When a muscle is overstretched, asked to contract hard against a sudden load, or overused, injury can occur. Small tears in the muscle fibers or the fibers of the tendon that connect the muscle belly to nearby bone is called a muscle strain. An elbow strain involves one of the many muscles and tendons that cross and attach near the elbow. Elbow strains can involve the following muscles and tendons:

• Biceps brachii
• Brachioradialis
• Brachialis
• Triceps
• Anconeus
• Supinator
• Extensor muscles of the wrist
• Flexor muscles of the wrist

An elbow strain can occur in several ways:

• Overuse–Example: a throwing athlete could strain their elbow from too much throwing or a worker can strain their elbow during manual labor
• Sudden high load–Example: lifting a weight that is too heavy at the gym, pulling something very heavy
• Overstretch–Example: falling onto an outstretched arm

WHAT DOES AN ELBOW STRAIN FEEL LIKE?

When a muscle or tendon is strained, you will experience pain in that specific muscle or tendon when it is contracted strongly or stretched. Bending or straightening the elbow, flexing or extending the wrist or rotating the forearm can cause pain at the elbow. Because many elbow muscles overlap, it can be difficult to tell exactly which muscle is injured. An examination by a doctor or physical therapist can usually identify the muscle/muscle group based on the motions that provoke symptoms. Imaging techniques such as ultrasound can also help diagnose a muscle strain.

If the strain is moderate in severity, you may notice some localized stiffness, tenderness, and swelling. You may also observe that the muscle feels weaker than usual. If the strain is severe, the muscle belly can tear completely or separate from the tendon causing the range of motion in the joints at either end of the muscle to be either significantly reduced because of guarding or excessive because the torn muscle or tendon is no longer limiting it.

It is important to note that in most cases a muscle or tendon that has been severely torn will need surgery to repair the injury so the muscle can function normally again. For less severe injuries, physical therapy is just what the doctor ordered.

If you decide to work with a physical therapist to help correct your elbow strain issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your sessions yet in the comfort of your own home.

PHYSICAL THERAPISTS CAN HELP YOU RECOVER

While mild elbow muscle strains often recover on their own within a few weeks, you may choose to see a physical therapist to address a more severe strain or if the symptoms of a mild strain are interfering with your activities. The goals and interventions for rehabilitation of an elbow strain can be broken down into three stages:

Early/acute phase (first 5-7 days):

• Protect the injured muscle or tendon to allow healing to begin
• Use bracing, taping, and immobilization as needed to minimize painful motions
• Consider ice, ultrasound or other modalities to manage inflammation and promote healing
• Passive range of motion that is pain-free may be used to prevent stiffness, maintain range of motion and reduce pain
• Exercising nearby but uninjured areas of the body is helpful

Middle/subacute phase (7-21 days or so after injury)

• Introduce active range of motion
• Wean off bracing, taping, etc
• Begin submaximal exercise to lightly load the muscle and promote good fiber alignment
• Begin very light stretching as needed
• Apply gentle soft tissue mobilization to promote healing, reduce pain and mobilize edema

Late/chronic phase (21 days to many months)

• Begin loading the muscle more intensively while monitoring for signs of acute regression including lasting soreness or inflammation
• Increase the load on resistance training
• Increase stretching and mobility
• Begin exercises to improve tendon stiffness
• Incorporate more dynamic arm exercises
• Perform work and sport-specific drills to prepare the elbow to return to full activity