Chronic elbow problems among shoers can be difficult to diagnose and treat and even harder to resolve. Many of us have experienced a sore elbow from hammering too much in a construction project. We rest the arm, the elbow pain resolves and we never think of it again. 

It’s the chronic cases that demand our attention. Chronic elbow pain requires a thorough understanding of anatomy and biomechanics and an evaluation of the person’s work environment, hobbies and habits. It’s like playing Sherlock Holmes, and I take great delight in figuring out the causes of these chronic cases. 

Elbow Anatomy

Since you probably know more about a horse’s limb anatomy than your own, here’s a quick lesson. Your elbow is not a single joint, but a complex joint made up of the humeroulnar, humeroradial and proximal radioulnar articulations (Figure 1). Chronic elbow problems demand a comprehensive examination, starting at the neck and finishing at the wrist. 

Poorly defined elbow pain usually comes from the neck but can also come from the wrist. Orthopedic and range of motion tests help find the exact motion that causes the pain and site of injury. For example, passive movement (the doctor moving the joint) helps evaluate possible joint damage. Movement against resistance helps evaluate muscular involvement. 

Muscle involvement is a major factor with chronic elbow problems. I isolate and test with applied kinesiology techniques all the muscles of the neck, elbow and wrist for proper function, which tells me what muscles to rehabilitate. 

Poor biomechanics…