Guest post from Vive Recovery Studio.

Elbow tendons are common sites of overuse injury in many athletes and active individuals. Tendonitis of the medial and lateral tendons often goes by names like Tennis Elbow, Golfers Elbow, Little League elbow, and Swimmers elbow.

If you’re struggling with elbow pain, understanding the causes and effective strategies for recovery can make a world of difference.

The Injury

Elbow tendonitis, or more accurately tendonosis in some cases, occurs when the tendons that connect the forearm muscles to the elbow joint become inflamed or damaged due to repetitive stress.

This condition can be excruciating and debilitating, affecting not only athletes but anyone who engages in repetitive arm motions.

*Golfers elbow and tennis elbow are common injuries affecting different elbow tendons.*

Medial Elbow Tendonitis (Golfer’s Elbow)

Medial elbow tendonitis, is commonly known as Golfer’s Elbow. It is a condition that primarily affects the tendons on the inner side of the elbow. Individuals engaging in activities requiring repetitive gripping, lifting, or swinging motions often experience this.

Golfers, as the name suggests, are particularly prone to this condition. That’s due to the repetitive stress of swinging a golf club. However, it can also affect people involved in weightlifting, construction work, or even those who spend long hours typing on a keyboard.

Golfer’s Elbow is characterized by pain and tenderness on the inner side of the elbow. Sometimes that pain radiates down the forearm. Gripping objects, and simple tasks like shaking hands or turning a doorknob can be painful.

Lateral Elbow Tendonitis (Tennis Elbow)

"Tennis" elbow is a common tendon injury in racket sports like tennis and pickleball — *“Tennis” elbow is a common tendon injury in racket sports like tennis and pickleball*, *but it can also occur from other repetitive forearm and wrist motions.*

Lateral elbow tendonitis, or Tennis Elbow, is a condition that affects the tendons on the outer side of the elbow. This type of injury is frequently associated with activities that involve repetitive gripping and wrist extension. Think of the racquet motion while playing tennis or pickleball.

However, it can also occur in people using hand tools, or even working on a computer for extended periods.

The pain is often exacerbated during activities that involve gripping or lifting, like swinging a tennis racket or carrying heavy objects.

Inner elbow pain is also called Pitcher’s elbow. While it primarily affects baseball pitchers, it can also affect other athletes who engage in overhead throwing motions, such as softball players and javelin throwers.

1. REBUILD Tendon and Kinetic Chain Strength

To alleviate elbow pain and prevent further injury, you must focus on rebuilding strength. Strength in the tendon and in the entire upper kinetic chain.

Strengthen It

Strengthening the tendon involves a three-phase approach:

Isometric: This phase focuses on reducing pain and initiating the strengthening process. Isometric exercises involve static contractions that don’t cause the tendon to lengthen or shorten.
Eccentric Strengthening: This step is crucial for improving tendon function and reducing pain. Eccentric exercises require the muscle to lengthen under load, helping to build tendon resilience.
Rapidly: Incorporating quick reactive loads into your training regimen helps the tendon prepare for sports movements and enhances its elasticity.

Strengthen the Entire Upper Kinetic Chain to Get Rid of Elbow Pain

Remember that excessive stress on the elbow tendon can result from weaknesses or limitations in other parts of the upper body, such as the shoulder, neck, and scapular-thoracic joint. A holistic approach to getting rid of your elbow pain is strength training to distribute the load more evenly and reduce the strain on your elbow.

2. REMODEL the Tendon and Collagen Fibers

collagen and fibrosis — *You can use these remodeling tactics help align and change composition of collagen fibers*

Remodeling the damaged tendon and realigning collagen fibers are vital for long-term recovery. Here are some techniques to consider:

Eccentric Strengthening: As mentioned earlier, eccentric exercises are not only beneficial for strength but also serve as a stimulus for remodeling damaged tendon tissue.
Manual Therapy: Techniques like myofascial release, myofascial decompression cupping, and cross-friction massage can stimulate collagen fiber realignment and promote healing.
Nutrition: Incorporating collagen peptides and vitamin C into your diet can support the remodeling process by providing essential building blocks for connective tissue repair.
Red Light Therapy: This non-invasive treatment has shown effectiveness in reducing pain and improving function in superficial tendons like those in the elbow. Learn more about Red Light therapy.
Blood Flow Restriction: An emerging technology, blood flow restriction, can help stimulate cellular healing and trigger the release of growth hormone, aiding in tissue repair.

