Elbow Pain

Elbow pain is an extremely common condition and societies heavy reliance on hand held technology is making elbow ever more prevalent. By far the largest cause of elbow pain is repetitive stress injuries where a movement, motion or activity is simple performed too much. This can include anything from gardening to playing tennis or using a mouse at the computer.

. At Incline Health we have a passion for fixing joint and muscle problems and the elbow is of particular interest for us. We use evidence based treatments to reduce elbow pain and improve elbow function. Our chiropractors use the latest and highest standards in national and international guidelines to ensure you get the absolute best care and treatment.

The following is a list of conditions that our chiropractors in Balmain and Dee Why have put together to educate you about the elbow:

  • Tennis elbow
  • Golfers elbow
  • Biceps tendinitis
  • Elbow (olecranon) bursitis

Tennis elbow

Tennis elbow is also called lateral epicondylitis or lateral epicondylalgia and is a condition that affects the outside tendons of the forearm. These tendons are called the wrist extensors, and they either attach at the elbow or just above it. This is an overuse injury that is common in sports such as tennis. That involve a combination of elbow flexion and wrist extension.

Causes of tennis elbow

In the vast majority the cause of tennis elbow is overuse or repetitive stress injury. The extensor carpi radialis brevis muscle seems to be affected most. This muscle helps stabilise the wrist when the elbow is straight. Repeated stress to this muscle leads to micro tears in the tendon and pain and inflammation result. This is common in tennis players, carpenters and weight lifters.

Symptoms of tennis elbow

The most common symptoms of tennis elbow would include:

  • Pain on the outer aspect of the elbow
  • Weak grip strength
  • Pain on holding things

Treatment of tennis elbow

Wrist exercises, along with chiropractic and physiotherapy hands on treatments will improve the vast majority of patients. Non-surgical treatments such as this have around an 80-95% success rate, however progression can be slow. Our chiropractors at Incline Health will aim to:

  • P.R.I.C.E. protocols where appropriate in initial injury (PROTECT. REST. ICE. COMPRESSION. ELEVATION)
  • Reduce pain or unload the elbow extensor tendons with activity modification
  • Chiropractic and physiotherapy methods for pain reduction and to reduce irritation/inflammation
  • Initial exercises for pain reduction and to help tissue healing
  • Strengthening exercises and increase the loading capacity, and tendon properties of the wrist extensors


Golfers elbow

Medial epicondylitis, more commonly known as golfers elbow, is an injury caused by overuse. It is a similar injury to tennis elbow, however it is on the inside (medial side) of the elbow instead. It is also referred to as throwers elbow or little league elbow. There are a number of terms that you may come across being used interchangeably, however they do all mean slightly different things:

  • Medial epicondylitis – Acute inflammation of the wrist flexor tendon on the inside of the elbow
  • Medial epicondylosis – Degeneration of the wrist flexor tendon on the inside of the elbow
  • Medial epicondylalgia – Pain come from the wrist flexor tendon on the inside of the elbow

Causes of golfers elbow

Golfers elbow results from repeated bending of the wrist or wrist flexion, particularly against resistance such as holding and moving a golf club. Certain manual jobs and occupations can also cause golfers elbow, such as working at a computer or carpentry. Repeated overuse causes the tendon to become inflamed and painful.

Symptoms of golfers elbow

Symptoms of golfers elbow include tenderness on the bony area on and around the inside of the elbow. This can be particularly tender when gripping things with the hand. Weakness is often also experienced in the wrist, with pain occurring when bending the wrist. Golfers elbow often comes on gradually, starting off as a niggle and then becoming stiff and painful, resulting in a loss of function and preventing movement.

Treatment of golfers elbow

Please note in this article we are speaking about a true medial epicondylitis, the assumption here is that it is an acute injury where there is irritation and inflammation about the medial flexor tendons at the elbow. For more chronic injuries, we would change this treatment. Treatment for golfers elbow includes:

  • Protect the area and stop movement and activities that irritate the area, such as gripping activities.
  • Wear an elbow support relieve tension and reduce movement, whilst acute. This doesn’t mean wear a brace. A suppor takes a little tension from the medial tendons whilst they are hyper-irritable.
  • Electrotherapy, such as ultrasound or laser treatment performed by a chiropractor or physiotherapist to reduce pain and inflammation and help the healing process.
  • Anti-inflammatory medication as need and coordination by your GP or pharmacist
  • Sports massage, performed by a chiropractor or physiotherapist.
  • loading strategies and rehabilitation exercises to reduce pain and improve inflammation
  • Strengthening exercises to improve tendon qualities and prevent future episodes

