Elbow Stiffness: Boxers Elbow

by Mr. David Shields

Elbow pain is a common issue in many sports, especially those that put a lot of demand on the upper body, like golf, throwing sports and striking sports like boxing. As a boxer, you might be familiar with the specific type of elbow issue known as “Boxer’s elbow”. This condition involves pain and discomfort in the elbow joint, and it’s important to understand what it is and how to manage it.

What exactly is Boxer’s Elbow?

Boxer’s elbow isn’t just a single injury, but a combination of issues that can occur in the elbow. It’s often linked to repetitive force and hyperextension, which is when the elbow joint bends backwards more than it should. This can happen from the repetitive motion of throwing punches and especially when you miss the target. Interestingly, it seems that the combined movement of hyperextension and pronation (turning your hand downwards) of the arm is the specific movement that contributes to this pain.

Elbow Stiffness

Boxers are prone to both anterior (front) and posterior (back) elbow impingement. In fact, a study of seven boxers found that six of them had anterior impingement lesions and six had posterior impingement. This means there’s a squeezing of tissues at the front and back of the elbow joint. The lead arm of a boxer is the most likely to be affected. So, if you’re a right-handed boxer with an orthodox stance, your left elbow is more vulnerable.

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How does it feel?

The main symptoms of boxer’s elbow are pain in the front and back of the elbow, particularly with movement. You might also experience:

    • Stiffness in the elbow joint
    • Swelling
    • Redness
    • Weakness in the joint
    • Limited movement
    • Muscle spasms
    • Numbness

If the hyperextension is severe, you might even notice an elbow deformity, discolouration or blotchy skin.

How to Tackle Boxer’s Elbow?

It’s essential to seek medical help if you think you have boxer’s elbow. Doctors may use X-rays, MRI, or CT scans to diagnose the issue. Treatment options will vary depending on the severity of your condition. Here’s a look at some common approaches:

Managing Pain
  • Rest: It’s important to stop any activities that cause pain to avoid further damage.
  • Ice: Applying an ice pack wrapped in a cloth for up to 20 minutes at a time can reduce pain and swelling. Repeat this several times a day.
  • Compression: Using a bandage to apply pressure can reduce inflammation and swelling. Make sure it’s not too tight, or it could cause numbness or pain.
  • Elevation: Keep the elbow raised above heart level as much as possible to reduce swelling.
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Rehabilitation
  • Isometric exercises: These are exercises where you tense your muscles without movement. They can reduce pain and prevent muscle loss. Isometric holds in different angles of elbow flexion can load the forearm muscles which are important in elbow rehab.
  • Tendon glide exercises: These exercises can help manage pain and restore load into the forearm muscles.
  • Upper limb tolerance exercises: This helps the upper limb as a whole, the shoulder, elbow and hand and wrist, learn to distribute load together again.
Strengthening and Stabilisation
  • Open kinetic chain exercises: These exercises help with proprioception (awareness of your body’s position) and dynamic joint stabilisation.
  • Plyometrics: Variations of open chain exercises focusing on coactivation of muscles to better distribute joint forces and prevent excessive movement.
  • Reactive neuromuscular control: This is required to throw a punch without excessive elbow extension. Exercises in this area will help to regain the specific movements of boxing.
Other options
  • Pain relief medication: Over-the-counter anti-inflammatory drugs such as ibuprofen or aspirin can reduce pain and swelling.
  • Braces: An elbow brace might be used to immobilise the elbow in the first few days after the injury. However, long-term use isn’t usually recommended unless for specific sports activities to prevent re-injury.
  • Cortisone injections: For more severe cases, injections might be suggested to reduce inflammation.
  • Platelet-Rich Plasma (PRP) injections: PRP injections involve injecting your own blood platelets into the injury to help stimulate healing.
  • Surgery: If there’s a lot of damage to the ligaments or other tissues, you might need surgery. The two surgical options available are open elbow surgery and arthroscopic (keyhole) elbow surgery. Arthroscopic surgery is less intrusive.
  • Physical therapy: This is a critical component of recovery to improve strength and healing.
Prevention

While it’s hard to prevent all injuries, there are measures you can take to reduce your risk:

  • Use proper form: When training, make sure you’re using the correct form and technique in your activities to help protect your joints.
  • Use a brace: Consider using a brace or support sleeve during exercises to help reduce the risk of injury.
  • Avoid repetitive hyperextension: Be careful to avoid repetitive hyperextension injuries as this can cause changes in the bone and joint
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FAQs About Boxer’s Elbow
What does a hyperextended elbow feel like?

You might hear a popping sound with immediate pain, and you’ll likely have swelling, stiffness, and pain when you touch or move your elbow.

What are the risk factors for hyperextending your elbow?

The risk is higher if you are involved in vigorous sports, as well as with advancing age and if you have a history of elbow injuries.

Can you treat a hyperextended elbow at home?

Yes, for minor injuries, the RICE method (Rest, Ice, Compression, and Elevation) can be effective. Over-the-counter pain relief medications can also help.

When should I see a doctor for a hyperextended elbow?

You should seek medical attention if you think you have this injury or if home treatment doesn’t help. Your doctor can carry out tests to check for soft tissue or bone damage.

FAQs About The Upper Limb Clinic
What does the Upper Limb Clinic specialise in?

The Upper Limb Clinic specialises in comprehensive care for athletes, including boxers . We focus on finding the root cause of your elbow pain and providing personalised treatment plans that promote healing and prevent recurrence.

What kind of treatments does the Upper Limb Clinic offer?

Our multidisciplinary approach combines several modalities, including physical therapy, osteopathy, and when required, injections like cortisone or PRP. We also offer rehabilitation and preventative strategies.

Conclusion

Boxer’s elbow can be a challenging condition for boxers to deal with, but with the right knowledge and treatment plan, recovery is possible. By understanding the causes, symptoms, and treatments , you can take steps to protect your elbows and keep performing at your best. If you’re struggling with elbow pain, don’t hesitate to contact The Upper Limb Clinic, a leading orthopaedic clinic in Glasgow for expert care.