The most common elbow injuries are well known – normally referred to as tennis elbow and golfer’s elbow, the correct medical terms are lateral epicondylitis and medial epicondylitis respectively.

The terms tennis and golf are not the definite causes of injury; they are a generic term applied to a set of symptoms usually experienced on either the inside, or outside of the elbow. Though it is common in those that play racket sports and golf, it can be experienced by many athletes whose sport involves any significant gripping/grasping of an object.

Identifying and addressing the root of the problem is the key to its resolution. In some instances practitioners like to simply inject the injury and carry on. However, this does not address the underlying cause and can just be a temporary fix. A complete treatment solution, addressing all aspects of the injury gives the best possible chance of success, injections do have their place, but as part of a more detailed management strategy.

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Finger pain
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Why is your elbow pain lasting longer than it should?

Does this sound like you?

If any of these have happened to you – we would love to help you. The fact that you’ve tried any or all of these things already is actually a good thing, because when you know what doesn’t work – you are closer to finding the thing that does!

We invite you to come and see us. Why? Because we do things differently. We’ll do a thorough assessment and test all the possible causes. After we’ve diagnosed your problem, and explained what it’s going to need to heal, we’ll make sure you understand why this is happening.

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What you can do to get rid of your elbow pain quickly?

If you’re looking for solid advice on how to start solving your problem, you might not know if our treatment is the right thing for you, we encourage you to give us a call. This is an opportunity to get an expert’s advice about your situation. Our goal is to help you make the right decision about what to do next.

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Get rid of your elbow pain – in the next few days!

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Muscle pain

Whether it be direct trauma to the elbow or repetitive strain on the structures in the elbow joint. We are able to assess where the pain is coming from. The elbow has 3 joints which connect the forearm with the upper arm. Pain coming from inside the joint during movement could be due to injury of these joint connections.

Muscles like the biceps ends in the elbow and many body builders have torn this muscle. The triceps muscle also ends in the back part of the elbow and its tendon is usually the culprit at producing a pain that limits you from bending the elbow.

There are only two groups of muscles that extend into the fingers from the hand. One group bends the knuckles forward (lumbricals) and the other spreads the fingers apart as wells as bring them back together (interosseous).

Both groups of muscles attach onto the first bone in the fingers (closest to the palm). The lumbricals are on the palm side of the hand and the interosseous muscles are more towards back side of your hand.

Injury to these muscles can occur due to forcefully splitting the fingers apart or from trauma such as a cut to the side of the fingers.

Trauma to the muscle in the finger will cause swelling and pain due to an inflammatory process that the body naturally implements. The swelling will restrict the movement of the finger.

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Tendon Pain

On the palm side of the finger there are two groups of rope-like tendons that run from the forearm to your fingertips. The Flexor Digitorum Superficialis, and Flexor Digitorum Profundus, that gives you the ability to close your fingers into a fist.

The back of the finger has the Extensor Digitorum Communis that allows you to straighten your fingers. Injuring these tendons will leave you unable to straighten your fingers.

Unfortunately the Flexor group on the palm side of the hand is more prone to injury. You can cut these tendons by either glass or a knife. Defending yourself against an incoming knife by shielding yourself with an open hand may lead to severing your flexor tendon group. Another scenario may be washing dishes and the glass breaks in your hand, or even trying to catch a falling sharp object.

Trigger finger is a common phenomenon that involves the tendon running in the finger. This leaves the finger stuck in a bent position.
A Mallet finger is when the tendon (EDC) that anchors onto the tip of the finger, rips out a piece of bone (avulsion fracture) that leaves the last joint of the finger to stay bent.

Nerve Pain

Nerve injury or compression that causes the forearm to become numb (in the ring and pinkie fingers) can be from the Ulnar nerve. The discomfort can be treated by neural mobilizations to release the nerve compression.

