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Mike D

Elbow Injuries and Prevention

Injuries to the elbow are very common in overhead athletes and are usually misdiagnosed.  Most of you have heard of tendonitis (now referred to as tendonapathy), epicondylitis (lateral or medial) (now referred to as epicondylalgia), strains sprains etc, but do you know what they mean and what to do.  The funny thing about the elbow is that most of the time the stress and strain of workouts are dissipated to the elbow from the shoulder or the wrist.  The elbow becomes the symptom and the cause usually originates from somewhere else.  Now, realize if you hit your elbow on something and know that you hit it, then yes it is coming from the elbow.  If the pain started to come up idiopathically (no known cause to you) then you need to look up and down the chain.  By no way is the following a diagnostic tool.  These are simply ways to help yourself.  In no way is this meant to diagnose and if you have doubts please get it evaluated by your orthopedist, chiropractor, massage therapist or physical therapist.  The following are positional reasons for elbow pain and possible causes and solutions.  Rest and ice usually are not the answer nor are pain medications.  Using your body the right way is the best treatment.  There is no substitute for strength and mobility and no reason for lack thereof.

Pain in the front rack position

You can systematically figure out what is going on by breaking down the movements that you do.  If your pain is on the inside of the elbow you may want to start at the wrist and take a look at your form during movements.  Let’s look at the front squat or rack position.  If you hold the bar in the tips of the fingers and the elbows are lower than your hands you are smoking the soft tissue (wrist flexors) that attach to the inside of the elbow.  In other words you are taking the muscles that attach to the inside of the elbow and flexing the elbow fully and then extending the wrist (bringing the top of your hand closer to your wrist) putting an extreme amount of stress at the elbow and the wrist.  You may need to work on your wrist flexibility and mobility.  To do this you take a band and hog tie to the low part on the rig, loop the other end around the wrist just above where the hand meets wrist, place the hand on the floor as if doing a push up but stay on your knees.  Take the slack out of the band and create some tension and then bend and straighten the elbow with the hand stabilized on the floor.  Repeat this for about 2 minutes and recheck your wrist ROM and your front rack position.  You can also take the band and again hog tie to the rig midway up to start.  Then loop the hand through the band and put the elbow and wrist in the front rack position with the band going over the shoulder and bring the elbows up to the level of the hand and shoulder.  This will stretch more of the wrist flexors with taking the wrist out of the equation.  Start with the band high and lower as the mobility increases, there should be minimal pain mostly stretch.

If the pain is on the outside of the elbow, look at when this occurs.  If you get pain with gripping the bar and you have a death grip on the bar (white knuckles), relax the hands a little and decrease the tension going to the outside of the elbow.  Seventy five percent of the time the pain to the outside of the elbow originates from the shoulder (specifically the infraspinatus-medial lower border).  This is a trigger point that needs the tender touch of your massage therapist or physical therapist.  If there is a trigger point in the shoulder then why did you get that?  Look at your thoracic mobility.  If your thoracic cage cannot move and you are stuck in flexion, your body still wants to get the bar to the front rack position and the shoulder blades have to get the wrist, and elbow to that position so there is increased stress on the shoulder to hold up the bar and the shoulder blade (rotator cuff muscles) muscle are put in a poor position and they have to over work causing the most stressful part of the muscle to go into spasm or trigger point.

Next post we will talk about Pain while snatching or Back squat position