Every year millions of teenagers participate in sports activities. 40% of all pediatric injuries are sports related. When a sports injury occurs, it is important to quickly recognize it and seek proper treatment. Injuries among young athletes can be divided into two categories: acute and overuse injuries. Acute injuries are caused by a sudden trauma, for example a collision on the field between players. Overuse injuries occur gradually over time and can affect muscles, ligaments, tendons and growth plates. They are caused by repetitive trauma to a certain body area with no adequate time to heal. Training errors combined with rapidly changing physical characteristics of a young body contribute to a rising injury rates.
The elbow is a relatively simple joint which only allows flexion and extension but is very important in numerous sports activities. The elbow joint is made up of three bones: the upper arm bone (humerus), and the two bones in the forearm (radius and ulna). There are two bony bumps at the bottom of the humerus called epicondyles, one on the outside (lateral) and one on the inside (medial). You can easily feel them when you flex and extend the elbow. The muscles and tendons of the forearm attach to each of them.
Activities that are repeated over and over again can put too much strain on the elbow tendons. This may result in a series of tiny tears and inflammation at the site of bony bumps outside the elbow and can cause soreness and pain.
Certain sports activities can obviously be responsible, and the most common overuse injuries at the elbow site are tennis elbow and golfer’s elbow.
Tennis elbow, called lateral epicondylitis by your doctor, involves the tendons that attach to the outside bony area. Golfer’s elbow (medial epicondylitis) is the same process on inside of the elbow. There is usually tenderness and pain when pressing on the bony bumps. The pain may spread into the upper arm or down to the forearm. You may experience weakness in your hand and wrist and occasionally numbness and tingling in some fingers (especially with golfer’s elbow). It affects usually your dominant hand and the pain can get worse when swinging a golf club or racket, squeezing or pitching a ball, shaking hands, turning a doorknob or holding a coffee cup.
Tennis elbow affects almost 50% of teens who are involved in racquet sports, golfer’s elbow is less common, but tennis players can get golfer’s elbow and vice versa. However, it can be caused by sports other then golf and tennis, sports that require repetitive arm, elbow, wrist, and hand movements like baseball, softball, bowling and weight training.
In many sports overuse injuries there is no straightforward treatment. The activity causing the condition should be limited. For example, put your tennis game on hold until the pain is gone, even if total rest is not recommended. Anti-inflammatory medications, like Ibuprofen and Naprosyn, may help alleviate the pain. Apply ice packs to the elbow for 15 minutes three times a day for few days. Stretching and strengthening exercises will help. A strap worn around the top of the forearm or elastic bandage reduces the load on your elbow.
You can take steps to prevent overuse injuries. Exercise to strengthen your forearm muscles. Stretch before your sports activity. Choose appropriate equipment. A racket with a small grip or a heavy head may increase the risk. You can lower string tension and use softer strings (natural gut string cured my tennis elbow). Work at your technique. It is so important how you hit a forehand or swing a club. A two-handed backhand can keep you out of trouble.
Remember, overuse injuries, if ignored and left untreated, can lead to chronic injury that will keep you out of your favorite sport for long time and could even require surgery.
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