There are three branches of nerves that supply the power and feeling to your fingers. The Median nerve supplies the palm side of the Thumb, Index and middle finger. Similarly the Ulnar nerve supplies the palm side of the Ring and Little fingers. On the other side the radial nerve gives feeling to the back of your Thumb and fingers.

In most cases nerves are compressed, irritated or injured closer to the wrist, but the dominant pain, burning, shocks, cramps, tingling, pins & needles or any other nerve pain is felt at your fingertips.

A web of nerves that spreads out over your finger to give your skin feeling is present in the finger. These digital nerves are always involved when a tendon is severed, which cuts off the sensation to the skin after the laceration.

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Joint pain

The first joint of your finger is where the finger and the hand meet, commonly known as your knuckles but medically known as the Metacarpal phalangeal joint (MCPJ for short). After that the finger can bend at two points the first, known as the Proximal Interphalangeal Joint (PIPJ). Second is the Distal Interphalangeal Joint (DIPJ).

Enlarged or swollen finger joints (mostly the DIPJ’s or PIPJ’s) is one of the clear signs of osteoarthritis. Heberden’s node’s are nodules that form on the DIPJ or PIPJ, associated with osteoarthritis, which is distinctively different from rheumatoid nodules.

When the MCPJ’s deviate from a straight position, drifting towards the outside this may be a sign of Rheumatoid arthritis.

Any swelling in a joint will lead to pain and difficulty moving the finger.

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Ligament Injuries

Volar Plate is a ligament that prevents your finger from hyperextending. Trying to catch a ball but the ball overextends your fingers, may rupture these sensitive yet vital ligaments.

Ulnar Collateral ligaments are ligaments on the side of the pinky that prevents your fingers dislocating towards your Thumb’s side. Radial Collateral ligaments are on the Thumb’s side of your fingers that prevent the fingers deviating towards the pinky finger. These ligaments are at every joint MCP, PIP and DIP joints.

The finger joints are more vulnerable to dislocate. Any overload and force to any of the fingers may dislocate the finger in any direction. During a dislocation it is important to note that torn ligaments are common. Ligaments are responsible to keep the MCPJ, PIPJ and DIPJ stable, if these ligaments sustain an injury, the risk of you dislocating your finger again is high. A dislocation and/or torn ligaments are associated with swelling and bruising in the finger and joints.

Elbow fracture

The bones in your fingers are called phalanges. Each finger has three phalanges. Starting at the tips the bones in your fingers are the Distal Phalanx, then the Middle Phalanx, and your Proximal phalanx that connect to your knuckles.

A fracture of the finger involves the crack or splinter of any of the three bones that makes up your finger. You may not always be sure if your finger is broken. If it’s broken and you try to bend it, it will be painful, but you’ll still be able to move it. Don’t be fooled if you can still move the finger, this does not mean the finger in not broken.

When an egg is in an upright position it is able to hold a much greater weight than when it’s turned onto its side. In the same way, when a force is applied to the finger bones at the wrong angle, it can be very fragile to break.

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Elbow pain in the …

Tennis elbow

Fractured elbow

Median nerve entrapment

Rotator Teres major muscle strain

Bicep tendon rupture

Golfers Elbow (Medial epichondylitis)

Ulnar nerve entrapment

Tennis elbow

Radial nerve entrapment

Cubital tunnel syndrome

Triceps muscle strain

Burisitis (Student’s elbow)

Olecranon Fracture

finger joint pain, swollen fingers
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What causes my elbow pain

To understand where your elbow pain is coming from, you’d have to determine how you injured it, or if you can remember when it started. Some are outright obvious like when you fall onto the floor or bang into a door, meanwhile others are subtle and creeps up on you – getting worse day by day. So, it’s easier to establish how your pain started and changed until now. Changes in your elbow pain gives us many clues to understand where your pain is coming from.