Restore Pliability of Tendon and Upper Kinetic Chain

Restoring tissue pliability is a critical aspect of recovery when dealing with elbow pain, especially for athletes and active individuals. It involves addressing the flexibility and adaptability of the muscles, tendons, and fascia in the upper kinetic chain, from the shoulder down to the hand. This process not only reduces excessive stress on the elbow but also enhances overall performance and reduces the risk of future injuries.

tissue work to restore pliability and remove limitations in the fascial slings — *Manual tissue work can help restore pliability to tissue throughout the kinetic chain and reduce stress on the elbow tendons.*

Here are some effective methods to restore tissue pliability and get rid of elbow pain:

Tissue Work: Manual therapy techniques like massage, myofascial release, and myofascial decompression cupping can target specific areas of tension, breaking up adhesions, and improving tissue elasticity.
Assisted Stretching: Working with a qualified sports or physical therapist can help you perform assisted stretching exercises that target the muscles and fascia of the upper kinetic chain. This can help improve flexibility and range of motion.
Self Myofascial Release: Use Self-myofascial release techniques such as foam rollers, lacrosse balls, or specialized massage at home. This targets trigger points and tight areas in the muscles and fascia. This can be particularly beneficial for maintaining tissue pliability between therapy sessions.

By incorporating these methods into your recovery routine, you can enhance the pliability of your upper kinetic chain, reduce excessive stress on the elbow, and enjoy improved performance and comfort in your sports and activities.

TL:DR to Get Rid of Elbow Pain

These proven strategies help improve tendon health and alleviate the pain associated with conditions like Tennis Elbow and Golfer’s Elbow.

The key is to take action early, before the tendon degenerates into a chronic problem.

By rebuilding tendon and kinetic chain strength, remodeling collagen fibers, and restoring the pliability of the upper kinetic chain, you can return to enjoying your sports and activities without the burden of persistent pain.

Don’t let elbow pain hold you back; take these steps to reclaim your active lifestyle.

Expert Advice for Parents and Coaches of Young Athletes and Athletes

Shoulder injuries can be a common concern in sports that involve repetitive overhead movements.

However, by understanding the importance of scapular control, you can significantly reduce the risk of shoulder injuries. In this article, we will explore the role of scapular control and provide valuable tips to help prevent shoulder injuries.

Why Scapular Control Matters

The shoulder is a complex joint that allows for a wide range of motion. However, this mobility also makes it susceptible to injury, especially during sports that involve repetitive overhead movements like swimming, tennis, baseball, and volleyball.

The scapula, or shoulder blade, plays a crucial role in shoulder function and stability. It acts as a foundation for proper shoulder movement and helps distribute forces during athletic activities. Maintaining proper scapular control ensures that the shoulder joint operates smoothly and efficiently.

It is a foundation for proper movement and positions in overhead activities. If the shoulder blade is not rotating and elevating properly, there are consequences.

Overhead mechanics can be altered that impact performance and stress on the athlete’s body.

Compensations can occur in other body parts to get that arm overhead that contribute to impingement, tendonitis, and ligament strain.

scapular control is essential for overhead athletes

Weakness or dysfunction in the muscles that control the scapula can lead to imbalances and increased stress on the shoulder joint, increasing the risk of injury. This is why scapular control is essential for preventing shoulder injuries and optimizing athletic performance.

Understanding Scapular Control

Scapular control refers to the ability to move and stabilize the shoulder blade effectively. It involves the coordination of several muscles, including the trapezius, serratus anterior, and rhomboids. These muscles work together to control scapular movement, positioning, and stability during sports activities.

The trapezius muscle helps retract, rotate and elevate the scapula
Serratus anterior muscle plays a crucial role in protracting and stabilizing the scapula against the rib cage.
The rhomboids assist in retracting and stabilizing the scapula.
Levator scapulae helps to rotate and elevate the scapula.

When these muscles work harmoniously, the scapula moves smoothly, allowing for optimal shoulder function and reducing the risk of injury.

