Why does your elbow hurt when you swim? – 2024-07-11 22:05:40

Why does your elbow hurt when you swim?
 – 2024-07-11 22:05:40

Injuries caused by swimming to the upper limbs are common, especially among professional swimmers. Although more known are those that appear on the shoulders from the specific sport, a significant percentage concerns the elbow.

Of course, elbow and hand injuries can occur to all those who love swimming or be noticed during it while they already exist.

Analyzing and learning the correct hand movement technique in the water, or modifying it, removes the possibility of injury and joint pain. When it occurs, however, its effective management requires valid and rapid diagnosis and treatment.

“Elbow pain in sports that require the arm to be raised above the head – and swimming is one of them – is common. It is caused by overuse and repetitive use of the tendons that connect the elbow to the forearm (the ulna and ulna – the two bones that join the elbow to the wrist), from activities that involve pronation (hyperextension) of the forearm or hyperextension of the elbow.

Most often the pain is located on the inner side of the elbow and the condition is called medial epicondylitis or tendinitis or swimmer’s elbow”, explains Orthopedic Surgeon Dr. Panagiotis Pantos, Director of the Upper Extremity Orthopedic Clinic at the Athens Medical Center and head of the Upper Extremity and of Sports Injuries of the Osteon Orthopedic & Spine Clinic.

“Despite the name, the condition does not only occur in swimmers, but also in people who perform various repetitive hand movements. In swimming, the dynamic and continuous use of the forearm muscles can lead to microtears and inflammation in the tendons, resulting in the characteristic pain on the inner side of the elbow.

The pain is accompanied by swelling, redness and stiffness, tingling or numbness of the hand. Sufferers experience more pain when fully extending or flexing the wrist, grasping objects, making a fist, or lifting weights.

Other athletes such as javelin throwers, golfers, tennis players, bowlers, mountain climbers, archers and weightlifters often suffer from epicondylitis, as well as non-athletes such as typists, carpenters or waiters .

Smokers, obese and diabetics, as well as those with weak muscles in the upper limb, are more at risk. Because of the pain, most patients stop performing any painful movement. About 80% recover within 1 to 3 years,” he explains.

Although uncommon in swimmers due to the way most swimming styles put pressure on the inside of the elbow joint, pain can also be due to external epicondylitis, which is 7-10 times more common than medial in the general population. In those with this condition, the pain is located on the outside of the elbow.

“Medial epicondylitis is essentially a chronic tendinitis that is diagnosed following a detailed history, clinical examination and imaging tests (MRI and CT), although most often the latter are needed to identify or rule out other pathologies in the area.

Treatment is mainly conservative and initially involves stopping the work that led to the condition and implementing practices aimed at relieving pain and reducing inflammation.

Analgesic drugs and nonsteroidal anti-inflammatory drugs, oral and topical, reduce pain and make patients more functional. Splinting (especially when lying down) can be helpful, as can kinesiology tape.

Physical therapy, which initially focuses on achieving a full range of motion without pain, also offers great elbow mobility and symptom relief. These exercises are followed by stretching and later by resistance exercises to strengthen the muscles. After recovery, the patient must follow a maintenance program to prevent recurrence.

However, there are also cases of patients who do not benefit as much as they should from physical therapy. For them there is the option of injectable medications. Corticosteroid infusions are useful for short-term relief of symptoms. In recent years, treatments have been carried out with platelet-rich plasma and with botulinum toxin.

Most recover with these conservative treatment methods. But in a percentage the symptoms do not subside and their daily life becomes difficult. Not only can they not swim but they often struggle to drive a nail into a wall or lift a supermarket bag or wring a load of laundry.

If despite efforts for 6 to 12 months there is no improvement, then surgical repair is considered, which involves releasing the common flexor tendon at the epicondyle and debridement of the abnormal tissue. It is followed by a period of rest, use of a splint and then physical therapy. However, only regarding 3% of patients need surgery.

Finally, with regard to swimming, which is an issue that concerns patients at this time, the decision is individualized and depends on the severity of the symptoms. It is good to follow the recommendations of the doctors, both in terms of managing the condition and preventing further injury, which depends on the correct technique of executing the movement according to the swimming style”, concludes Dr. Pantos.

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