Our body consists of various types of tissue, some elastic like tendons, or strong like cables (ligaments), some tissue can generate movement & force like muscles. We rely on your elbow ligaments to keep joints stable, tendons to coordinate movements, and muscles to generate power to grip. The structures in your elbow are quite vulnerable to injury, especially overuse injuries. There are more than 52 structures in your elbow that can get injured, some problems are more common than others, but just to be safe – we test them all.

Here’s a breakdown of a few structures that can get injured that gives you different types of elbow pain:

Get to the root of your elbow pain

Different structures, cause different types of elbow pain, although these are not concrete it’s a good guideline to which structure produces what type of pain

Muscle — Dull ache or stiffness, sharp pain with contraction
Nerve — Numbness, tingling, weakness, electrical stabbing feeling
Tendon — Burning pain with certain specific movements, pain comes & goes
Ligament — Pain at the end of range, unstable, clicking
Bone — Constant pain, sharp pain with certain movements
Joints — Cramp, constant stiff feeling, worse after rest, better with movement
Cartilage — Sharp pain when at certain point, painful arch of movement
Arteries — Pins & Needles, dead leg feeling, heavy feeling
Fat pad — Pinching pain, pressure increases or decreases pain immediately
Bursa — Pain only comes on after being active, better with rest
Referral from other joints — Difficult to pinpoint pain, vague painful area

Causes of elbow pain

Trauma – Ligament sprain, Muscle strains, Fractures
Overuse – Tendonitis, athritis
Pinched nerves – Median, Radial or Ulnar nerve branches
Referral from other joints – upper arm, wrist and joints in your hand

Types of elbow pain & structures they may relate to:

Nerve pain in your elbow

  • Burning pain

  • Pins & Needles

  • Tingling

  • Sharp stabbing, shooting pain

  • Electrical shock pain

  • Numbness

  • Unable to control movement

  • Dead feeling over skin

Nerve pain

Muscle pain in your elbow

  • Pain gets worse during activity

  • Burning or cramp like pain

  • Stiffness and tightness

  • Dull pain when stretched

  • Pain only at the end of range

  • No loss of muscle strength

  • Able to move your elbow through the full range of movement

  • Little swelling

Muscle pain

Joint pain in your elbow

  • Sharp sudden pain

  • Worse when moving as compared to static positions

  • Pain when doing a specific moment

  • Muscle tightness surrounding sharp pain

  • Deep pulling feeling when stretched/ moved

  • With or without swelling

  • Pinching feeling at end of range

  • Unable to pinpoint it to one specific spot

  • Dull ache over a large area

  • Unable to find a pain-free position

Joint pain

Symptoms of elbow pain

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How bad is my elbow pain, really?

Size – The larger the area of your elbow pain, is better, because tendons in your hand stretch from your finger tip to your elbow. Pain tends to radiate along the tendons and affect large areas. Tendons heal easier & recover faster.

Colour – Bruising in & around your elbow are quite common after a crack, splinter or fracture, because of the high concentration of small blood vessels in your hands. These capillaries rupture & leak plasma that pools in your elbow. Clearly something is wrong. Blue discoloration closer to your wrist is more concerning for it involves your possible injury to the small bones in your wrist & hand.

Swelling – Swelling is your body’s way of healing itself by sending cells to heal the tissue. More swelling could mean more tissue damage, however not all hand injuries swell. Injury to tissue that develops over a few weeks doesn’t swell, because the tissue trauma is continuous and repetitive, so your body stops the inflammatory reaction. A new injury on an old problem is also possible.

Area – Elbow pain on the palm’s side are more restrictive when you grip & hold things, while pain at the back of your elbow limits you from carrying. If your elbow pain renders you unable to move you must be more concerned. Sharp pain over a small area makes it easier to pinpoint structures near your pain. Vague, dull & deep elbow pain can take longer to identify the root cause. Compensatory patterns develop, sometimes it takes a while to just get rid of those.

