The elbow joint, a hinge connecting your upper and lower arm, allows for a wide range of motion, crucial for everyday activities.
But like any hardworking joint, it can become susceptible to pain and discomfort.
This blog looks into the anatomy of the elbow, explores different types of elbow pain, and unveils how acupuncture can offer a natural approach to finding relief.
Understanding Your Elbow
The elbow joint comprises three bones: the humerus (upper arm bone), radius (one of the two forearm bones on the thumb side), and ulna (the other forearm bone on the pinky side). Ligaments, tendons, and muscles provide stability and allow for movement.
Common structures involved in elbow pain include:
- Medial epicondyle : The bony bump on the inner side of the elbow.
- Lateral epicondyle : The bony bump on the outer side of the elbow.
- Flexor and extensor muscles : Responsible for bending and straightening the arm.
- Ulnar nerve : Provides sensation around the inner side of the elbow and to the pinky and half of the ring finger. It supplies motor function to some of the muscles in the hand that help to grip.
- Radial nerve : Provides sensation in the back and thumb side of the hand, or in the thumb, 2nd, and 3rd fingers. It supplies motor function for extending the wrist and fingers.
Types of Elbow Pain
Elbow pain can manifest in various ways, each with potential causes:
- Tennis elbow (lateral epicondylitis) : Pain on the outer elbow, often caused by repetitive motions.
- Golfer’s elbow (medial epicondylitis) : Pain on the inner elbow, from overuse of forearm muscles.
- Little league elbow : Pain in a young throwing athlete’s elbow, which may be due to injuries to the muscles, tendons, ligaments, and/or bones. (See the end of this blog for more detailed information)
- Bursitis : Inflammation of the fluid-filled sacs cushioning the bones and tendons.
- Tendonitis : Inflammation of the tendons connecting muscles to bone.
- Arthritis : Degenerative joint disease causing pain, stiffness, and swelling.
- Joint Capsule Strain/Sprain : The joint capsule is a fibrous sac that surrounds the elbow joint, providing stability.
A sprain or strain in the joint capsule can occur due to a sudden forceful movement or overuse. This can cause:- Aching pain around the entire elbow joint
- Point tenderness where the capsule is injured
- Difficulty with full range of motion (flexion, extension, rotation)
- Swelling or bruising in the area
- Proximal Radioulnar Joint (PRUJ) / Annular Ligament Injuries : The PRUJ is a joint near the elbow where the head of the radius (forearm bone) meets the ulna (another forearm bone).
The annular ligament encircles the head of the radius, holding it in place.
Injuries to this area can be:- Subluxation (partial dislocation) : This often occurs in young children when the arm is pulled suddenly, causing the radial head to slip out of its normal position within the annular ligament. Symptoms include pain, limited pronation (turning palm down), and a fixed, extended arm position.
- Ligament Sprain : Overuse or a forceful twist can strain the annular ligament, causing pain on the outer aspect of the elbow, especially with forearm rotation movements.
Causes
Elbow pain can arise from various factors, impacting different areas of the joint.
Here’s a breakdown of some common causes:
- Cervical Facet Joint Referred Pain : The facet joints in the cervical spine (neck) can sometimes refer pain down the arm and into the elbow.
This pain can mimic true elbow pain and requires proper diagnosis by a healthcare professional. - Extensor Carpi Radialis Brevis (ECRB) and Extensor Carpi Radialis Longus (ECRL) Issues : These two forearm muscles are responsible for wrist extension. Inflammation , tightness, or degeneration in these muscles can cause pain on the outer side of the elbow.
- Rotator Cuff Injuries : While the rotator cuff is located in the shoulder, some rotator cuff muscle imbalances or injuries can contribute to referred pain in the elbow joint.
- Overuse Injuries : Repetitive motions from activities like sports (tennis elbow, golfer’s elbow), work tasks, or hobbies can strain muscles, tendons, and ligaments around the elbow. This overuse can lead to inflammation, pain, and tenderness.
- Overthrowing Athletes : Athletes who throw overhead sports like baseball, tennis, or javelin throw are prone to elbow pain due to the repetitive stress on the joint. This can lead to ligament sprains, muscle tears, or inflammation.
- Improper Technique : Incorrect form during exercise, throwing motions, or activities that put excessive stress on the elbow joint can cause micro-tears or strain, leading to pain.
- Grip Strength : Weak or imbalanced grip strength can place additional stress on the elbow joint, especially during activities requiring forceful gripping or grasping.
Additional Considerations
- Age: As we age, the cartilage in the elbow joint can wear and tear, leading to osteoarthritis and pain.
- Underlying Conditions: Certain medical conditions like rheumatoid arthritis or gout can affect the elbow joint and cause pain.
