Elbow Pain: Root Causes and Treatments

 Nurudeen Tijani (T.J.) Founder of TitaniumPhysique | Pain Relief Fitness Coach

Written by: Nurudeen Tijani

Updated: May 10, 2024

Athletes and individuals in sports or fitness training can experience elbow pain and tendonitis injuries. The root causes of this pain are chronic inflammation, magnesium deficiency, and muscle restriction. This article will focus on these root causes and how to treat and fix elbow injuries.

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Article Summary:

  • Causes of Elbow Pain: The root causes of elbow pain are chronic inflammation, lack of magnesium, and muscle tightness in the triceps and forearms.
  • Elbow Injuries: Common elbow injuries experienced by athletes include tennis elbow, golfer's elbow, triceps tendonitis, brachialis tendonitis, distal bicep tendonitis, and elbow bursitis.
  • How to Treat and Fix Elbow Pain: To fix elbow problems, keep the triceps, biceps, and forearm muscles pliable through self-myofascial release (SMR) exercises. SMR is the fastest way to treat and alleviate muscle and tendon pain.
  • Traditional Remedies & Solutions: Traditional remedies alleviate symptoms without addressing the root cause of the pain. Holistic solutions like the TitaniumPhysique Program can help fix and prevent elbow problems.

Root Causes of Elbow Pain

The root causes of elbow injuries and pain experienced by athletes include:

  1. Inflammatory pain: caused by strain and inflammation of the elbow tendons.
  2. Muscle pain: caused by tense, tight, and restricted triceps, biceps, and forearm muscles.
  3. Magnesium deficiency: This can lead to muscle and tendon pain.
Illustration of elbow pain causes: inflammation and muscle pain

Root Cause #1: Chronic Inflammation

Physical activity helps build and strengthen muscles but also leads to inflammation in tendons, ligaments, and joints. Sports, exercises, or activities involving the elbow can cause inflammation in the elbow tendons and joints.

This inflammation causes a 'burning' sensation and pain around the elbow - a condition known as elbow tendonitis.

The burning sensation and pain around the elbow joint are signs of acute inflammation, which is usually temporary and resolves as the body heals the affected tendons. If the tendons fail to heal and the pain persists over three months, it becomes a chronic inflammatory condition [1].

When your body's natural healing process doesn't work, it can lead to chronic inflammation and hinder the healing of muscles, tendons, and ligaments. In this case, it leads to chronic elbow tendonitis.

Root Cause #2: Magnesium Deficiency

Calcium helps muscles contract, while magnesium aids in relaxation. However, when the body has an excess of calcium, which is often the case, muscles struggle to relax and remain tense. This muscle tension strains the tendons, leading to inflammation and pain, in this case - pain in the elbow joint.

Magnesium also dissolves calcium and prevents the calcification of soft tissues. Calcification occurs when there is excess calcium in the body. Calcification hardens soft tissues like tendons and muscles [2]. In this case, the calcification of the triceps and elbow tendons can lead to tendonitis and pain in the elbow joint.

In "The Magnesium Miracle," a scientific reference on the health effects of magnesium, it is highlighted that heavy exercise, physical activity, and factors such as caffeine, stimulants, diuretics, stress, and dehydration can deplete magnesium levels in athletes.

Further, calcium is a direct cause of inflammation. Any disease ending in "itis" (such as tendonitis) is an inflammatory condition, which also means magnesium deficiency [3].

Therefore, athletes and individuals engaged in physical activity must actively replenish magnesium in their bodies.

40% of magnesium in the body is in the muscles. Twitching muscles, muscle cramps, and muscle spasms are signs of low magnesium levels in the body.

The Magnesium Miracle - Discover the Missing Link to Total Health, By Carolyn Dean, MD, ND

Root Cause #3: Muscle Restriction

Illustration of restricted muscles, trigger points in human muscle anatomy

During sports or physical activity (specifically, activities involving the elbow), the triceps, biceps, and forearm muscles contract, becoming tense and tight, eventually losing their elasticity over time [4]. Muscle restriction occurs when these inelastic muscle fibers shorten and cannot relax and return to their normal state.

