Summer can be painful for elbows

By Adam Smith, M.D.

As summer goes down the stretch, it’s routine to hear the crack of batted baseballs in West Tennessee. Golf balls are flying, and colorful tennis balls are being smacked as folks play their favorite summer sports. That can only mean one thing: elbow injuries.

Throwing sports
Athletes who throw overhead are particularly hard on elbows. Pain on the inside of the elbow can develop over time with repetitive throwing or after a single pitch. The pain usually occurs with each pitch. Throwers may notice loss of velocity and accuracy with each thrown ball.

This type of injury in younger athletes (Little League age) can represent a stress fracture through one of the growth plates in the elbow.

Older athletes can have similar pain with tearing or stretching of the medial collateral ligament of the elbow.

Young athletes with this type of pain should stop throwing immediately and be seen by a physician for careful evaluation.

Racket sports
Tennis elbow is a common problem in athletes participating in racket sports, particularly tennis. Athletes with tennis elbow usually have pain on the outside part or lateral aspect of the lead elbow during a backhand type swing.

Pain during the backhand is usually due to incorrect form during the backhand stroke. Correct form during a two-handed backhand requires the lead wrist to be locked with no active wrist extension throughout the stroke.

Players prone to injury usually try to “flick their wrist” during the backhand, leading to severe stress on the extensors of the wrist, which attach on the outside or lateral elbow. Pain usually is minimal at first, but can become limiting and painful, even in non-tennis related activities.

Treatment is usually conservative. Rest, ice and anti-inflammatories usually can be helpful. Modification of swing technique to correct swing flaws is important and usually prevents further injury.

While golf is thought of as a gentle sport, elbow injuries in golfers are common. Golfer’s elbow is associated with pain on the inside of the elbow at the medial epicondyle.

Repetitive strain of the flexor muscles of the forearm occurs during the down portion of the swing on the player’s back arm. As the back elbow drops down to deliver the club forward, the wrist is in the extended position, which places significant strain on the forearm flexors. This repetitive motion, and the occasional divot swing, leads to injury at the medial epicondyle where the muscles attach at the elbow.

Pain can be severe even in non-golf related activities that require power grasping. Rest and anti-inflammatory medication can be helpful. If pain continues, consultation with a physician is recommended for consideration of other options. 

Elbow Injury Q & A

Information provided by Chris Hoffmann, PT, Cert MDT, MPT, ATC, AT/L

Q: I’ve heard that one way to prevent tennis elbow (lateral epicondylitis) would be to flick your wrist during your backhand. Is this true?
A: No, it is not. In fact, flicking your wrist will cause excessive strain on the extensor muscles and lead to elbow pain. Using a two-handed backhand will decrease this stress on these muscles.

Q: How do I prevent tennis elbow from developing?
A: To prevent tennis elbow, straighten the arm using the opposite hand and pull your hand/wrist downward.

Q: How do I prevent golfer’s elbow?
A: Straighten the arm and, using the opposite hand, pull your wrist/hand backward. When performing a stretch, you should pull and hold 15 seconds and repeat this three to five times. It takes a minimum of six seconds for the muscle to relax to allow for a stretch. Repeating this a minimum of three times ensures a sufficient lengthening (stretch) of the tissues for injury prevention.

Q: Are younger athletes, such as Little League baseball players, less susceptible to elbow injury than someone who is older?
A: No. Anyone can experience an elbow injury. Younger athletes can actually have a disabling injury occur to a growth plate of the bone. It is important that these young athletes see a physician if experiencing these pains.