Ultimate Guide on Physiotherapy for Elbow Pain

Elbow pain can significantly limit daily activities and grip strength. Patients experiencing intense pain from an elbow injury or overuse report difficulty lifting or reaching objects and enjoying recreational activities.

The source of elbow pain is not only limited to injuries or overuse. The elbow joint's complex structure and their associated anatomy can sometimes make pinpointing the exact cause of pain difficult. This is why a proper diagnosis is crucial for effective treatment.

*Recommend to change or delete picture, not really touching elbow

In Singapore, tennis elbow (lateral epicondylitis) is the most common cause of lateral elbow pain, affecting adults over 40 or 50 years. It is also a very common cause of elbow pain worldwide, affecting 1-3% of the population annually.

Physiotherapy for elbow pain offers a safe and non-invasive solution to get you moving freely again. Medical experts consider it a "first line of treatment", paired with stretching exercises and mobilisation techniques.

In this article, we'll first determine the causes and diagnosis of elbow pain and further understand its symptoms. We will also explore elbow physiotherapy treatments and exercises to manage pain and promote healing.

What is Elbow Pain?

Elbow pain is a general term for discomfort in the elbow joint or elbow tenderness. This complex joint, with its network of muscles, ligaments, and nerves, is susceptible to various injuries and conditions. It can manifest as elbow swelling and inability to straighten the arms.

The pain may be localised around the lateral side of the elbow radiating back to the forearm, especially when you straighten or extend your arm.

When your elbow pain persists after two to three weeks without treatment, consult a healthcare professional to assess and properly diagnose your condition.

Diagnosis of Elbow Pain

A physiotherapist will conduct a thorough assessment to diagnose the cause of your elbow pain. This may include a detailed history of your symptoms, a local examination of the elbow joint, and possibly objective examinations like X-rays to rule out fractures or other bony abnormalities.

*Recommend to change or delete picture, focus doesn't seem necessarily to be elbow therapy

Physical therapy usually provides treatment and pain relief from elbow pain without corticosteroid injections or surgery. In cases where you do need more invasive methods to treat tennis elbow or severe elbow injury, a physical therapist will know where to refer you.

Causes of Elbow Pain

Elbow pain can arise from various sources, which is why a systematic differential diagnosis is important to determine and rule out contributing factors.

Muscle tension, poor posture, a broken arm, and other medical conditions are just a few root causes of elbow pain. Below are more underlying issues behind it.

• Repetitive stress injuries: This is a common injury in athletes and those engaged in repetitive movements. In tennis elbow, repeated micro-tears in the tendon cause inflammation. These tears can occur from activities that involve gripping or twisting the wrist, such as playing tennis, using screwdrivers, or painting.
• Overuse injuries: Throwing or racquet sports, weightlifting, or computer work can strain the elbow joint and lead to pain.
• Trauma: A fall or direct blow to the elbow can damage muscles and ligaments, or even cause fractures.
• Arthritis: Rheumatoid arthritis can inflame the elbow joint, causing pain, stiffness, and swelling.
• Bursitis: Inflammation of the bursa, a fluid-filled sac near the elbow joint, can lead to pain and tenderness.
• Nerve compression: Pressure on a nerve in the elbow can cause pain, numbness, and tingling.

Elbow Pain Physiotherapy Treatment Options

There are several physical therapy techniques to treat elbow pain. This approach is a cornerstone of treating elbow pain and other muscle and joint-related health issues.

Phoenix Rehab is a top physical therapy provider in Singapore that offers a personalised treatment plan for elbow pain. Unlike generic treatments, physiotherapists have a functional knowledge of the complexities of elbow joints and will pinpoint the exact reason behind your pain - be it tennis elbow, golfer's elbow, or something else. This targeted approach ensures exercises and techniques address the specific issue for efficient healing.

While there isn't a single "best" physiotherapy treatment for elbow pain, the most effective approach depends on the underlying cause of your pain. It typically incorporates a combination of techniques to address pain and restore function to your elbow. Below are some common elbow pain physiotherapy treatments.