In the case of elbow pain, poor exercise form or technique can lead to overstretching of the triceps and forearm muscles, causing them to become restricted. These circumstances are often the trigger that initiates pain in the elbow.

When the triceps, biceps, and forearm muscles become restricted, they shorten and become tighter. The tightness in these muscles puts tension on the elbow tendons and joints, leading to inflammation and discomfort.

Tendonitis vs. Tendinosis

  1. Elbow tendonitis refers to the inflammation of the elbow tendon. In contrast, tendinosis involves the degeneration of the tendon's collagen fibers.
  2. Tennis elbow, golfer's elbow, and triceps tendonitis are distinct types of tendonitis where pain occurs outside, inside, and at the back of the elbow.
  3. Tendonitis can develop gradually over time (chronic) or can occur suddenly (acute) from excessive strain on the elbow tendon.
Illustration of elbow tendinopathy, elbow tendon tear, tendinosis

Illustration of tendinosis in the medial and extensor elbow tendon.


Tendonitis refers to the inflammation of a tendon, resulting in acute inflammatory pain. On the other hand, tendinosis is the deterioration of tendon collagen due to repetitive stress and chronic injury.

Tendinosis leads to a loss of strength in the tendon and can often result in tendon tear or rupture. For instance, consistently exercising with elbow tendonitis (inflammatory pain) can lead to tendinosis (degeneration of the elbow tendon).

When the injury initially occurs, the elbow tendon experiences micro-tear damage, known as tendonitis. As the exercise or activity continues, the injury to the tendon worsens and becomes degenerative, known as tendinosis. Ultimately, this progression can lead to the rupture of the elbow tendon.


Types of Elbow Tendonitis

  1. Tennis elbow, also known as lateral epicondylitis, is a form of tendonitis causing pain at the outer part of the elbow joint due to inflammation of the common extensor tendon. It results from repetitive movements during "push" activities and exercises.
  2. Golfer's elbow, or medial epicondylitis, is another type of tendonitis causing pain at the inside part of the elbow joint due to inflammation of the medial elbow tendon. It results from repetitive movements during "pull" activities and exercises.
  3. Triceps tendonitis is inflammation of the triceps tendon, resulting in pain at the back of the elbow. This condition is common among athletes because of the repetitive strain on the triceps muscle and tendon during "push" activities.
  4. Brachialis tendonitis is inflammation or irritation of the brachialis tendon, which connects the upper arm bone (humerus) to the forearm bone (ulna). The brachialis muscle is primarily responsible for flexing the elbow joint. An injured or restricted brachialis from lifting heavy objects, sports, or other physical activities can cause pain, instability, weakness, and swelling on the inside part of the elbow.
  5. Distal biceps tendonitis is inflammation of the tendon that attaches the biceps muscle to the radius (forearm bone) just below the elbow. This condition causes pain in the lower biceps near the elbow, primarily during elbow flexion and forearm rotation.

Over time, these inflammatory injuries can result in degenerative conditions like elbow arthritis and Elbow Bursitis or Bodybuilder's Elbow.

For weight-training athletes, this group of elbow injuries contributes to Weightlifter's Elbow.

3d illustration of brachialis tendonitis

The photo above illustrates the right brachialis muscle and tendon. The "X" indicated in the image is where trigger points in the muscle tend to occur. Trigger points, known as muscle knots, are small, hyperirritable spots within a muscle. They cause pain and tenderness and can develop due to muscle overuse, stress, or injury.

Symptoms: Acute vs. Chronic Pain

  1. Acute pain: inflammatory pain experienced during or immediately after physical activity. It often causes a sharp pain or burning sensation in the elbow.
  2. Chronic pain in the elbow is indicated by persistent discomfort lasting over three months, causing a dull or nagging sensation in the elbow.

