outer elbow pain

Outer Elbow Pain & Elbow Strains


Medically reviewed by Misty Seidenburg

Pain in and around the elbow has several potential causes, and the location of your pain provides important clues about your condition and how to treat it. This article will focus on outer elbow pain, which can keep you from the activities you enjoy and the simple tasks that are part of your daily routine. Learn what causes outer elbow pain and strains and how they are treated with physical therapy.

What Is an Elbow Strain?

Strains are a leading cause of elbow pain. A strain is an injury to a muscle or tendon, which is the fibrous tissue that connects muscle to bone.  Also known as a “pulled muscle,” a strain develops when the tendon or muscle overstretches or tears through overuse or sudden trauma to the body.

Outer elbow pain and strains are more common in certain activities than others due to repetitive gripping, which can strain the tendons.

A sudden, unnatural movement, like twisting or turning the arm awkwardly, can cause an elbow strain. Moving too fast without warming up properly increases the risk of elbow strains. In either case, the force of the impact or motion becomes too great for the tissue to withstand it.

What Is Tennis Elbow?

Because tennis elbow, or lateral epicondylitis, is one of the most common causes of outer elbow pain, it’s worth a closer look. Tennis elbow is an overuse injury affecting 1-3 percent of adults in the U.S. Although it can occur from an acute injury, it often happens from repeated wrist extension. Poor form or a heavy racquet increases the risk of tennis elbow.

As pickleball overtakes other activities to become America’s fastest-growing sport, the term pickleball elbow has become synonymous with tennis elbow. Both sports can stress the same tendons and muscles, as players grip the paddle or racquet tightly and twist and turn their wrists repeatedly.

What Does an Elbow Strain Feel Like?

If you have an outer elbow strain without a complete rupture of the tendon, you may experience:

  • Pain when moving the injured tendon
  • Swelling
  • Numbness
  • Tingling
  • Difficulty moving the affected arm

With a complete tear, elbow strain symptoms are usually more severe:

  • Bruising
  • Swelling
  • Weakness in the affected area
  • Inability to bear weight on the injured arm
  • Elbow popping or snapping at the time of injury
  • A crunchy or gritty sensation when bending the arm

Elbow tendon tears are more likely in events involving considerable force, such as a contact sports injury, car accident, or fall on outstretched arms. Knowing the signs of a serious elbow injury is important to seek medical attention if needed and avoid further complications.

Elbow Strain Vs. Sprain

Elbow strains and sprains are often confused, but the two injuries involve different structures. An elbow sprain is a stretched or torn ligament, which are the tissues that connect bones to a joint. Twisting your arm, falling on it, or getting hit can cause a sprain. The symptoms of sprains and strains can be similar, and treatment for minor injuries often includes physical therapy.

How Do You Treat a Strained Elbow?

Physical therapy for a pulled elbow muscle can help relieve outer elbow pain in several ways:

  • Manual therapy, including a wide range of evidence-based hands-on therapies and treatments to improve soft tissue mobility, relieve pain, and increase range of motion
  • Exercise and stretching to lengthen and strengthen the involved muscles and those surrounding them and address secondary back and shoulder impairments caused when the body compensates for the injured elbow
  • Preventive physical therapy to correct form and build strength and flexibility, making the arm less susceptible to injuries
  • Education to help the patients understand why they got hurt and steps they can take to avoid future injuries, like warming up before activity and the importance of hydration and nutrition to keep the entire body healthy

Physical therapists also prescribe home exercise programs (HEPs), which are exercises patients do at home in conjunction with an active physical therapy plan. Each HEP is carefully crafted to help the patient improve upon or maintain their functional movement goals. Studies show that patients who adhere to their HEPs increase their physical function and have improved outcomes overall.

How Long Does An Elbow Strain Take to Heal

The prognosis for an elbow strain with outer elbow pain varies depending on the extent of tissue damage. Mild strains generally improve within 6-10 weeks, while more severe injuries can take much longer. Some strains require surgical repair, followed by physical therapy. To get to the root of your nagging elbow pain, request an appointment online or find a physical therapy clinic near you.

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Medically reviewed by

Misty Seidenburg

Vice President of Clinical Programs

Dr. Misty Seidenburg has been a practicing physical therapist since 2006 after obtaining her Doctor of Physical Therapy Degree from Gannon University. Dr. Seidenburg completed an Orthopedic Residency in 2009 and subsequent Spine Fellowship in 2010 where she discovered a passion for educating clinicians. Since 2019, she has developed and refined several post-professional residency and fellowship programs and currently serves as the Vice President of Clinical Programs for Upstream Rehab Institute. She serves on several APTA committees to help advance the profession, is adjunct faculty at Messiah University, and is also a senior instructor and course developer for the Institute of Advanced Musculoskeletal Treatments with a special interest in exercise integration. Outside of work, she enjoys challenging herself with new adventures and is currently competing as an endurance athlete.

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