What if Stretching and Strengthening Does Not Help Your Elbow Pain?

I got this email from James about his elbow pain.

I thought my reply might be of interest to you.

Hi, I purchased a couple of your fixing elbow pain books a while back and have run through the stretches/exercises but am still having a pain, I wondered if I gave you some information you could give me any advice, specific possible stretches/exercises.

History

Training, competing and performing demonstrations throughout the UK in a sport combining Martial arts and gymnastics at high level.

Time/ Length of injury

Roughly 6 years.

Injury

Was hyper extended in an armbar in training.

Treatment attempted

• RICE
• Light stretches
• Isometrics
• Conditioning exercises – light weight (can/dumbbell bar) wrist extensions/lifts/twists
• Powerball
• Wrist grippers
• Squeezeballs
• Anti inflammatory medication/gels
• Massage techniques
• Physio Therapy
• Used several supports/braces
• Remedial Massage Therapist treatment (see sheet)
• Steroid injection

Result = Nothing seems to work

When it hurts/aggrivates

• Main: Handstands/cartwheels/roundoffs etc
• Push ups
• Punching
• Throwing
• Everyday life: Twisting something (turning on car engine)
• Pushing door open
• Shaking something (ketchup bottle)
• Stirring/mixing
• Handshake
• Pushing a button
• Squeezing bike brakes
• Pushing off floor/bed to stand up
• Texting
• Writing (when pushing on hard)
• Getting dressed
• Any weight bearing

Medical Investigation:

I have had mri and xray scans which haven’t picked anything up, I just wondered if you had any ideas of what might help, it would be much appreciated.

If you want any more info please ask

Thanks,

James

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James,

Thank you for the email and your questions.

This is common. People will focus on the stretching and strengthening for their elbow pain. They get frustrated when this does not help with their injury.

When I hear this, this are a few things that I look at or suggest:

#1 – Get a Clear Diagnosis

You want to go to your physician and get a clear diagnosis and have anything serious ruled out.

It looks like you have done this but I am not fully sure what the diagnosis of your injury was.

#2 – Look at the Rest of Your Day

When it comes to injuries, what you do during the rest of your day can wipe out the benefit of an exercise rehabilitation program.

You need to look at the rest of your day and decrease or eliminate any unnecessary stress on your elbow.

Things you need to look at are:

• computer work
• computer set up
• mouse use
• driving use especially if you use a standard
• phone use
• cellular use
• activities where you use your wrist and elbows
• what you do for recreation
• see if there are ways that you can do your job which puts less stress on your elbow (Sundstrup 2013)

Doing what you can to decrease stress on your elbow during the day will put less stress on your elbows, allow for you to benefit more from the exercise rehabilitation exercises and allow the elbow to recover.

This one is very, very important.

#3 – Warm Up Prior to Your Workouts (Especially Your Elbow)

There are a lot of benefits and controversy when it comes to warming up prior to activity.

I know for myself, I need to do it. When I do not warm up, I don’t perform as well and I get injured more.

Plus, as I get older, I now need to spend more time warming up.

Warming up is important for your elbows and the recovery of your elbows if you your are doing any elbow rehab exercises.

In this paper Ingham 2010, performing an elbow warm up reduced loss of strength, range of motion and muscle soreness.

You can try these exercises:

For more warm up ideas, look at the two videos that Jedd did in Fix My Elbow Pain on warm-up.

#4 – Look At Your Shoulder

I cover it in more detail in this video:

James, there you go. There are four things that you can do to help with your elbow pain.

Let me know how it goes.

Rick Kaselj, MS

P.S. – If you are looking for a program to help you overcome elbow pain, then check out Fix My Elbow Pain, here

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