Acute pain is inflammatory pain experienced during or immediately after exercise. The following symptoms can identify it:

  • Burning pain in the elbow
  • A sensation of heat, redness, soreness, swelling, or tenderness around the elbow

  • Throbbing sensation in the elbow

Inflammation is a natural immune response triggered by the body to combat infections and injuries [5]. For example, poor exercise form or technique can strain and injure muscles and tendons, leading to an inflammatory response. Acute elbow inflammation typically lasts a few days to a few weeks.

An injury is chronic when the injury does not heal and persists over three months. Depending on the stage of tendonitis [6], athletes with chronic elbow injury experience the following symptoms:

  • Dull and nagging pain in the elbow
  • Discomfort when bending and straightening the arm
  • Stiffness in the elbow joint
  • Sharp, sudden, shooting, severe, or dull ache in the elbow
  • Weak grip strength

When the body's inflammatory response fails to heal the injury and becomes chronic, it starts a progressive and irreversible deterioration of the elbow tendon, known as degenerative tendinopathy [7].

A comparison of acute vs chronic elbow pain symptoms

Treatment and Solutions

  1. Cold therapy: acute pain management involves the RICE Method (Rest, Ice, Compression, Elevation). It can reduce elbow inflammation.
  2. Short-term relief remedies: compression sleeves, joint supplements, and painkillers have pros and cons. They alleviate symptoms without addressing the underlying cause of the pain.

  3. Holistic Treatment solutions like the TitaniumPhysique Program can help treat and prevent elbow problems.

Acute Elbow Pain Treatment

Elbow pain after physical activity is often an acute inflammatory condition. If you're experiencing pain after exercise and notice the following symptoms:

  • Burning pain around the elbow joint
  • A sensation of heat, redness, or swelling around the elbow joint
  • Throbbing sensation in the elbow

The best treatment approach is the RICE Method, which stands for Rest, Ice, Compression, and Elevation [8]. Applying ice, also known as cold therapy, to the affected area helps reduce inflammation and promotes the healing of the inflamed elbow tendon.

Illustration of a man applying ice pack on an injured elbow

Illustration of a man applying an ice pack to elbow joint to relieve pain - RICE Method


How to Apply Cold Therapy at Home

  1. Apply ice or an ice pack to the affected area as soon as possible after the injury.
  2. For the first three days after the onset of acute pain symptoms, ice the elbow for 10 to 20 minutes, four to eight times a day. For example, you can try 15 minutes ON, followed by 15 minutes OFF.
  3. Make sure not to apply the ice directly on your skin. Instead, wrap the ice or ice pack in a towel before placing it on your elbow.
  4. You should notice an improvement in your elbow within 48 to 72 hours of using cold therapy as the burning pain, redness, and swelling decrease.

Limitations of the RICE Method

While the RICE method effectively addresses acute inflammatory symptoms, it does not address the root cause of the pain. As a result, the pain often returns and worsens upon resuming physical activity.

Short-Term Solutions: Pros and Cons

Illustration of pain relief remedies, painkillers, anti-inflammatory gel, kinesiology tape

Joint Supplements & Health Vitamins

Individuals often use joint supplements and vitamins to treat tendonitis. They commonly contain Methylsulfonylmethane (MSM) and Chondroitin, which support joint health by aiding cartilage function.

Pros: Joint supplements can provide short-term relief for acute elbow injuries. Incorporating them into a maintenance routine may help prevent tendonitis.

Cons: In my experience of seeking treatment for chronic elbow tendonitis, I tried supplementing with MSM, Chondroitin, Turmeric, and Fish Oil for several years. However, I did not notice any significant relief for my elbow discomfort. These supplements cannot fix the root cause of elbow injuries.

A 2016 study published in Arthritis & Rheumatology found that MSM and Chondroitin did not demonstrate significant benefits in reducing chronic joint pain [9].

Painkillers (NSAIDs)

ProsPeople frequently use nonsteroidal anti-inflammatory drugs (NSAIDs) or painkillers as a treatment for elbow discomfort. They reduce acute inflammation, providing temporary relief from joint pain.

ConsPainkillers only address the symptoms of acute elbow pain and do not target the condition's root cause. Consequently, the pain often returns and persists.

