Introduction
Elbow pain commonly presents in people without ever incurring an injury. Symptoms of pain or discomfort are typically found on either the lateral or medial side of the elbow, with pain on the back of the elbow as a rare occurrence.
Inflammation, tenderness, and stiffness can be present when the arm is straightening or bending, when lifting light or heavy objects, when performing the bench press, or other movements where the hand is grasping an object. Elbow pain can sometimes be accompanied by wrist or shoulder pain as well.
But what causes elbow pain to begin with? Should you keep lifting weights when elbow pain is present? And are stretches for elbow pain a viable option?
In this article, we will go over the different types of elbow pain you may experience as well as the potential causes that could be attributed to this discomfort, and strategies to attack the root cause as well as prevent elbow pain in the future.
Types of Elbow Pain
Lateral epicondylitis, also known as ‘tennis elbow’, is typically presented as a traumatic onset of pain on the lateral side (outside) of the elbow, while medial epicondylitis, also known as ‘golfer’s elbow’, showcases discomfort and pain on the medial side (inside) of the elbow (Javed, et al. 2015).
Another type of elbow pain can be chronic bilateral (both sides) elbow pain with restriction of extension or end range of motion (straightened) accompanied by painful clicking, catching, or locking of elbow.
Lastly, neurological symptoms such as numbness, tingling, or burning pain may be present in the elbow, typically accompanying medial elbow pain.
Although ‘tennis elbow’ and ‘golfer’s elbow' are named as such, they are not exclusive to their respective sports. Medial and lateral elbow pain are also common among baseball pitchers, javelin throwers, bowlers, rock climbers, archers, weightlifters, as well as those who participate in no sport at all.
These symptoms of elbow pain usually emerge when straightening the arm, lifting light objects, and even after benching. There can also be pain from the wrist and shoulder that accompany the elbow pain as well.
Now that we have covered the major types of elbow pain one may experience during or after exercise, let’s try and understand why this elbow pain might be showing up in the first place.
What’s the Cause of Elbow Pain?
Elbow pain is quite a unique symptom that manifests itself even without traumatic injury. It is commonly categorized as an overuse injury caused over time by poor biomechanics. This means that if you move your arms in a particular isolated fashion in which the bones of your arm, shoulder, and rib cage are not situated in a position to create efficient leverage, your muscles, ligaments, and tendons will have to compensate to help you grasp and move the object, whether it be lifting, swinging, throwing, or pulling.
This can be very confusing to some, but let’s take a look at a few examples of the elbow position and how it relates to the rest of the body.
Example 1. Results by HBS Practitioner Shane Delange
Notice the resting position of the elbow from left to right (oldest to more recent). As this client’s spine and scapulae start to find a more stable position with tension around her ribcage, the position of her elbow starts to sit in a more tensioned position. By correcting the client’s capacity to control her shoulder blades, it changes the myofascial tensions around the arm, creating more stability of the elbow joint. These results were not produced by simply performing stretches for elbow pain or isolated elbow pain exercises; this client’s posture was improved by addressing their biomechanics in a way that respected the FP Big Four; standing, walking, running, and throwing.
But standing isn’t usually where a person feels pain in their elbow, so let’s take a look at a result during a dynamic setting, like throwing.
Example 2. Dynamic Results by HBS Practitioner Dan Welch from FP New Jersey
In this freeze frame of a throwing exercise, Dan would get elbow pain from performing swinging motions with his arm above his head. Without the structural integration between his shoulders, rib cage, and pelvis, Dan would experience a significant increase in elbow, shoulder and wrist pain. By focusing on the entire system rather than just his symptoms, and by using exercises that respect standing, walking, running, and throwing, Dan was able to correct the way his elbow was interacting with the rest of his structure by using Functional Patterns protocols, and his symptoms completely went away.
Posture Results by HBS Practitioner Dan Welch from FP New Jersey
What’s the Fix?
In a study looking at risk factors for throwing-related shoulder and elbow pain in adolescent baseball players, researchers found that those who grew in height over the year had a higher risk of developing throwing-related shoulder and elbow pain (Tajika, et al. 2021).
Perhaps the growth in the skeletal structure of these players caused their biomechanical patterns to not adapt to the addition of new bone. Practicing and improving their biomechanics as they are developing may provide a means to reduce these risks as they continue playing their sports while they develop.
The majority of strength and conditioning coaches would suggest that these growing athletes should perform weight lifting exercises that isolate the shoulder and elbow joint to develop muscle mass, such as the bench press or external rotation band pull-aparts. They might even suggest changing grip width, loading pattern of the bench press, or symmetry while benching, but these exercises don’t respect standing, walking, running, or throwing. Therefore these athletes may maladapt to the motions of those exercises instead of the movements that are evolutionarily consistent with our species.
