From the stubborn lionheart who refuses to tap to the world-worn veteran with an onset of arthritis, every MMA athlete needs to look after their elbows.

Elbow problems are common in mixed martial arts.

There are a number of different causes of elbow pain and in this feature we’ll cover some of the most likely culprits. Striking and grappling both stress the elbow joint in slightly different ways. While more serious injuries may come from a sudden strain on the joint, or (more commonly) from a gradual accumulation of ‘wear and tear.’

The elbow consists of three closely related joints that connect the two bones of your forearm (radius and ulna) with your upper arm (humerus). 

ACUTE ELBOW INJURIES

Let’s have a look at the acute injuries first. This kind of injury may happen as the result of an armlock, a fall onto the hand, or a badly blocked kick. A good rule of thumb is (where possible) to use R.I.C.E. (rest, ice, compression and elevation) as soon as you can after the injury happens. If you are concerned about the severity of the injury, then also seek immediate medical attention.

For a nasty fracture or other serious injury, not getting proper treatment might affect your arm in the long term, so don’t chance it. 

> Fractures

Fractures are, fortunately, rare and usually the result of a freak accident. This type of injury will require hospital treatment. A cast may be used to immobilize the arm while the bone heals, and sometimes surgery might be needed to make sure the bone heals in proper alignment. 

> Acute ligament sprains

Ligament injuries are a common result of not tapping fast enough to an armlock. Correctly applied, straight armbars and americanas both stress the ligaments of the elbow. Some people regard a ‘popping’ sound as a sign that the ligament has been torn. This could indeed be the case, but it may or may not be as bad as you think.

A total ligament rupture may require surgery, but more often a strain will heal by itself with a good rehabilitation program. 

CHRONIC ELBOW INJURIES

Chronic problems may stem from repeated impact with a heavy bag or grip work. For those with a day job in an office, spending a lot of time at a computer may also compound these factors. 

> Tendonopathies

The muscles that move your fingers and control your grip mostly reside in your forearm. Tendons attach these muscles to the bone close to the elbow joint. Problems may gradually develop in these tendons that lead to a nagging elbow pain that is worse when you try to use it.

At first, you may only notice the pain when you’re active, but over time it may progress to the stage where you find it is continually there.

In severe cases, even a task like lifting a cup can become agonizing. 

This kind of injury can often be difficult to treat, but using hands-on treatment together with the right kind of exercises may relieve – or even eliminate – the symptoms. 

> Bursitis

A bursa is a small fluid-filled sac. They often occur in places where there may be friction between two surfaces. The olecranon bursa sits on the tip of bone behind your elbow.

Most of the time this sac is flat and you don’t notice it, but it sometimes becomes inflamed and swells to a large, painful, squashy lump.

This may happen as the result of an impact, repeated minor knocks, an infection in the bursa, or for no apparent reason. 

Bursitis may improve on its own, or with R.I.C.E. and anti-inflammatory medicines. Your doctor may recommend that it is aspirated (drained), or an anti-inflammatory injection. If it is infected, you may need antibiotics. As a last resort, surgery is sometimes used.

> Wear and tear

Damage to the cartilage that lines the boney surfaces of the joints can lead to various disorders, including osteoarthritis.

At the elbow, this commonly affects the radio-humeral joint.

Although arthritis usually manifests later on in life, repetitive stress can also lead to the formation of ‘loose bodies’ which cause ‘locking’ or ‘catching’ in the joint and may need to be removed surgically. 

MULTIPLE CAUSES

In chronic elbow pain, it can sometimes be hard to pinpoint the exact cause of the pain. Often, when there are repetitive strains on the joint, pain occurs due to a number of closely related factors that all need to be addressed, rather than a single one. 

For example, one of the most common causes of elbow problems in a typical MMA gym is holding pads for fighters.

Coaches often get this type of pain from cushioning repeated impacts many times a day, sometimes for years on end. This causes chronic ligament strain on one side of the elbow joint, and wear and tear due to compression on the other side. This can set in motion a chain reaction leading to tendon problems. 

Muscle imbalances are also common amongst MMA fighters.

Excessive tightness in the shoulder joint, for example, can make it more likely that a fighter will experience chronic problems at the elbow.

Using the flexors (gripping muscles) in the forearm more than the extensors on the back of the arm is another common pattern that spells trouble. Grapplers are especially susceptible to this type of problem. 

This covers only some of the more common elbow injuries that can occur. If you’re experiencing problems, then we’d advise you to speak to a doctor, osteopath, physiotherapist or other healthcare professional for advice about your particular injury. 

If you’re not in pain, but looking for good ways to strengthen your elbow joint and prevent injury, then consider adding some negative pull-ups to your routine. Like a pull-up, but in reverse – you jump up to the bar, then slowly lower yourself down. This is a particularly good exercise for strengthening the tendons, and helps to add stability to the joint.

If you can easily handle your own body weight, then consider using a weights belt to add more resistance, or switching to single-arm negatives. 

If you have elbow trouble, or have had problems in the past, then be careful – this may not be the right exercise for you.

If you get any pain while trying the exercise, stop and consult a professional.