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By Will Ambler
3rd June 2022 | 4 min read
Elbow injuries plague athletes who perform movements like the baseball pitching action, tennis shots, and golf swings. These movements place repetitive stress on athletes’ joints and the recent rise in these injuries can only be described as an epidemic, a leading performance physical therapist says.
“Year-round play and long competitive seasons are a significant reason for the epidemic of elbow injuries. Research by Leland et al., 2019, outlined that elbow reconstruction surgery, as a result of injury, has increased by 3% (2012 – 2018). The current prevalence of injury reconstruction surgery stands at 26% and 19% in Major League Baseball and Minor League Baseball athletes respectively,” leading performance physical therapist Ziad Dahdul said during his Science for Sport presentation titled ‘Elbow Injury Rehab’.
There are a number of elbow-related repetitive stress injuries seen across all levels of sports like baseball, tennis, and golf.
“These sports place repetitive valgus stress (when the forearm is angled out away from the body when the arm is fully extended and affects medial collateral ligament) from concentric and eccentric loading during their sport-specific movements. Related elbow injuries are referred to as golfer’s and tennis elbow, or to give them their scientific terms, medial and lateral epicondyle tendinopathy,” says Dahdul.
In addition to golfer’s and tennis elbow, Dahdul explains there are a number of other common repetitive stress injuries: “these include ulnar collateral ligament tears, medial apophysitis (referred to as little league elbow), olecranon bursitis, and olecranon stress fractures.”
Anatomy of elbow with lateral, posterior or anterior view vector illustration.
These all-too-common injuries occur at various parts of the elbow and recovering from them effectively is dependent upon the extent of the injury, a structured rehab program, and athletes’ rest and behaviour changes.
Designing a rehab program that is staged and structured will best prepare athletes to return to their respective sports, Dahdul said.
Dahdul’s five-step recovery plan:
Before a full return-to-play, Dahdul said: “it’s important to integrate body regions into compound movements to allow for good translation to their sport. The primary goal during repetitive stress rehab is to decrease excessive loading, improve tissue capacity, and determine the root cause of your athlete’s issues.”
Dahdul said: “whilst focusing on the elbow and the injured area, it is also important to focus on areas outside of the injured area. The shoulder, thoracic spine, and hips play a significant role in the recovery from elbow injuries.”
Rest and improved technique are also important aspects to mitigate repetitive stress injuries or their reoccurrence during rehab.
“Each athlete is going to recover at their own pace and managing the entire human body through sleep and nutrition all play a credible part of rehabilitation,” explained Dahdul.
Ziad Dahdul
Ziad Dahdul is a performance physical therapist and owner of Ignite Phyzio & Sports Performance in Orange County, California. He specialises in treating overhead athletes and ACL rehab with a passion for bridging the gap between rehab and performance.
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