Research indicates that long-term use of NSAIDs can lead to health issues, including gastrointestinal side effects and kidney disease [10].

Joint Injection (Cortisone Shot)

ProsA cortisone shot involves the injection of a steroid medication into the affected joint, such as the elbow joint. The steroid helps provide temporary relief by suppressing inflammatory pain in the joints—the effects of a cortisone shot typically last for three to six months [11].

Cons: The cortisone shot only offers temporary pain suppression. Once the effects of the steroid wear off, the pain and discomfort often return. Repeated cortisone injections can lead to long-term health side effects, including damaged cartilage, joint infection, and nerve damage.

Topical Anti-Inflammatory Remedies (Oil, Cream, Spray, Gel)

ProsTopical tendonitis relief solutions such as pain relief oils, creams, sprays, and gels often contain anti-inflammatory medications like MSM. They can effectively treat acute inflammatory pain, particularly for new elbow injuries. They can also be beneficial as part of a maintenance routine to help prevent tendonitis.

ConsIf your elbow condition is chronic, lasting three months or more, topical pain relief solutions provide little to no relief in reducing the ache. They are unable to address the root cause of the condition. Therefore, they are not effective in treating chronic injuries.

Strength Therapy & Physical Therapy

Unlike tendonitis, tendinosis results in a loss of strength in the elbow tendon and reduced arm mobility.

Pros: Strength therapy is a crucial component of elbow tendinosis treatment. It plays a significant role in healing degenerative tendons and restoring full arm strength and mobility.

ConsPhysical therapy for elbow injuries can be ineffective for many individuals. It is essential to address chronic inflammation, magnesium deficiency, and muscle restriction caused by the exercise or activity before focusing solely on elbow strengthening exercises. Skipping these steps can render physical therapy ineffective and a waste of time for most people.

Elbow Sleeves, Straps & Braces

Elbow sleeves, straps, and support braces are popular solutions for athletes with elbow injuries.

ProsThese solutions work by compressing the elbow tendon and joint. This compression can temporarily relieve elbow discomfort during physical activity.

Cons: Sleeves, straps, and support braces provide short-term relief by masking the problem without addressing the underlying issue. Using these aids without treating the root cause of the injury can lead to prolonged symptoms and potentially progress to elbow tendinosis, which involves irreversible degeneration of the elbow tendon and joint.

Sports & Kinesiology Tape Therapy

Athletes often use sports tape and K.T. tape to address tendonitis. They offer support to injured muscles and tendons.

ProsWhen applied correctly, sports tapes can temporarily relieve elbow tendonitis and pain associated with elbow injuries.

Cons: Prolonged use of sports tapes and relying solely on kinesiology therapy can mask the underlying issue, potentially prolonging tendonitis. If left untreated, tendonitis can progress to tendinosis, leading to irreversible degeneration of the elbow tendon and joint.

Pain Relief Patches

There are two types of pain relief patches: medicated and non-medicated.

Medicated patches contain nonsteroidal anti-inflammatory medication and are directly applied to the painful area, such as the elbow joint, to alleviate pain. Non-medicated pain relief patches, like nanotech patches, claim to utilize nanotechnology to support the body's natural pain-fighting ability.

Pros - Medicated Patch: Medicated patches can offer short-term relief for elbow tendonitis, with the effects lasting for a few hours.

Cons - Medicated Patch: Medicated patches only provide temporary pain relief and do not address the root cause of tendonitis. Consequently, the underlying issue remains, and the pain may return after resuming exercising. Medicated patches can also have long-term gastrointestinal side effects.

ProsNanotech Patches: They can be beneficial as part of a maintenance routine to prevent acute pain.

ConsNanotech Patches: Nanotech patches cannot resolve the root causes of the pain. As a result, they offer limited benefits in reducing chronic pain and discomfort.

Stretching Therapy

Stretching is essential to treating chronic elbow injuries, much like physical therapy.

ProsStretching the forearms and triceps helps elongate these muscles, improving blood flow, nutrient delivery, oxygenation, and waste removal from the muscles and tendons. This function aids in faster healing of elbow injuries. When the triceps, forearm muscles, and elbow tendons are healthy and lengthened, elbow tendonitis and pain will decrease.

