Kiters Elbow

Kiters Elbow??? With every new sport comes new demands on our body and kiteboarding is no exception. I am a Physical Therapist and kiteboarder as well and I have observed on many occasions kiters complaining of elbow aches and pains after kiting sessions. I have also been approached by a few kiters who knew I was a PT and consulted me with their elbow concerns. All the kiters I have seen that had elbow pain had identical signs and symptoms.

So, what is Kiters Elbow. Kiters elbow is very similar to Tennis elbow or what we in the Orthopedic line of work call “ Lateral Epicondylitis “. Kiters elbow, though very similar to Tennis Elbow has a different mechanism of injury, which leads to the same pathology as Tennis elbow.

Lateral Epicondylitis is the result of repetitive micro trauma to the wrist extensor muscles especially where they originate from which is on the outer side of the elbow.

These are the muscles that extend your wrist: example: The action involved when twisting the grip to accelerate a motorbike.

In my opinion the trauma involved in the kiting version of tennis elbow is different to the classic Tennis elbow due to the nature of our sport but in the end presenting with the same symptoms.

It seems to be caused when we steer the bar aggressively while having our elbow tucked into out chest or rib cage, such as when sheeting the kite and diving it hard at the same time or when going into a forward spin while sheeting the kite for that extra pop. An additional factor is having the wrist flexed laterally or cocked towards the little finger.


So, now that we know these, what do we have to do?

First is avoidance, try not flying on underpowered conditions and identifying those moves that may trigger the extra strain on the elbow. When you start to feel pain then it means that the condition is fairly advanced so avoidance even when we are pain free is paramount. How do we avoid or protect ourselves: Correct riding position: back straight, avoid the pooh position, relaxed shoulders, relaxed handgrip, avoid bars that are bent downwards. All these will have the cumulative effect of relaxing the forearm muscles and reducing trauma to the elbow.

Second is to train or exercise the area related to kiting. Lets call this “prehab”. Kiting mainly involves resisting a pulling force. So exercises that involve pulling: seated rows, dumbbell rows, lateral pull downs, core training , will help tune your body to kiting. At the elbow, biceps curls with the hand facing palm down will work the right area but be careful not to overwork the area and cause the strain we are trying to avoid or if you already have the elbow symptoms this is an exercise that has to be avoided until healed. Weighted roll ups of a line around a PVC pipe will train the wrist extensors muscle as well.

What if you have the signs and symptoms of Kiters Elbow. If you are symptomatic this means that the condition is in it's chronic stages and rehab will be in order. Pls. consult a Physical Therapist.

Kiters Elbow “Lateral Epicondylitis” rehabilitation is treated specific to the persons condition but there are some general guidelines we can follow.

  • Stop doing what causes the pain. I don't mean to stop kiting but to avoid the wrist postures discussed earlier.
  • Stretching of the extensor muscle: flex the wrist down (palm down) with the other hand while the elbow is straight and hold for about 1 minute x 3 sets.
  • Cross Friction massage. Massaging across the fibers, in this case use your thumb to massage across the elbow.
  • Use of Tennis Elbow brace, this is an over the counter support placed around the elbow with an air cell / cushion that is placed approximately ½ inch below the painful area which will allow the muscle to rest and generate force from the support and not the extensor muscle origin…a little too technical there…trust me, it works.
  • Icing immediately after your kiting sessions and moist heat during your off session days.

If not healing with above techniques, Cortisone may be injected; Cortisone is a powerful painkiller and anti-inflammatory medicine. Often used as a treatment, I prefer it as a last resort before surgery or administered to someone who will follow through with avoidance of the sport for a few weeks. Often, a cortisone shot can feel like a miracle treatment but be weary as this may only be short term. The downside is Cortisone weakens the connective tissue and makes the area prone to further injury. Especially after feeling the painkilling effects the person may return prematurely to kiting and make the pain even worse the second time around. Often people will get bouts of cortisone shots severely weakening the connective tissue and making surgery, which is the last resort almost impossible secondary to a poor surgical healing prognosis. An alternative to injected cortisone is a treatment administered by PT's called Phonophoresis or Iontophoresis, this is ultrasound or electricity respectively used instead of injections to administer Cortisone but is much more conservative in it's delivery to the affected area, Pls. consult your Physical Therapist.

In summary:

  • Correct biomechanics
  • Choose right kite size and avoid bent bars and thick diameter bars.
  • Prehab: exercises specific to our sport

Gerard Alleje PT

Gerard is a practicing PT for the past 12 years and has been kiting since 2000

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