Biceps tendonitis

Biceps tendonitis can occur at two locations. At the elbow or at the shoulder. Biceps tendonitis is an injury that causes pain and inflammation to the biceps tendon near the crease of the elbow or in the shoulder. Biceps tendonitis at the elbow is not as common as biceps tendonitis at the shoulder. In the shoulder, this is also referred to as the long head of the biceps tendon. This structure is strong and cord-like and connects the biceps muscle to the bones in the shoulder. People who play a lot of racket sports or who have labour intensive occupations such as digging with a spade are at risk. The chiropractors at Incline Health use the highest standards in treatment for biceps tendinitis at the elbow and shoulder. The following are common names that may be used interchangeably but are slightly different:

  • Biceps tendonitis – Acute inflammation to the biceps tendon
  • Biceps tendonosis – Degeneration of the biceps tendon – no inflammation
  • Biceps tendinopathy – Condition of the biceps – preferred term

Causes of biceps tendonitis

The cause of biceps tendonitis at the elbow or the shoulder are often due to a lifetime of normal activities. During the ageing process our tendons gradually weaken with day-to-day wear and tear. Overuse and repeating the same elbow and shoulder motions can worsen and accelerate this process.

Overuse damage can be caused by occupation and sports that involve repetitive overhead or elbow motions. The result of repetitive overhead motion is often shoulder problem that occur with bicep tendinitis. Other conditions that are caused by overuse are chronic shoulder or elbow instability and osteoarthritis. Previous elbow injuries are a risk factor for biceps tendonitis at the elbow and rotator cuff tears are a risk factor for biceps tendonitis at the shoulder.

Symptoms of biceps tendonitis

Biceps tendonitis symptoms include redness and thickening over the biceps tendon. Pain is often felt on the front and inside of the elbow and discomfort when bending the arm against resistance. In the crease of the elbow, patients also often mention tenderness when touched. In shoulder the biceps tendon can be tender to touch and overhead activities are usually painful.

Treatment of biceps tendonitis

Please remember that a true biceps tendonitis is an acute condition where the biceps tendon has become irritated at the elbow or the shoulder. If problems that last longer, it is more than likely a biceps tendinopathy and this is treated a little differently. For acute biceps tendonitis:

  • Apply P.R.I.C.E – protection, rest, ice, compression and elevation.
  • Electrotherapy, such as ultrasound or laser treatment performed by a chiropractor or physiotherapist to reduce pain and inflammation and help the healing process.
  • Exercises as part of a rehabilitation program under the support and guidance of your chiropractor or physiotherapist to improve tissue healing and reduce pain
  • Hands on treatments by a chiropractor for pain and inflammation reduction.
  • Strengthening exercises to improve tendon properties and qualities and reduce the risk of recurrence.


Elbow (Olecranon) Bursitis

Olecranon bursitis describes inflammation to the bursa on the back of the elbow called the olecranon bursa. Bursae are small pillows to cushion soft tissues as they go over hard tissues such as bone. They reduce friction and allow things to move freely over one and other.

Causes of olecranon bursitis

There are two categories of why the bursa may become inflamed.

  1. Mechanical factors and this may include trauma, prolonged pressure and repetitive stress such as that in overuse injuries.
  2. classified as non-mechanical and this involves getting an infection in the bursa or systemic inflections such as rheumatoid arthritis or gout that infects the bursa.

Symptoms of olecranon bursitis

In regards to olecranon bursitis the major symptoms are pain, swelling, restriction of elbow movement and visual ball like bump on the elbow. If there is an infectious or systemic cause they redness and heat by come from an infected bursae and the signs and symptoms elsewhere in the body of the primary disease.

Treatment of olecranon bursitis

Chiropractor offer treatments for mechanical causes of bursitis. If the bursitis is from an infection or underlying disease then your chiropractor or physiotherapist will refer you to the appropriate doctor for medication such as antibiotics. For mechanical causes of elbow bursitis your chiropractor or physiotherapist at Incline Health will look at what the underlying cause of your bursitis is. If it is a pressure issue then elbow pads may be given, for an overuse injury activity modification and rest may be given. Identifying the cause, reducing pain and enhancing function will be the primary goals of your chiropractor or physiotherapist

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