Motion & sore elbow

Stiff – Elbow stiffness followed by pain is regressing and getting worse. Seek help. However, pain followed by stiffness is a good sign of tissue healing, specifically scar tissue formation. Scar tissue is hardening wound tissue that tends to shorten and pull on structures surrounding the injured site. This is more pronounced in muscle strains & tears, where the normal slide of muscles is restricted during a contraction.

Range of movement – Difficult moving your elbow through its range is a big problem. A painful arch means the structure injured only takes tension over that specific range i.e Only painful when you straighten your arm the last 10 degrees. Elbow pain over a smaller range of movement is not necessarily better. This may point to connecting joint surfaces being injured like cartilage. If you feel pain only at the end of your range its less severe and easy to fix. When your elbow pain stops movement completely and its too painful to move, you should definitely come see us as soon as possible.

Changes over time:

Intensity – When you grade your pain from 0 – 10. You may think it’s not that bad because it’s not that painful. On the contrary, pain intensity is not a sign of how severe your tissue injury is for example, complete ruptures of ligaments are less painful than partial tears. When fibers are stressed while it’s anchors are completely loose, there’s not much pain, but fibers that are partially torn will produce severe elbow pain. People have different pain thresholds, so be careful not to ignore your elbow injury.

Frequency – Pain that’s fleeting or intermittent, short burst of pain must not become more frequent and constant. This shows that the tissue damage is not getting any better. Pain that only lasts for a few seconds tend to heal faster, so the longer your pain lasts the faster you should get to us.

Latency – If your pain lags to come on and builds up over the day you must be very cautious. This is a sign of a relapse of your tissue pathology. It’s difficult to judge what makes it worse, because the pain only comes on a few hours after your activity, and not during. Your pain tends to be worse in the afternoons rather than in the morning.

Loading – Pushing through your elbow pain while you work is not a good idea. Putting compromised tissue under strain is dangerous. Would you tow a car with a partially torn cable? No! Because it just needs that final pull or jerk that could cause catastrophic tissue damage. Loading soft tissue without knowing what it’s able to handle is dangerous & reckless.

finger joint pain, finger joint pain treatment, Ganglion, ganglion wrist, ganglion cyst causes, lump on wrist, ganglion cyst treatment
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Diagnosis of elbow pain

Our experts know and understand the intricate anatomy of your elbow. There are many structures to test, and we even consider the complex biomechanics of your shoulder & hand. We’ll accurately diagnose which structures are involved, and to what degree. This gives you a good idea what exactly is happening inside your elbow in order to establish the extent of the tissue damage.

During your evaluation, we’ll be stretching & stressing the soft tissue structures like muscles, ligaments, nerves and tendons. This way we can diagnose muscle tears, ligament sprains, tendinitis’s and nerve irritations. We’ll test different aspects like muscle strength, range of motion, flexibility and stability in order to confirm how severe your tissue damage is, which will lead us to tailor a treatment plan. Then we’ll customize the treatment to your specific needs. Therefore our specialists are the best at diagnosing elbow pain & elbow injuries.

The Process of Diagnosis:

Diagnosis is a process of exclusion, not inclusion. Medical professionals are taught a process of elimination and deduction to identify the most possible diagnosises for your elbow pain. The better you can describe & elaborate on your pain, the better picture you’ll give us to understand what’s happened & what you’re feeling.

The practitioner uses their skills to eliminate diagnosis’s it’s not and zoom in on your problem. This elimination brings us to only a few possibilities to what could be causing your elbow pain. Then we test & assess all our possibilities to get to the root cause of your pain. We encourage you to be honest and open about what you’re feeling – to clarify, carry on or change our approach.

