Lifter’s Elbow (What it is it, what causes it, and how PT can help)

​ Elbow pain in lifters is a common and an especially frustrating occurrence, which can derail your goals, cause lost gym time, and create a great deal of misery.    
​Elbow pain in weightlifters is generally attributed to an overuse or inflammatory issue of the tendons, muscles, and other soft tissues ​around the elbow. Pain and symptoms can be at the inside of elbow (sometimes called golfer’s elbow), the outside of the elbow (tennis elbow), or on the back side of the elbow (triceps tendonitis).  Additionally, peripheral nerves running through this area can also be over tensioned or compressed and create symptoms. If too much stress is locally placed on these areas, the tissues can become irritated and inflamed. Often the onset of symptoms happens with:  

• Dramatic increases in volume (Think Murph training)
• Increase in load/weights (Trying to to hit a new PR)
• Introduction of new exercises or positions with high mobility demands at the shoulder and wrist (Learning snatches or handstand walks. Doing Open workouts with new movements.)​

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What are the most common complaints of lifter’s elbow?​

• Dull pain and ache in elbow joint when lifting, gripping, or holding​
  •  Inside elbow pain with a low bar back squat or during pullups
  • Pain on outside of elbow with overhand gripping a barbell such as when pulling a snatch or deadlift 
  • Achiness and pain behind the elbow in the front rack position or with certain triceps exercises
•      Burning feelings or pain in the elbow joint after working out
•      Difficulty bending and straightening the elbow after workouts
•      Weak grip strength when lifting dumbbells or barbells
•      Tenderness, swelling and soreness in elbow after lifting

    Far too often, lifters will try to ignore the symptoms, "push through it", or use band aids such as aspirin or braces/sleeves to deal with the symptoms. This misses the root cause of the problem and does not provide an opportunity to resolve it for good. This is where physical therapy can be invaluable. ​

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What causes it?
    The standard explanation is an overuse or over stress of tissues around the elbow as explained above. This can be the result, but not necessarily a good explanation of the cause.  Predominantly, complaints of elbow pain and irritation are the symptoms of an issue that is happening upstream or downstream from the elbow. Similarly to the knee, the elbow is stuck between two other major joint areas.  If the hip or ankle/foot cannot do their jobs due to mobility or strength deficits, the knee joint and tissues around it will have to “pick up the slack” and take on extra stress. 
The elbow will act in a similar fashion if the shoulder and wrist/hand cannot meet the demands of the task imposed upon them. Examples of this include increased inside elbow stress if one lacks mobility in the shoulder, trunk, or wrist while in a front rack or catching a clean. Any activity involving a barbell or pull up bar will put the hands in a fixed position, The body must find a way to get into a shape to successfully perform the lift or task. If mobility is lacking in the wrist, shoulder, or even the spine, the elbow is prime candidate to bear the brunt of extra stress. This is an underappreciated component and many times why rehab programs that only address the local area without looking at the whole body are not successful 

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What can PT do to help?

• Get rid of symptoms of pain- PTs have a large toolbox of treatments that can improve blood flow, reduce muscle tightness, decrease inflammation and pain. These may include soft tissue work, active release techniques, Graston and blading, dry needling, myofascial decompression (cupping), and manual stretching and joint mobilization.         
• Help you develop a plan to CONTINUE TRAINING while rehabbing the elbow.  The advice most lifters do not want to hear from their doctor is to stop lifting.  When working with a therapist who knowledgeable in weightlifting,  you can develop a strategy to modify certain lifts or use alternative exercises to allow you to continue to train while not interfering with rehab of your elbow. 
• Conduct a comprehensive assessment to identify not only what is hurting, but the root cause of why.  This may be the most important piece a PT can help you to provide long term relief and prevent reoccurrence of pain. As discussed, a physical therapist can identify areas or dysfunction upstream and downstream of the elbow, and program a complete program addressing not only the 
  

         local structures of the elbow, but globally treating whole system and how to integrate the body                   together, allowing more efficient movement and improved distribution of forces. ​

If you are experiencing lifter’s elbow, don’t wait and hope it will go away. Contact ProFormance Therapy and Wellness today!

Kevin Steen, PTA