Overuse injuries

What is it?

This term constitutes damage caused through repetitive movement to any of the tissues surrounding the elbow joint. Excessive flexion-extension motion can stress the muscles, tendons and ligaments that act to stabilize the elbow joint. These injuries often occur over time, and make the tissues vulnerable to further aggravation. Tennis elbow and Golfer’s elbow are more commonly recognised examples of an overuse injury.

Why does it occur?

These injuries are commonly seen in those with specific sporting, recreational or occupational activities. Young athletes involved in racket sports, throwing, weight lifting and golf are all at risk through flexion-extension movements conducted during their intense training. This continued strain leads to microtears in the tissue, chronic inflammation and scar tissue formation. As these movements are repeated tissue is more susceptible to ’flare-up’ and pain.

What are the symptoms?

You may have recognised that pain is associated with a particular movement at the elbow. The site of concern will depend on the structures affected, but swelling and tenderness may be present. Some patients have associated neurological symptoms such as weakness and altered sensation.

How is it diagnosed?

Your clinician will need to take a thorough history and examine the affected elbow to establish which movements elicit pain. Through assessing the range of motion, muscle strength and sensation this will build a picture as to what structures are affected. Further imaging will possibly be required including X-ray to establish any bony malalignment and CT or MRI to visualize the internal structures of the elbow. In cases where nerve compression is suspected, conduction studies can be used to investigate symptoms of muscle weakness or altered sensation.

How is it treated?

Non operative

The predominant course of management is conservative through rest, ice and anti-inflammatory medication. The majority of conditions settle without further intervention over a course of 2-3 weeks. Reducing aggravating factors through lifestyle modification and focused physiotherapy are also known to be beneficial.

Operative

Surgical intervention is reserved for those very few cases not responding to conservative measures. The specific procedure will depend on the diagnosis, but may be conducted open or arthroscopically to debride or repair affected structures surrounding the joint.