Preventing elbow pain or epicondylalgia
Hello and welcome to a new PadelMBA article.
I’m Pau Calatayud, responsible for the physical preparation area. The intention of these articles is to deal with certain topics that have to do with physical training, performance, and injuries.
My intention is to provide you with knowledge that can help you to improve those aspects that will help you to play better and for a longer period.
In this particular article we are going to take a closer look at the famous elbow pain.
I am going to teach you the main theoretical and practical issues that will help you to avoid this typical pathology or to know how to react to it. I hope that if you are one of the many who have suffered from it, it will help you not to fall back into it, and if you are one of the lucky ones who have never had this type of discomfort, it will help you to continue without it.
“We will learn about the main risk factors, you will know how to detect when you are at risk of suffering this injury and I will give you resources to avoid it or deal with it”.
Elbow pain is commonly called epicondylalgia, and it can be of two main types:
medial elbow pain or lateral elbow pain.
Medial elbow pain is pain that appears on the inner side, the side closest to your central axis, also called golfer’s elbow.
Lateral elbow pain is pain that appears on the outer side, the one furthest from your central axis, also called tennis player’s elbow.
Weak points of the elbow
There are three points through which this pain can attack us and which can be manifested only by this point, or combined.
– Affecting the tendon, where an inflammatory process appears that alters the proper functioning and chemistry of this tendon, also known as epicondylitis.
– Joint involvement, at bone level, in the conjunction of the radial humerus, ulnar humerus or ulnar radius.
– Neural involvement, which is due to nerve impingement.
If we have suffered an injury or an episode of pain in this elbow, it is more likely that we have this pathology compared to a player who has not had this injury.
There are cases of people or players whose work, hobbies or daily activities are strenuous for this injury, as they are based on other manual activities or forced positions maintained for a long time.
The fact that that joint or that dominant arm has a localised fatigue that is going to alter the proper functioning of the joint and its mechanics.
On the other hand, and due to the very nature of padel, we will have repetitive gestures in the form of strokes that are going to be present and are going to demand a level of demand “x” of this joint.
A bad technique that alters the optimal range of strokes, a bad grip or a grip that is too thick or too thin can also compromise our elbow.
The fact of not being adapted, either for having spent a period without activity or for being an initiated player, can also give us a certain probability of falling into this pathology.
We can detect, below, when we may be at risk of suffering this type of pathology.
The first thing I would recommend is to listen to your body, listen to it when you are playing and when you are in the resting period. Your body will eventually send you signals if your elbow is not well.
These signs will come in the form of overload, diffuse soreness, or instead in the form of a pain that you can point to with your fingertips. These discomforts, whether during the match or at the end of the match, even when you are cold the same day or the next day, are signs that we need to be aware of and not overlook.
Resources to be able to avoid this pathology, whether it is medial or lateral elbow pain.
In order to prevent or avoid falling into this pain is the warm-up. It has to be a warm-up that I recommend, in addition to the general warm-up, should also be specific to the elbow.
The sport of padel compromises this joint very much and deserves an extraordinary amount of time.
We have to try to work on this elbow in all its movements, mainly in the flexion and extension of the dominant arm, which is where we are going to have the racket, where the stress is really going to be produced by the use of the same. We are going to try to make these movements occur in all ranges and progressively increase in speed.
“The benefits we are going to get from it are going to be an increase in vascularisation, more blood is going to pass through and that is going to increase the temperature and oxygenate each tissue better. On the other hand, it will also increase the viscosity of the tendons and ligaments. To put it simply, we will be able to grease the joint”.
Let’s talk now about the best way to avoid elbow pain pathology: adaptation.
Adaptation is distinguished between specific adaptation and sport adaptation. Specific adaptation refers to the adaptation we make to the handling of the racket at a muscular, tendon and nervous system level, at a neural level.
