Preventing Rugby Injuries
Diagnosis: Elbow
Your elbow is the joint that connects your forearm with the upper arm. The bones and muscles are supported by ligaments and tendons, which enable the forearm to bend, straighten and rotate.
Why does my elbow hurt?
The most common cause of elbow pain is tendinopathy (formerly called tendinitis). This is when small tears develop at the point where the muscle attaches to the bone and won’t heal. The tears may be caused by an injury or by overuse. However, there can be many other causes of elbow pain. We use the location of the pain to help us narrow down what might be causing the problem. This might include:
Lateral (outer) elbow pain
- Tennis elbow tendinopathy – a painful condition caused by the overuse of the hand, forearm or other arm muscles.
- Osteoarthritis/cartilage damage – osteoarthritis is a degenerative condition that causes pain, stiffness and loss of movement due to loss of cartilage, which helps to cushion healthy joints.
- Nerve entrapment – radial nerve entrapment at the elbow, also called radial tunnel syndrome, occurs when the nerve in the arm becomes compressed or irritated.
- Ligament tear – ligaments are strong bands of tissue connecting one bone to another. Lateral ligament tears can occur as the result of an accident.
Medial (inner) elbow pain
- Golfer’s elbow tendinopathy – this is similar to tennis elbow (which occurs on the outside of the elbow), however golfer’s elbow occurs on the inside of the elbow.
- Nerve entrapment – ulnar nerve entrapment at the elbow, also called cubital tunnel syndrome, occurs when the nerve in the arm becomes compressed or irritated.
Anterior (front) elbow pain
- Biceps tendinopathy – The biceps is a muscle at the front of your upper arm that connects to your forearm. Pain and tears may develop as a result of repetitive lifting.
- Nerve entrapment – Pronator syndrome is compression of the median nerve at the front of the elbow.
Posterior (back) elbow pain
- Triceps tendinopathy – this is the result of small tears in the tendon that connects the muscles at the back of your arm (triceps) to the elbow. It can be caused by repeatedly extending the elbow. Sometimes a bone spur will develop.
- Bone impingement/spurs – this is usually because excess bone has developed due to arthritis.
- Bursitis (usually this is visible as a soft lump) – this is inflammation or irritation of the bursa, a fluid-filled sac at the bony tip of the elbow. Inflammation causes more fluid to accumulate.
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Why is my elbow stiff?
The elbow is one of the joints in the body that is most prone to developing stiffness. Sometime this is called a contracture. It may be due to a tightness in the soft tissues (usually after an injury) and/or bony spurs from arthritis which can hinder movement. Occasionally a piece of cartilage comes loose and becomes wedged between the moving parts of the joint.
Which type of scan might be useful?
Most elbow conditions can be successfully diagnosed after a physical examination, questions about your symptoms, and an X-ray. However sometimes other scans are needed to get to the bottom of the problem and ensure you receive accurate treatment:
MRI scan: This uses a magnetic field to create highly detailed pictures of all the structures in your elbow.
Ultrasound scan: Soundwaves are used to show-up soft tissue problems. This type of scan has the added advantage of assessing the blood flow to muscles/tendons to see how smoothly they are moving against the bone.
CT scan: If your elbow if stiff and/or painful due to bony spurs, the position and size of these will be demonstrated best by a CT scan.
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Our approach
Whatever your symptoms and however long you’ve been in pain, the first step towards recovery is receiving an accurate diagnosis. Once we know what is causing the problem, we can discuss your treatment options with you. We always explore the possibility of non-surgical treatments first, if appropriate, because these generally offer the shortest recovery times and the lowest level of risk. We have access to the best physiotherapists who will work with you to support your recovery. However, where surgery is needed, we will book you in quickly and use the latest, evidence-based techniques to restore functionality and movement.
If you are concerned about your elbow, contact us to arrange prompt diagnosis and treatment so you can begin living life to the full again.
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