ConsSimilar to physical therapy, stretching alone may provide little relief for elbow injuries if used out of step. Before focusing on stretching exercises to treat the pain, it is crucial to address chronic inflammation, magnesium deficiency, and muscle restriction resulting from physical activity. Skipping these vital steps can render stretching ineffective for relieving elbow injuries.

Fix the Root Causes of Elbow Tendonitis

To fix the root cause of elbow tendonitis:

  1. Reduce chronic inflammation in the body: Addressing chronic inflammation accelerates the healing process of injuries.
  2. Supplement with magnesium: Magnesium reduces inflammatory pain and relaxes tense triceps and forearm muscles.
  3. Massage the triceps and forearm muscles: This step can provide immediate elbow relief. Myofascial pain relief tools are the fastest way to accomplish this.

To fix the root cause of elbow issues, we must address chronic inflammation, magnesium deficiency, and muscle restriction.

As an athlete and bodybuilder, I could not find a solution to accomplish this, so I created one. It's called the TitaniumPhysique Program. It is a fast and effective way to fix muscle pain and tendon injuries.

The program relies on research in tendinopathy, sports medicine, sports injuries, musculoskeletal pain treatment and management, supplementation, and nutrition.

By combining research and ten years of experience as a trainer, nutritionist, bodybuilder, and wellness coach, I developed the program for anyone involved in physical activities.

To learn more about how this program works and why it effectively heals muscle and tendon injuries, I recommend this helpful guide: How To Fix Tendonitis.

Here is an overview of the three steps involved:

  1. Reduce chronic inflammation in the body: Addressing chronic inflammation accelerates the healing process of injuries. Note - although this step is necessary for long-term health, it is not required to fix acute or chronic elbow injuries.
  2. Supplement with magnesium: Replenishing muscle magnesium levels offers numerous benefits, including reducing inflammation and pain, relaxing tense triceps and forearm muscles, and decalcifying the elbow tendon and joint.
  3. Perform triceps and forearm muscle massage: Utilize myofascial pain relief tools such as a massage ball to massage and release tension in the triceps and forearm muscles.
A collage on how to treat elbow pain

Self-Myofascial Release for Elbow Injuries

Self-myofascial release (SMR) uses manual therapy tools (like massage balls) to apply pressure to specific points on the body. SMR helps release muscle tension, increase elasticity, improve performance and flexibility, and enhance tissue mobility by targeting trigger points in the fascia, the connective tissue around the muscles [12].

Elbow pain treatment and myofascial release tools, massage balls

Massage balls are highly effective in releasing tight muscles and addressing elbow injuries. They are durable and inexpensive to acquire, making them a sustainable solution to tackle and avoid elbow issues.

The peanut ball can release the biceps, forearm extensors, triceps muscles, and tendons. The lacrosse ball is ideal for targeting the forearm flexors.

Elbow Pain Treatment Exercises

The self-myofascial release (SMR) exercises below can help you relieve tennis elbow, golfer's elbow, triceps tendonitis, bicep, or brachialis tendonitis. To keep the elbow healthy, use a holistic approach and treat the entire triceps, biceps, and forearm muscles.

For a more detailed guide on these exercises and to ensure you're performing them correctly and effectively, get instant access to my in-depth video course for step-by-step guidance. Start eliminating your elbow pain today! Click here to access the TitaniumPhysique Program now.

You will need a peanut ball and a lacrosse ball, found on Amazon or your local sporting goods store.

How To Fix Tennis Elbow (pain on the outside of the elbow): Use a peanut ball to massage the forearm extensor muscles (click the link to see photo).

  1. Lean against a wall and place the peanut ball on the forearm extensor muscles.
  2. Roll out (massage) the muscles with the peanut ball for 3-5 minutes.
  3. Stretch the forearm extensor muscles.
  4. Perform this routine once a day. Rest the muscle the following day, then repeat the routine. For faster results, perform the exercise twice a day, once in the morning and once at night.
Nurudeen performs an exercise to fix tennis elbow

I'm demonstrating how to fix tennis elbow using a peanut ball to massage the forearm extensors.