However, if there is a muscle imbalance, weakness, or poor coordination, scapular dyskinesis can occur, leading to abnormal scapular movement patterns and an increased risk of shoulder injuries.

Tips for Improving Scapular Control

Now that we understand the importance of scapular control, let’s explore some practical tips to help improve scapular control and prevent shoulder injuries:

Warm-Up and Stretching
- Begin every practice session or game with a proper warm-up routine to prepare the muscles for activity.Perform mobility exercises that target the shoulder, thoracic spine, and hips promoting flexibility and range of motion.Include exercises that activate the rotator cuff, scapular muscles, and the core.
Strengthening Exercises
- Engage in specific exercises that target the muscles responsible for scapular control.
- Include muscle that strengthen and integrate the scapular and shoulder muscles with the entire kinetic chain.

Technique Awareness
- Emphasize the importance of proper technique and form during sports activities.
- Sport coaches should provide guidance on sport specific mechanics so the athlete moves efficiently and safely.
Connected Training
- Incorporate exercises that challenge the demands of the specific sport through the kinetic chain.
- Engage in activities and exercises that challenge scapular control during whole body movements such as overhead kettlebell exercises and medicine ball throws.
Consult with Professionals
- If there are concerns about scapular control or the risk of shoulder injuries, seek guidance from sports medicine professionals or physical therapists.They can assess and provide personalized exercises and strategies to address any scapular control issues and reduce the risk of injury.

Strengthening Exercises

This article focuses on strengthening the scapular muscles and connecting them to the kinetic chain. So, while mobility work and other areas need strengthening for overall performance and health, we’ll keep this limited to a few key exercises.

Strengthening Scapular Muscles with Resistance Bands

Resistance bands are an effective tool for targeting the scapular muscles through exercises such as Ys, Ts, and Ws. Let’s explore how to perform these exercises using resistance bands:

Ts:
– Hold the band with an overhand grip, arms extended in front of you.
– Begin by squeezing your shoulder blades together and pulling the band outwards, creating a T shape with your arms.
– Maintain the contraction in your scapular muscles and control the band as you return to the starting position.
– Aim for 2-3 sets of 10-15 repetitions.

Ys & As (Diagonals):
– Hold the band with an overhand grip in front of body, one arm diagonally up and the other down.
– Begin by squeezing your shoulder blades together diagonally and pulling the band outwards and upwards with one hand, and outwards and downwards with the other.
– Maintain the contraction in your scapular muscles and control the band as you return to the starting position.
– Aim for 2-3 sets of 10-15 repetitions of each diagonal or alternate.

Ws:
– Hold the band with an overhand grip in front of body on one hand with the elbow at 90 degrees, the other arm other down.
– Begin by externally rotating the shoulder moving the top hand up and out.
– At the same time squeeze the scapula and move the upper back.
– Maintain the contraction in your scapular muscles and control the band as you return to the starting position.
– Aim for 2-3 sets of 10-15 repetitions of each diagonal or alternate.

Exercise Tips

When performing these exercises, keep the following tips in mind:

Focus on maintaining proper form throughout the movements.
Engage the scapular muscles by retracting and depressing the shoulder blades (…don’t let your shoulder come up by your ears).
Control the resistance band as you move through each exercise, avoiding jerky or rapid motions.
Perform the exercises in a slow and controlled manner to maximize their effectiveness.
Start with a lighter resistance band and gradually increase the intensity as your strength improves.

Incorporating Ys, Ts, and Ws exercises with resistance bands into your training routine can effectively target and strengthen the scapular muscles, promoting better shoulder mechanics and reducing the risk of shoulder injuries.

Strengthening the Serratus Anterior

The serratus anterior is a crucial muscle for scapular control and stability, playing a vital role in preventing shoulder injuries and optimizing athletic performance. Let’s explore some effective exercises that specifically target the serratus anterior:

Facing the Wall Slides with Thoracic Extension

This variation of wall slides not only strengthens the serratus anterior but also promotes thoracic (upper back) extension, further improving scapular control and mobility.

Stand facing a wall with your feet about shoulder-width apart.

Place your hands on the wall at shoulder height, slightly wider than shoulder-width apart.Keeping your arms straight, slowly slide your hands up the wall while maintaining contact with your palms and fingers.