Manual Therapy

This involves hands-on techniques to improve flexibility, reduce stiffness, and enhance recovery. Physiotherapy for tennis elbow pain typically uses this method such as massage, friction massage, and specific joint mobilisations to target the tight and inflamed tissues around the outer elbow joint.

Therapeutic Modalities

This technique includes ultrasound, electrical stimulation, or laser therapy. In some cases, physiotherapy for an elbow fracture uses sound waves to promote tissue healing. Electrical stimulation can help manage pain and improve muscle function, while laser therapy might be used to reduce inflammation and improve blood flow.

Exercise Therapy

This is a crucial component of physiotherapy for elbow pain. A physiotherapist will design a personalised exercise programme that includes gentle stretches, strengthening exercises to build muscle strength and stability, and proprioceptive exercises to enhance joint awareness and coordination.

Bracing

Wearing a brace can help support your elbow and reduce stress on the joint. After a session of physiotherapy for elbow dislocation, you may continue using this for a short period in certain situations, such as during specific activities or pain management for occasional soreness.

Taping

Kinesio taping improves proprioception, reduces pain, and supports overall healing. This involves applying colourful elastic therapeutic tape to the skin in specific patterns, believed to offer several benefits for elbow pain.

Acupuncture

In this practice from traditional Chinese medicine, thin needles inserted at specific body points help stimulate the release of substances that increase blood flow to the targeted area. This can enhance healing and reduce inflammation. It can also relax tight muscles in the forearm and around the elbow.

Exercises for Elbow Pain

People have varying pain tolerance, flexibility, and activity levels. A tailored treatment plan considers these factors, customising exercises, and intensity to your unique situation. This optimises progress and reduces the risk of further injury.

Here are some physical therapy exercises a physical therapist may recommend following treatment for elbow pain.

Early Stage Exercise

Passive range of motion exercises help prevent stiffness while an elbow fracture heals, including:

• Passive elbow flexion and extension: Lie on your back with your affected arm resting comfortably. Your physiotherapist will gently move your elbow through its pain-free range of motion, bending and straightening the joint.

Strengthening Exercises

Below are physical therapy exercises to restore elbow strength and stability after treatment:

• Towel twist: This exercise strengthens the forearm muscles. Hold a towel in both hands, twist it in opposite directions, and maintain the twist for a few seconds. Repeat with both hands.
• Fist clench: Comes with increasing grip strength as tolerated. This strengthens the hand and forearm muscles.
• Supination with a light dumbbell: Hold a light dumbbell in your hand, palm facing down. Slowly rotate your forearm so your palm faces up (supination). Hold for a few seconds, then return to starting position. Repeat 10-15 times on each side. This strengthens the muscles that rotate your forearm.
• Wrist flexion: With a light weight or no weight, hold your arm out straight in front of you, palm facing down. Gently bend your wrist upwards, bringing your fingers towards you (flexion). Hold for a few seconds, then return to starting position. Repeat 10-15 times. This strengthens the muscles that bend your wrist.
• Elbow extension: Hold your arm out straight in front of you, palm facing down. Slowly straighten your elbow further, pushing your hand back (extension). Hold for a few seconds, then lower your arm back to the starting position. Repeat 10-15 times. This strengthens the muscles that straighten your elbow.

Work closely with your physical therapist to monitor your progress and adjust the exercises as you improve.

Precautions When Dealing with Elbow Pain

While physiotherapy offers significant pain relief, certain precautions are important. Avoid performing the exercises above while there's still inflammation present.

Moreover, avoid aggravating activities and take a rest if they worsen pain. Maintain proper posture when performing any activity to reduce stress on the elbow joint. Ensure you exercise with proper technique to avoid worsening symptoms.

Conclusion

Elbow pain physical therapy can effectively manage pain, improve mobility, and restore function to your elbow without resorting to invasive treatments. Working with a qualified physiotherapist can help you develop a personalised treatment plan to get back to enjoying the activities you love.

Physical therapy exercises also go a long way in improving your recovery process with the right programme and guidance. Keep the dos and don'ts in mind to prevent other injuries or complications.