Most traditional therapists would also suggest that you rest and let the elbow heal before engaging in physical activity that involves the elbow. While we do agree with this suggestion, this alone won’t solve the root cause of the problem and should not be seen as a long-term strategy.
It is important to understand how the systems of the body should be addressed together in order to have the best chances of preventing future bouts of elbow pain from recurring, and how addressing biomechanics is a foundational strategy to do this. If you experience shoulder and elbow pain when benching or after lifting, maybe your exercise selection is not optimal to address the biomechanics of the human organism.
Standing, walking, running, and throwing are fundamental movements that humans predominantly performed while our ancestors survived in nature over 100,000 years ago. Therefore, we should focus more on improving those fundamental movement patterns, instead of performing isolated elbow strengthening exercises or passive stretching modalities that may decrease symptoms of pain in the elbow joint only for the short term. These isolated or passive approaches may lead to more imbalances and more instability, not only in the elbow joint but also the shoulder, neck, and rib cage, causing wrist and shoulder pain as well.
Functional Patterns Protocols
What are the most beneficial FP protocols to follow then?
First, we suggest eliminating activities that would irritate the elbow pain you are currently presented with as much as possible. This will remove the stresses being applied to the overused ligaments, tendons, and muscles around the unstable elbow joint. We know that sometimes you may not have the opportunity to take time off work or stop taking care of your children and doing chores. You might also follow a gym routine where you enjoy lifting weights or your physical therapist has suggested certain elbow pain exercises to follow, but do realize that if you do not give your elbow time to rest and you continue to move through the same pattern of movement as you have done in the past, your elbow pain may take quite a lot longer to resolve.
Click here to check out the Movement Elimination Protocol
Second, apply a diet elimination protocol to remove grains, nuts, seeds, legumes, and seed oils. This will decrease the amount of inflammation in the body and help the tissues around the elbow become less swollen and tender. It will promote healing and regeneration of the tissues while reducing the symptoms of pain. This will also allow an adequate amount of rehydration to take place in order to deal with the inflammatory nature of your elbow pain.
Click here to check out more on diet elimination.
The third and probably most important step is to begin addressing your biomechanics. As we looked at in the above examples, learning to objectively assess your body while it stands, walks, runs, and throws will give you the information necessary to understand why your elbow pain began in the first place. The 10 Week Online Course consists of the initial steps to start addressing your postural dysfunctions and reinforcing more optimal foundations to your movement patterns.
Click here to check out more information on the 10 Week Online Course
If these steps seem too difficult to apply on your own, we suggest seeking out an FP Human Biomechanics Specialist to guide you and help you stay accountable in order to achieve the results you are looking for.
Conclusion
Elbow pain can be a very finicky symptom to deal with and is very rarely the result of a traumatic injury. It presents itself typically on the medial or lateral sides of the elbow, and is generally termed ‘golfer’s elbow’ or ‘tennis elbow’, respectively. Elbow pain can also affect both sides of the elbow simultaneously and cause locking or painful clicking when straightening the arm.
Although the terms are sports-associated, many deal with elbow pain when performing simple tasks such as lifting even light objects, straightening or bending the arm, and during or after performing upper body exercises like the bench press.
The cause of elbow pain can be quite mysterious as the pain can sometimes be accompanied by wrist pain and shoulder pain. Isolated stretches or exercises for elbow pain are often prescribed in order to provide short term relief, but these do not address the root cause as they don’t account for enough variables.
At Functional Patterns, we suggest following a few simple protocols such as removing as many forms of activity as possible which exacerbate the elbow pain, in order to let the elbow rest. We also suggest removing foods that may cause an inflammatory response of the body, to allow for a more restorative regeneration process to remove inflammation and promote hydration of the tissues surrounding the elbow joint. Finally, you should begin to address the biomechanical dysfunctions your body may be experiencing that do not allow for proper integration between your elbow, shoulder, and rib cage with the rest of your body during the Big Four movements of Functional Patterns: standing, walking, running, and throwing.
References
- Javed, M., Mustafa, S., Boyle, S., & Scott, F. (2015). Elbow pain: a guide to assessment and management in primary care. The British journal of general practice : the journal of the Royal College of General Practitioners, 65(640), 610–612. https://doi.org/10.3399/bjgp15X687625
- Tajika T, Oya N, Kuboi T, et al. (2021). Risk Factors for Throwing-Related Shoulder and Elbow Pain in Adolescent Baseball Players: A Prospective Study of Physical and Developmental Factors. Orthopaedic Journal of Sports Medicine. 2021;9(9). doi:10.1177/23259671211017129