Don’t

  • No ibuprofen or other forms of Anti-inflammatories in the first 48 hours after an injury

  • Do not use heat packs or soak your hands in warm water for the first 2 to 3 days after an injury

  • Don’t try to lift heavy objects or grip anything too tightly

  • Carry, pull or push things

  • Try to stretch through the pain

  • Ignore swelling (clearly something is wrong)

  • Treat it without a proper diagnosis, you may end up causing more harm

  • Ignore the pain (it may be a sign of a deeper problem)

  • Leave it untreated & hope it’ll heal

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Must Do

  • Protect it from further injury

  • Put an ice pack in a towel and place it on your wrist for up to 20 minutes every 2 to 3 hours

  • Stop, cut down or limit activities that brings on your pain

  • Wear a splint to support your elbow, especially at night – you can get these at our reception (if you’re strapped for cash)

  • We can diagnose your problem fast & treat it

  • If you’re unsure what it might be – rather get an expert’s opinion

  • Give us a Call to set up an appointment to determine the tissue damage & how severe your problem is.

Makes it worse

  • Typing

  • Writing

  • Painting

  • Carry bags

  • Lifting heavy objects

  • Moving furniture

  • Open & closing doors

  • Texting

  • Driving

  • Unlocking a door

  • Pushing onto it

Hand therapy treatment for elbow pain

We have seen many patients with elbow pain and provide the best possible treatment for a faster recovery. Pain and stiffness after a elbow injury prevent you to grip or hold things. You might feel afraid to move, or scared you’ll damage it even more. We know that you’re anxious about the unknown, so that is why we are here to guide you and give you all the answers.

Your elbow pain treatment will be tailored according to various factors, but just to give you a broad idea, our focus of our treatments are:

  1. Determine what structures are injured in your elbow
  2. How bad is it injured?
  3. Protect it from further injury
  4. Help accelerate healing
  5. Re-evaluate to monitor progress
  6. Change and adapt as you get better

Hand therapy expert

Our experts can diagnose, test and treat any kind of elbow pain. We guide you to get rid of your pain as fast as possible. Our world class techniques & machines make sure you get the best value for your money. We will test a lot of different possibilities why you’re feeling this elbow pain in order to explain what’s going on in your body. It all depends on the results of our tests to determine what needs to be done. All our experts are hand specialists that can determine the slightest problem coming from your elbow, hand or wrist, so if you’re uncertain – we can help you.

Our experts determine multiple problems that can be involved, this means that we test everything to ensure we’re treating it the right way. This is our expertise & what we’re best at. We take on many roles to achieve your goals: Teacher, counselor, trainer, coach and engineer. As a teacher we explain the extent of tissue damage & the intricate details of your elbow pain & how it may affect other problems. As a counselor & pain expert, we’ll guide you every step of the way. As engineer we check the structural integrity of the tendons, ligaments & joints in your elbow.

Elbow pain Treatments we offer:

  • Custom splints

  • Strapping

  • Laser

  • Electrotherapy

  • Waxing

  • Progressive exercises

  • Stretches

  • Nerve gliding techniques

  • Transcutaneus Electrical stimulation

  • Biomechanical Analysis
  • Grip exercises

  • Joint mobilizations

  • Medications

  • Neurodynamics (Nerve tissue mobilizations)

Tell me more about Treatment

Some Questions we get about elbow pain:

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What our patients say:

“I’ve been struggling with a tennis elbow for so long I can’t even remember, it got to the point where I couldn’t take it any more. Now after 4 weeks I wish that I knew what she could do for me, I would have come much earlier. She’s amazing. I recommend her any day!”

A Botha

“She’s fantastic & brilliant. She explained my problem & set out a plan of treatment that I still follow to this day. It’s solved my problem, maybe she can help you too”

N Ngobena

“Very professional & her knowledge is exceptional. Truly an expert with elbow pain. Just call her, she’s sooo friendly & helpful. Glad my problem is fixed now.”

H Bekker

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Elmarie van der Merwe

I am a passionate Occupational Therapist with a post graduate diploma in Hand Therapy. I spesialise in treating any pathology from the elbow to the finger tips. As a Hand Therapist I place high value on the correct assessment and treatment of any pain/problem and the cause of that problem rather than the symptoms. I enjoy educating my patients as I strongly believe in a therapeutic partnership and that knowledge is power.

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