As you slide your hands up, focus on protracting your shoulder blades (bringing them away from the spine) and maintaining a gentle squeeze between your shoulder blades.

At the top of the movement, actively extend your upper back by arching slightly backward.

Return to the starting position by sliding your hands back down the wall, maintaining control throughout the movement.

Perform several repetitions of this exercise.

Scapular Controlled Articular Rotations (CARs)

Scapular Controlled Articular Rotations are excellent exercises for improving the mobility, stability, and strength of the serratus anterior and other scapular stabilizers.

Stand tall with your arms extended forward at shoulder height, palms facing down.

Slowly rotate your shoulders in a circular motion, focusing on maintaining control and feeling the activation in your serratus anterior.

Perform clockwise and counterclockwise rotations for several repetitions.

Straight Arm Pushups

Straight arm pushups, also known as scapular pushups, specifically target the serratus anterior and promote scapular stability.

Start in a high plank position with your hands directly under your shoulders, arms fully extended, and body in a straight line.

Slowly lower yourself toward the ground while maintaining a stable scapula and keeping your arms straight.

Push back up to the starting position, focusing on protracting your shoulder blades and feeling the engagement in your serratus anterior.

Repeat for the desired number of repetitions.

Incorporate these exercises into your training routine will effectively target and strengthen the serratus anterior muscle, enhancing scapular control, stability, and reducing the risk of shoulder injuries.

Remember to perform the exercises with proper form and start with an appropriate intensity that challenges the

Connected Exercises Using a Kettlebell

In addition to the previously mentioned tips and exercises, incorporating kettlebell exercises can further enhance scapular control and shoulder stability. These are the most challenging because they coordinate more dynamic movements across more of the kinetic chain.

LEARN MORE ABOUT THE KINETIC CHAIN IN OVERHEAD ATHLETES HERE

Kettlebells provide a unique training stimulus because of the “off-balance” design. Because of this, they challenge stability in the entire body, including the scapular muscles.

Here are some connected exercises using a kettlebell that can benefit athletes:

Turkish Get-Ups (TGU)

The Turkish Get-Up is a full-body exercise that promotes scapular stability and control throughout the movement.

Start by lying on your back while holding the kettlebell with a straight arm.

Gradually transition to a standing position while keeping the kettlebell overhead and maintaining a stable scapula.

Reverse the movement back to the starting position.

Windmills

Windmills target the shoulder stabilizers and promote scapular control through rotational and lateral movements.

Start with the kettlebell in one hand, raised overhead.Keep the arm extended and slowly hinge at the hips, lowering the opposite hand toward the ground.

Maintain a stable scapula and a neutral spine throughout the movement.

Return to the starting position and repeat on the other side.

Halo

The Halo exercise targets the muscles surrounding the shoulder girdle, including the scapular stabilizers.

Start by holding the kettlebell upside down by the horns in front of your chest.

Slowly move the kettlebell in a circular motion around your head, keeping the scapula stable and engaged.

Perform the movement in both clockwise and counterclockwise directions.

Bottoms-Up Presses

Bottoms-Up Presses challenge scapular control and shoulder stability by holding the kettlebell upside down.

Start with the kettlebell in a bottoms-up position, gripping the handle with your palm facing upward.

Press the kettlebell overhead while maintaining a stable scapula and controlling the kettlebell’s instability.

Lower the kettlebell under control and repeat for the desired number of repetitions.

Incorporating these kettlebell exercises into your training routine can further improve scapular control, shoulder stability, and overall athletic performance.

However, it is crucial to ensure proper technique and start with an appropriate kettlebell weight that allows for proper form and control.

TL:DR Summary

Remember, scapular control plays a significant role in preventing shoulder injuries among young athletes.

You can improve this through;

Proper mechanics in sports (i.e. throwing, serving, hitting, and swimming strokes)
Strengthening the scapular stabilizing muscles
Build better function in the scapular muscles through kettlebell exercises that “connect” them to the torso and kinetic chain.

By implementing these tips and exercises, athletes can enhance their scapular control, reduce the risk of shoulder injuries, and optimize their performance on and off the field.

Rebuild, Remodel, and Restore to Get Rid of Elbow Pain