Exercise Injuries to Your Arm

From the WebMD Archives

Accidents are just that -- accidents. Anyone can fall onto an outstretched arm during a soccer skirmish or daredevil skateboarding maneuver and fracture the wrist.

But sports and exercise injuries to the elbows, wrists and fingers often stem from overuse, faulty technique, or poor conditioning. That means welcome news: with a few smart measures, you can reduce your chances of injury.

What common types of exercise injuries occur in the arm? What puts golfers, baseball pitchers, and rock climbers at risk? WebMD asked two sports medicine experts to share their insights.

Elbow injuries

Tennis elbow and golfer’s elbow are two frequent complaints, says Jeanne Doperak, DO, a sports medicine physician and assistant professor at the University of Pittsburgh School of Medicine. “Both are overuse injuries, typically, one repetitive motion over and over again,” she says. (However, such problems also afflict people who don’t swing rackets or golf clubs, but use their arms repetitively, such as violinists.)

Tennis elbow, or lateral epicondylitis, causes pain on the outside of the elbow from inflamed tendons. Repeatedly hitting backhands in tennis can spur the condition.

Golfer’s elbow, or medial condylitis, causes painful, inflamed tendons on the inside of the elbow, near the pinky side of the arm. Poor technique in hitting a golf ball can cause the inflammation.

Sports doctors will also see a torn ulnar collateral ligament, also known as the medial collateral ligament, in the elbow, often in baseball players. “A pitcher will throw really hard and have a sudden pain,” Doperak says. “Or if someone playing football or wrestling falls on an outstretched arm, their elbow can buckle and cause [the ulnar collateral ligament] to tear.” This ligament plays an important role in stabilizing the elbow in many other throwing sports, such as javelin, racquet sports, and ice hockey.

Wrist injuries

“The most common things are sprains and fractures,” says Doperak, who also serves as a team physician for athletes at the University of Pittsburgh and Carnegie Mellon University. “We do see a lot of fractures from falling on an outstretched arm, typically. That can be in any sport.”

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But Doperak says that skateboarding, roller blading, football, and even soccer can put people at risk for wrist fractures. “I see quite a few in soccer, believe it or not. You shouldn’t be using your arm in soccer, but people trip and they fall down onto an outstretched arm.”

Sprains can also happen when the wrist is forced backward, tearing the ligament that connects the bones of the wrist.

Hand and finger injuries

Certain sports cause a lot of hand and finger injuries, Doperak says. “Rock climbing has a lot of finger injuries because people are grasping the rock. Football -- where guys are grabbing jerseys and using their hands to tackle -- we see quite a few finger injuries, as well.”

Finger fractures are a common problem, Doperak says. For example, people can break fingers by trying to catch a fast-flying baseball.

And that’s not the only problem attributed to balls. Thumb sprains happen when the thumb is pushed backward with force, causing the ligament to stretch or tear. Football, basketball, and baseball -- sports that involve catching a ball -- are more likely to sprain the thumb, according to Doperak. Symptoms include swelling and tenderness, pain when moving the thumb, and inability to hold things between the thumb and fingers.

The hands are also susceptible to tendon injuries, Doperak says. “People can get a mallet finger, which is a tear to a tendon in their finger that causes the end of the finger to fall forward toward the palm.” The damage to this tendon results in a finger or thumb that cannot be straightened. Typically the injury results from a force to the tip of the finger.

In fact, “If someone suspects that they have a tendon injury to their hand, that’s something that needs immediate attention,” she says. The main warning sign is an inability to straighten or bend a finger.

Treatment for arm and hand injuries

Treatment for elbow, wrist ,and finger injuries vary, depending on the problem. But common therapies include: resting, icing, and elevating the injured area; pain medication; cortisone shots in severe cases of tennis elbow; splinting or immobilizing the injured part; and wearing a cast to allow a fracture to heal.

