Preventing Elbow Pain

Traumatic injuries may be unavoidable.  However, the risk of pain caused by stressful, forceful or repetitive activities can be controlled.  Sportsinjuryclinic.net offers nine tips to reduce the risk of elbow injuries related to sports.  I have modified these injury-prevention tips and applied them to the computer athlete or the desk jockey.

1.  Warm-up before working.  Warming-up increases the temperature of a muscle preparing it for work.  It also increases the oxygen and blood flow to a muscle enabling it to work more efficiently with less risk of injury.

Use of Heat & Cold to Relieve Repetitive Strain Pain

2. Make sure you are using good technique.  Sportsinjuryclinic.net provides tips for those playing sports.  For the computer athlete or the desk jockey, this means looking at your ergonomic set-up and work methods.  For example, avoid reaching forward for the mouse.  Place it at keyboard height with your arm relaxed at your side and your elbow at a 90 degree or slightly greater angle.  Keep the wrist neutral when using the mouse and manipulate the mouse through small elbow and shoulder movements rather than swiveling at the wrist.

Ergonomic ABCs

3.  Make sure that you have the correct equipment.  Again, in racket sports, this may mean having the correct racket size, grip size and string tension.  For the computer athlete or desk jockey, ergonomic equipment and an appropriately fitted ergonomic chair can help prevent pain.  Awkward positioning increases the stress on the body and makes the work that the body does less efficient, awkward and more prone to injury.

Top 10 Ergonomic Picks

4. Get a massage.  Whether for the athlete or the computer athlete, massage can help relax the arm muscles and break down any scar tissue and trigger points.  Massage along the length of the forearm muscles moving from the hand towards the elbow.  Knead the bulk of the forearm muscle below the elbow joint.  Plant two or three fingers from the opposite arm at the bony prominence of the elbow and perform small oscillating movements across the bone to improve blood supply to the location that the muscles insert on to the bone.

5. Strengthen.  Strengthening the forearm, upper arm and shoulder muscles takes some of the strain away from the elbow joint.

6. Wear a brace around the muscles just below the elbow. This can help by taking some of the pressure off the attachments at the elbow and distributing stress throughout the arm.   Sportsinjuryclinic.net explains the use and purpose of a clasp, support and sleeve.

7. Don't overtrain or suddenly change your training routine or daily activities.  For the computer athlete or desk jockey, a change in routine, new desk set-up, or special project requiring long hours to complete can have an impact on pain level.  If you notice an increase in arm fatigue or soreness, stretch often, use cold packs and take mini-breaks frequently. 

8. Stretch.  Stretching the muscles around the elbow keeps them flexible which helps to reduce the strain placed on the muscle attachments surrounding the joint.

9. Apply cold packs.    For the early stages of elbow pain, whether caused by a sports-related injury or a repetitive or cumulative injury from the keyboard, cold can help reduce inflammation and help relieve muscle pain and spasm.

 Marji Hajic is an Occupational Therapist and a Certified Hand Therapist practicing in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.
 

Rotator Cuff

Chances are, if you are experiencing shoulder pain, the rotator cuff is involved. The rotator cuff is composed of four muscles - the suprasinatus, the infraspinatus, the teres minor and the subscapularis - that provide a stable base for shoulder movement.

The stability of the shoulder is provided through these four muscles rather than by bony structure. These muscles are responsible for positioning and holding the head of the humerus (the long bone of the upper arm) into the shoulder joint. If the head of the humerus is not positioned correctly, it hits the overlying bone, the acromion, pinching the tendons and the bursa (a sack-like, fluid-filled cushion in the joint) causing pain and inflammation. When the head of the humerus is correctly positioned, the larger muscles that move and position the arm can work efficiently and properly.

Because the stability of the shoulder is provided by soft tissues such as the ligaments and muscles, the shoulder has great ability to position the arm and hand in a wide arc of motion for activity. However, the shoulder is also at greater risk for muscular sprains and strains than a joint that derives its stability from bone (such as the elbow).

Even though the muscles of a healthy shoulder work in well-balanced synergy, the muscles that rotate the shoulder inward (internal rotators) are naturally stronger than those that rotate the shoulder outward (external rotators). However, it is the external rotators that are essential for proper positioning of the humeral head into the shoulder joint.
When the muscles of the rotator cuff are in balance, shoulder movement is pain-free. When the muscles are out of balance, the risk for injury, pain and inflammation increases. The rounded shoulder posture that often develops from computer and desk work can lead to muscular imbalance. A large percentage of those who experience hand and elbow pain also have shoulder pain.

To prevent rotator cuff injuries, it is important to do the following:

• Stretch the Internal Rotators
  
  • Lie on your right side with your right arm at shoulder height, elbow bent 90 degrees. Using your other arm, gently rotate your shoulder inward bringing your hand towards the mat by your hip. Hold for 20 seconds. Repeat 2-3 times. Switch sides and stretch the left side.
  • Picture of a Posterior Capsule Stretch from The Journal of the American Academy of Orthopaedic Surgeons
    
  • Picture A – Use a pillow to support the neck in a neutral position and stretch the shoulder gently, not aggressively.
  
  
• Stretch the Chest
  • Standing by a door, rest your right forearm along the door frame with the elbow at shoulder height or slightly below. Keeping the forearm on the door frame, slowly turn your body away from your arm until you feel a gentle stretch across the chest and into the front of the shoulder. If you feel a pinch in the back, take a small step forward until you feel the stretch in the chest instead. Hold for 20 seconds. Repeat 2-3 times. Switch sides and stretch the left side.
  • Picture of Doorway Stretch for the Chest (Pectoralis) from PhysioTherapyExercises.com
  
  Strengthen the External Rotators
  • Lie on your right side with your left elbow tucked into your side and bent at a 90 degree angle, hand towards the mat. Rotate your shoulder outward bringing the hand up towards the ceiling. Keep the elbow bent at the 90 degree angle and the elbow tucked in at the side. Hold at the end range for 3-5 seconds then relax the shoulder rotation and bring the hand back towards the mat. Repeat 8-12 times. Switch sides and strengthen the right side.
  • Picture of External Rotator Strengthening Exercise from PhysioTherapyExercises.com
  
  Focus on Posture
  • Avoiding the rounded shoulder posture will help keep the head of the humerus in proper position.
  • See these related articles for more information.
    • Perfect Posture - The Basics
    • Rounded Shoulders
    • Rounded Shoulders and Forward Head Posture
    
    
  Follow Ergonomic Guidelines for Improving Positioning
  • Being aware of correct ergonomic positioning while working at your desk or on your computer will help avoid the rounded shoulder posture.
  • See these related articles for more information.
    • How to Develop Healthier Ergonomic Habits
    • Ergonomics & Common Sense - Improving Posture
    • Ergonomic ABCs
    
    
  
  

If you are experiencing shoulder pain that is interrupting sleep or work and leisure activity, it is important to seek medical consultation.

Information for this article was taken from The Seven Minute Rotator Cuff Solution: A Complete Program to Prevent and Rehabilitate Rotator Cuff Injuries by Joseph Horrigan, D.C. & Jerry Robinson.

Also available from Amazon.com

The Frozen Shoulder Workbook by Claire Davies & Treat Your Own Rotator Cuff by Jim Johnson, P.T.

Additional Products Helpful for Relieving Shoulder Pain



Marji Hajic is an Occupational Therapist and a Certified Hand Therapist practicing in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.