We will have to adapt to the weight of the racket, the grip and the handling of the racket. That is, to execute a high number of strokes in a short time, that our elbow is able to absorb the vibrations produced by each stroke, and to get used to flexion, extension, pronation and supination movements together with the wrist.
In addition to specific adaptation, sport adaptation will consist of carrying out and adapting the specific movements of our sport. Gestures where the elbow is involved, which will be specifically the strokes where there will be a flexion and extension of the whole elbow.
From there we will have to practice throwing, which will be the basic motor skill on which we will be based in order to be able to work on any exercise that has to do with elbow rehabilitation.
Specifically, the muscles that we are going to try to adapt so that they are used to the demands of this sport are the first radial, the second radial, the long supinator, the short supinator, the common extensor of the fingers, the anconeus and the triceps.
All these muscles are involved in flexion and extension of the elbow and are the ones that normally go into dysfunction and need to be optimised.
When we refer to the resources that we will have to be able to deal with this elbow pain once we are in a situation where we get up with pain or we play and we feel some discomfort, at any moment our attention is directed to the elbow because we know that something is not right.
The main treatment we must have is to be able to adapt to the tolerance required by our sport. In other words, that our elbow is able to withstand all the sporting load that we have. Apart from this, if we go into an episode of some pain, but we are not yet limited and can continue to play, I recommend that you rely mainly on self-massage and stretching.
Specifically, self-massage is based on using the Lacrosse ball, which has different hardness and sizes, and we have to choose the one that adapts to our pain point. That means that the ball, in terms of size and hardness, can help us to handle it and carry out a gentle massage by pressing the points that are causing us pain, and we can then hold that degree of pain and modulate it.
We have to try to make this pain modulation based on tolerance, and to allow us to feel that we are somehow releasing tensions and that they are gently dissipating.
This self-massage will not solve the problem, but it will be part of the active treatment that will alleviate our pain and will allow us to do some stretching or preventive exercises.
As far as stretching is concerned, we have to differentiate between stretching for medial elbow pain and stretching for lateral elbow pain.
Stretches that target medial elbow pain should be stretches of the flexor muscles. Those muscles that allow the hand to approach our inner elbow.
In the case of lateral elbow pain, we will have to do extensor exercises. Those muscles that are responsible for making our palm face forward or our fingers point upwards.
If you enter a part of your pain episode where you are totally limited, you can’t finish playing the game or you don’t even consider picking up the racket because everyday gestures are also painful, you are entering a zone we call the “red flag” zone.
This pain, if it is limiting you from playing normally or even doing your daily tasks, we recommend that you address it based on fully professional support.
We recommend that you rely on the support of health and performance professionals, such as physical trainers, in particular retrainers, physiotherapists and doctors.
Any of them could progressively help you to regain function and it is important that you always start with a good diagnosis. This will mainly be done by doctors and physiotherapists. From a correct diagnosis, you will be able to make a good treatment. https://www.padelmba.com/ejercicios-fyxbody/
When you have pain the first thing you need is a good diagnosis. You will have to try to have a good specific assessment that allows you to know how your elbow is at that precise moment. From there you will go into two phases:
– The recovery phase where you will try to recover the functionality of your joint to allow you to perform those daily tasks that you could not do before.
– The readaptation phase where you are going to try to do more than just those daily tasks, the exercise on the court or the movements and strokes that padel demands of you.
Once you start to get familiar with everything again, the contact with the racket, the strokes and try to play minutes, you will make a second specific assessment of that elbow to make sure that it responds again and is ready to cushion all those strokes and vibrations that padel is going to demand from you.
“I recommend that in this progressive return to the court you rely on professionals, in this case padel coaches who can graduate and modulate the load that your elbow can tolerate at that moment.
They will do it progressively and will allow you to choose those carts, that frequency or those minutes that are appropriate for you to feel comfortable again”.
Last but not least, you should try to continue doing preventive exercises that you have done in previous phases in order to avoid relapse.