Hi Kevin, When I lift weights and perform exercises where my elbow is bent all the way. I get a sharp pain as I try to extend. “Skull Crusher” is the exercise if you are familiar.
– Thanks, Jim
Kevin Pyles, PT
Ask The Expert
Hi Jim,
I always recommend at least getting a quick assessment, but it sounds like lateral epicondylitis commonly called “tennis elbow.” We could check it out for you at the clinic and if you are diligent, you should be able to treat it at home by following our advice and do well. I am all too familiar with “skull crushers.” They are great for building strength, but you do have to be careful with the amount of load at maximum flexion.
Tennis elbow is a painful condition that affects the tendons on the outer side of the elbow with the worst point being on that little bone that sticks up. It is a common injury among athletes, especially tennis players, but can also occur in individuals who engage in repetitive arm movements or hit the area on a solid surface. We focus on reducing pain, promoting healing, and restoring function. Tennis elbow occurs when the tendons that attach to the outside of your elbow become inflamed or damaged. This condition is characterized by pain and tenderness on the outer side of the elbow, which can radiate down the forearm. A typical case of tennis elbow may look like this:
1. Assessment and Diagnosis:
The first step in treating tennis elbow is a thorough assessment by one of our physical therapists. We will evaluate the patient’s medical history, perform a physical examination, and may, but not often, recommend imaging tests to confirm the diagnosis. This assessment helps us determine the severity of the condition and guides the development of an individualized treatment plan.
2. Pain Management:
Managing pain is a crucial aspect of initial treatment. We may use various modalities such as ice, ultrasound, or electrical stimulation to reduce pain and inflammation. We may also recommend the use of braces or splints to provide support and alleviate stress on the affected area.
3. Manual Therapy:
We commonly use manual therapy techniques, such as soft tissue mobilization and joint mobilization to improve tissue flexibility, reduce muscle tension, and promote healing. These techniques help restore normal joint mechanics, set the tissue up for proper healing and improve overall function.
4. Exercise Prescription:
A tailored exercise program is a cornerstone of our treatment plan. Initially, the focus is on gentle stretching and usually follows ice to numb the area and then cross friction of the tendons to prevent scarring. This helps facilitate a normal length/tension ratio as the area heals. Once we have the pain under control and flexibility restored, then we progress to strengthening exercises to improve active flexibility. We will gradually increase the load on the affected tendons. Eccentric exercises, which involve lengthening the muscle while under tension, have shown promise in our clinic and in research.
5. Biomechanical Assessment and Correction:
We will assess the patient’s movement patterns and biomechanics to identify any contributing factors to tennis elbow. We may provide guidance on proper ergonomics, task modifications, and recommend specific exercises to address muscle imbalances or faulty movement patterns.
6. Activity Modification and Education:
Educating patients about their condition and providing guidance on activity modification is essential for successful treatment. We help patients understand which activities or movements may aggravate their symptoms and provide strategies to minimize stress on the affected tendons. We may also recommend modifications to sports techniques or work-related tasks to prevent further injury.
7. Gradual Return to Activity:
As symptoms improve, we guide patients through a gradual return to their desired activities. This includes a progressive increase in intensity, duration, and frequency while closely monitoring for any signs of recurrence. We may also provide ongoing support and guidance to prevent future episodes.
Feel free to call the clinic at 336-719-7129 and we will work with your PCP to schedule an assessment at your earliest convenience. Once assessed we will develop an individualized treatment plan which you can potentially perform at home and get back to doing what you love pain-free.