How To Fix Golfer's Elbow (pain on the inside of the elbow): Use a peanut or lacrosse ball to massage the forearm flexor muscles (click the link to see photo).

  1. Sit on a chair next to a table.
  2. Place the ball on the table and position your forearm flexor muscles on top of it.
  3. Roll out (massage) the muscle with the ball for 3-5 minutes.
  4. Stretch the forearm flexor muscles.
  5. Perform this routine once a day. Rest the muscle the following day, then repeat the routine. For faster results, perform the exercise twice a day, once in the morning and once at night.
Nurudeen performs an exercise to fix golfer's elbow

I'm demonstrating how to fix golfer's elbow using a lacrosse ball to massage the forearm flexors.


How To Fix Triceps Tendonitis (pain at the back of the elbow): Use a peanut ball to massage the triceps muscle and tendon (click the link to see photo).

  1. Sit on a chair next to a table.
  2. Place the ball on the table and position your triceps muscle on top of it.
  3. Roll out (massage) the triceps muscle and tendon with the ball for 3-5 minutes.
  4. Start near your armpit and roll to the triceps tendon above the elbow joint.
  5. Stretch the triceps muscle.
  6. Perform this routine once a day. Rest the muscle the following day, then repeat the routine. For faster results, perform the exercise twice a day, once in the morning and once at night.
Nurudeen performs an exercise to fix triceps tendonitis

I'm demonstrating how to fix triceps tendonitis using a peanut ball to massage the tricep muscle/tendon.


How To Fix Biceps or Brachialis Tendonitis (pain, weakness, and swelling at the front crease of the elbow), use a peanut ball to massage the biceps and brachialis muscle (click the link to see photo).

  1. Lay on the floor on an exercise mat (double up the mat to prevent pressure on the rib cage).
  2. Place the peanut ball on a stool next to your body and position your biceps on top of it. The stool height should be lower than your shoulder (see below).
  3. Roll out (massage) the biceps muscle with the ball for 3-5 minutes.
  4. Start near your armpit area and roll the biceps down to the elbow area (do not roll over the elbow joint). Note: the brachialis is a deep muscle under the biceps. You may need to roll out the biceps for a few minutes before you reach the brachialis.
  5. Stretch the biceps muscle.
  6. Perform this routine once a day. Rest the muscle the following day, then repeat the routine. Note: the biceps and brachialis are primarily responsible for elbow flexion. If these muscles become pliable too quickly, it might result in discomfort at the inside part of the elbow as the joint adapts to the new level of muscle elasticity. In this case, shorter treatments (3-5 minutes every other day) are better than longer treatments (10 minutes or more) per session.
  7. On rest days when you're not performing this routine, perform elbow mobility exercises (see below) to strengthen the elbow joint. Mobility exercises are essential to stabilize the elbow joint when treating biceps and brachialis tendonitis.
Nurudeen performs an exercise to fix brachialis tendonitis

I'm demonstrating how to fix brachialis tendonitis using a peanut ball to massage the biceps and brachialis muscle.

Mobility and Strengthening Exercises

Elbow strengthening and mobility exercises help the elbow joint and tendons heal faster and regain maximum strength for optimal performance. These exercises are essential when recovering from elbow tendinosis, biceps, or brachialis tendonitis.

The mobility exercises below can help strengthen the elbow joint:

  • Tricep Kickback (with a resistance band)
  • Tricep Pushdown and Tricep Pulldown (with a resistance band)
  • Cable One-Arm Tricep Extension (with a resistance band)
  • Tricep Overhead Extension (with a resistance band)

For a more detailed guide on these exercises and to ensure you're performing them correctly, get instant access to my in-depth video course and start eliminating your elbow pain today! Click here to access the TitaniumPhysique Program now.

Resources

TitaniumPhysique
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This program can help treat and fix:

Elbow tendonitis
Elbow pain and injuries
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Triceps tendonitis (back of elbow)
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