- Previous Injuries: Prior injuries to the elbow joint can increase susceptibility to future pain episodes.
Symptoms
Elbow pain can present with various symptoms, depending on the underlying cause:
- Aching or sharp pain
- Tenderness to touch
- Difficulty bending or straightening the arm
- Weakness or loss of grip strength
- Clicking or popping sounds
- Swelling or redness
Acupuncture for Relief
Acupuncture offers a promising approach to managing elbow pain. Here’s how it might help:
- Pain Relief: Acupuncture stimulates the body’s natural pain-relieving mechanisms, including endorphin release, reducing the perception of pain.
- Improved Blood Flow: By stimulating specific points, acupuncture can increase blood flow to the affected area, promoting healing and reducing inflammation.
- Muscle Relaxation: Acupuncture can help relax tight muscles around the elbow joint, improving flexibility and reducing pain.
Understanding Little League Elbow : Protecting Young Athletes
Little League elbow (medically known as medial epicondyle apophysitis) is not just for baseball players!
It can impact any young athlete (ages 9-14) who participates in throwing sports like water polo, volleyball, or even football quarterbacks.
What is Little League Elbow?
Medial Epicondyle Apophysis is an inflammatory condition affecting the growth plate (a weaker area of developing bone, apophysis) in the inner part of the elbow (medial epicondyle) due to repetitive throwing motions which leads to tenderness, pain or even swelling.
Since this condition is one of the most commonly seen injuries in young baseball pitchers, it is often referred to as “Little League Elbow“.
- Microtears : Tiny tears in the tendons or the growth plate itself.
- Inflammation : The body’s natural response to repair the microtears.
- Pain : As inflammation increases, pain becomes more noticeable.
Risk Factors
- Repetitive Throwing : Throwing too many pitches, especially with improper technique, puts excessive stress on the developing growth plate.
- Age : Children between the ages of 9 and 14 are most susceptible as their bones are still growing.
- Pitch count : Exceeding recommended pitch counts for a specific age group can be detrimental. (https://www.littleleague.org/playing-rules/pitch-count)
- Overuse : Throwing too much without sufficient rest periods increases the risk of microtears.
- Lack of Proper Technique : Incorrect throwing mechanics can increase stress on the elbow joint.
- Playing Multiple Teams : Playing on multiple teams or participating in year-round baseball without sufficient rest periods can significantly increase the risk.
Symptoms of Little League Elbow
- Pain on the inner side of the elbow, especially with throwing or gripping activities.
- Tenderness to touch in the inner elbow area.
- Decreased throwing velocity or accuracy.
- Difficulty fully extending the elbow.
- Swelling around the elbow (in some cases).
How Can Acupuncture Help?
While rest, proper throwing mechanics, and activity modification are crucial for recovery from Little League elbow, acupuncture can offer additional benefits :
- Pain Relief : Acupuncture stimulates the release of endorphins, the body’s natural pain relievers, reducing pain perception.
- Improved Blood Flow : The fine needles used in acupuncture can promote blood flow to the affected area, facilitating healing and reducing inflammation.
- Promoting Healing : Acupuncture may influence the body’s natural healing processes, aiding in the repair of the stressed growth plate.
Preventing Little League Elbow
Here are some tips to help prevent Little League elbow in young athletes:
- Proper Technique Coaching : Ensure proper throwing mechanics are taught and practiced regularly.
- Pitch Counts and Rest Periods : Adhere to recommended pitch count limits for each age group and allow for adequate rest between throwing sessions.
- Warm-Up and Cool-Down : Perform dynamic stretches before throwing and static stretches afterward to improve flexibility and reduce injury risk.
- Muscle Strengthening Exercises : Include exercises that strengthen the muscles around the elbow joint to improve stability and support.
- Pain as a Warning Sign : Educate young athletes to listen to their bodies. If they experience pain, they should stop throwing and rest.
By working together to prevent Little League elbow and seeking appropriate treatment when necessary, parents, coaches, and young athletes can ensure a safe and enjoyable experience on the field.
References
Little League Elbow
https://journals.lww.com/cjsportsmed/citation/2005/01000/little_league_elbow.8.aspx
The Effect of Acupuncture on Elbow Joint Sports Injuries Based on Magnetic Resonance Imaging
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9001099/
Use of Acupuncture for the Treatment of Sports-Related Injuries in Athletes: A Systematic Review of Case Reports
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7664377/
DISCLAIMER – Link to the Whole Statement
While this blog offers helpful information, it’s not a substitute for medical advice. As an individual’s health concerns are unique and require professional guidance, do not rely solely on online information for self-diagnosis or treatment. If you have health concerns, always consult a healthcare professional for personalized diagnosis and treatment.
