Overuse Injuries In The Elbow And Forearm

Overuse Injuries In The Elbow And Forearm

Our elbow and forearm area of the upper extremities are prone to overuse injuries due to sports or occupational stress. Overuse injury in the elbow and forearm is quite common among golfers and baseball players as well. Overuse of the elbow and the forearm can be caused by repetitive elbow flexion-extension or wrist motion. Because of the intricate anatomy of the elbow and the forearm, there could be various causes for the injury. Though predominantly seen in sportspersons, the injury is also very common amongst people who indulge in throwing or arm stretching as a part of their profession such as assembly line workers or skilled labourers. Another way in which a person can begin to be effected by this type of overuse injury is the office worker, that types rapidly throughout the day.

Various Elbow and Forearm injuries
Our elbow alone is composed of three articulations, two ligament complexes, four muscle groups and three major nerves. Repetitive stress to the elbow and the forearm can cause multiple types of injuries which include:

1.      Biceps tendinosis
This is an injury generally caused by microtrauma to the elbow which gradually develops into tendinosis as it is never allowed to heal. Repetitive elbow flexion (bending) or forearm supination (rotation of forearm so that palm faces upwards) can be responsible for the development of the injury.

2.      Pronator Syndrome
The median nerve that passes through our forearm can get compressed at multiple sites causing the pronator syndrome. This nerve entrapment generally occurs at the head of the pronator muscle in the arm as it gets hypertrophied (enlarged).

3.      Anterior capsule strain
Repetitive extension of the of the elbow causes strain the anterior capsule and inflammation of the brachialis muscle in the upper arm. This overuse injury causes minimal pain in the beginning but progresses slowly.

  •    Radial Tunnel Syndrome

This medical condition is similar to pronator syndrome in type as it is also a nerve entrapment syndrome involving the radial nerve. This condition is generally caused by compression of the radial nerve at the supinator arch which is located opposite to the forearm.

  • Treatment

Physiotherapy and gentle exercise therapy is the most preferred mode of treatment for overuse injuries in the elbow and the forearm. Surgery is recommended for individuals who have an acute condition and need to remove loose bodies and scar tissue from the arm.

  • Physiotherapy

Physiotherapy is the first line of treatment for overuse injury patients. Protection, rest, ice, compression, elevation, medications and modalities (PRICEMM) technique is used as a common treatment for all types of overuse injuries be it tendonosis, nerve compression or instability. Protection means the injured joint is protected from further damage with the help of medical equipment. Rest is recommended so that the injured part has enough time to heal. Ice is used to control swelling and fight pain whereas compression is used to prevent further swelling. To prevent venous stasis (slow blood flow) around an injury, the injured part is to be placed in an elevated position. Medications such as NSAIDs might be used in the beginning of the treatment to control pain. Modalities include procedures like ultrasound and electrical stimulation.

  • Surgery

Arthroscopy is performed on patients to remove bone spurs, any loose fragments of bone or cartilage within the elbow joint. The surgery is performed by inserting a small camera (arthroscope) into the elbow joint which transfers images to a display device. With this visual aid the surgeon carries out the procedure with minimum incision.

When indulging in a recreational sport, or working through your daily office activities make sure that you don’t over exert your arm and stay away from overuse injuries.