Some injuries require surgery, Doperak says, especially a tendon injury. For example, fingers may need surgical repair of the tendons in order for the hand to function properly again. Patients may also need surgery to stabilize a fracture or to treat a bone that hasn’t healed right.

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Tips for preventing exercise injuries

Overuse is a major reason for injuries, but there are other factors, too, experts say. Here are some prevention tips:

Don’t overuse your arm. Across a broad spectrum of sports, “Usually, you find the same theme in place, and that’s an overuse type of mechanism,” says Brian Hagen, PhD, DPT, a sports medicine physical therapist and clinical assistant professor at the University of Pittsburgh’s School of Health and Rehabilitation Sciences.

Not only should adults know their limits, but parents need to protect children from too much wear and tear. Overuse injuries in children and teens have soared now that many play a sport year-round, not just for a season, Hagen says. To make matters worse, many young athletes play in multiple leagues for the same sport, whether it’s baseball, soccer, or another activity. “They may play Monday night for one coach and Tuesday night for another coach,” he says.

“What we’re seeing subsequently is a lot of overuse injuries much earlier on in these kids,” he says. “They’re never giving themselves an off-season or a chance to recover or to train properly.” Hagen says that he has treated children as young as age 12 for shoulder and elbow overuse injuries, for example, from throwing balls too often.

Parents would be wise to monitor their children’s sports, according to both experts. “There are very specific pitch counts in Little League, and parents and children should be aware of those and stick within the parameters that are outlined,” Doperak says.

Adults and children should stop exercising or playing a sport when pain strikes, experts say. Continuing to exercise can damage more muscle and connective tissue and slow recovery. In contrast, resting the injured part aids healing.

Often, children and teens won’t complain about pain because they don’t want to sit on the bench, according to Hagen. But if a parent notices warning signs in a young athlete, such as pain, limping, rubbing the knee, or reluctance to do other activities after playing a sport, check in with the child’s doctor, Hagen says.

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Learn proper techniques for your sport and exercise type. Faulty technique, whether in the form of an amateur’s golf swing or a high school player’s baseball throw, can lead to elbow pain, Doperak says. “If someone is doing a lot of throwing and their form is not what it should be, they can overload the inside of the elbow.”

It pays to know the proper techniques for any sport that one plays. For instance, tennis players who let their wrists bend during a backhand have a higher risk of tennis elbow. The same is true if they play with a racket that’s too short or too tightly strung, if they hit the ball off center on the racket, or if they hit heavy, wet balls.

Conditioning matters. Golfer’s elbow can crop up when golfers play a vigorous game after long, fallow season, Hagen says. “A lot of us are in areas where we don’t play golf year-round. [You] have a stagnant winter, and you go out and play 18 or 36 holes of golf--putting that kind of stress and strain on your elbow--and you haven’t done it all year long.”

Typically, “people don’t do the activity for a long period of time, they don’t have the endurance build-up, they don’t have the strength build-up, they don’t have the flexibility, or they’ve created muscle imbalances, and now, they go out and do the activity with full vigor and then they get tissue breakdown,” he says.

Rather than jump headlong into a seasonal sport, such as golf, “Do a little preseason conditioning program that’s specific to the activity that you’re going to do,” says Hagen, who has worked with professional athletes. While physical therapists or personal trainers may be able to help, people can also buy self-help, exercise program that target the muscles specific to their sport, for example, golf conditioning programs.

And right before engaging in exercise or sports, “Doing appropriate stretching and strengthening in preparation for an activity -- and appropriate warm-up -- is always important,” Doperak says.

WebMD Feature Reviewed by Brunilda Nazario, MD on September 24, 2010

Sources

SOURCES:

Jeanne Doperak, DO, sports medicine physician; assistant professor, University of Pittsburgh School of Medicine.

Brian Hagen, PhD, DPT, sports medicine physical therapist; clinical assistant professor, University of Pittsburgh School of Health and Rehabilitation Sciences.

Merck Manual: “Elbow Injuries”.

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