epicondylitis |
The image above is of the inside of your right elbow. Run your thumb on the inside of your elbow and you should hit a bony bump, this is known as your medial epicondyle. It is at this bump that four forearm muscles attach. This muscle group, known as your wrist flexors, work together to bend your wrist down (flexion), twist your forearm down (pronation), and close your fingers to grip.
What is medial epicondylalgia?
Medial epicondylalgia is caused by repetitive strain on the medial epicondyle and the tendon attachments associated with it. Repeating the same activities over and over again (eg. tightly gripping a dodgeball, bending your wrist as you throw) can put too much strain on the tendon, especially if your tendon is not strong enough to withstand these forces to begin with (eORTHOPOD, n.d.). Although this injury is commonly seen in the sports population, it can also occur in occupational settings where plumbing, carpentry, and even typing are involved (Wise et al., 2011).
The wear and tear on your tendon leads to tissue degeneration, like when an old piece of rope becomes slightly frayed. The small tears try to heal but the continued repetitive activity keeps re-injuring it. Scar tissue is formed over these small tears but they don’t have the same tensile strength, leaving the area weak and painful (eORTHOPOD, n.d.).
Symptoms of medial epicondylalgia: (Svernlov et al., 2011)
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swelling over the inside of the elbow
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tenderness over the medial epicondyle
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pain in the area when bending the wrist down, twisting the forearm down, and with gripping
How can I make it better?
1. Decrease repetitive strain:
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Decrease the amount of throwing
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Take some time off from dodgeball
2. Stretching:
 *Adapted from http://www.picstopin.com/254/-medial-epicondyl-and-flexor-muscles-that-flex-the-wrist-fingers/http:||www*lesliearwin*com|images|wrist_stretch_extension*gif/ |
Try this wrist flexor stretch:
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3. Bracing:
 *Adapted from http://www.physioroom.com/injuries/arm_and_elbow/golfers_elbow_sum.php |
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4. Go seek professional help:
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Like any injury, if the pain and loss of function persists, seek help from a healthcare professional.
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A physiotherapist has access to different electrical therapies such as ultrasound, TENS, interferential current and shockwave therapy to help the tendon heal.
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A physiotherapist can also prescribe the proper strengthening exercises to prevent reoccurrence of your injury.
Carolyn Tam is a registered physiotherapist currently working in the Lower Mainland. She completed her Master of Physical Therapy degree at the University of British Columbia after graduating from UBC with a Bachelor of Human Kinetics.
References
eORTHOPOD. (n.d.). A patient’s guide to medial epicondylitis (Golfer’s elbow). Retrieved on October 25, 2013, from http://www.eorthopod.com/content/golfers-elbow.
Svernlov, B., Hultgren, E., and Adolfsson, L. (2011). Medial epicondylalgia (golfer’s elbow) treated by eccentric exercise. British Elbow and Shoulder Society. 4:50-55.
Wise, S.L., Owens, D.S., and Binkley, H.M. (2011). Rehabilitating athletes with medial epicondylalgia. National Strength and Conditioning Association. 33(2).