Guest post by Dr Kickass, Mike Piekarski, a Doctor of Physical Therapy, Former MMA Fighter, Brazilian Jiu Jitsu black belt. Follow him on instagram.

Ever having a nagging elbow pain that refused to go away? Epicondylitis is a condition that involves overuse of the forearm muscles that occurs from excessive repetitive activities. Overuse leads to inflammation of the tendons because the activity load surpassed the structure tolerance.
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The first step in all grappling is making your connection or establish your GRIP on your opponent. In martial arts like jiu jitsu and judo the heavy emphasis on grip fighting often is the culprit.
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How do you prevent or rehab this injury? Activity modification (reducing these excessive repetitive activities) and strengthen (global forearm muscles).

Here are some suggestions:
1) Stop relying on clothing grips: Many people have games highly reliant on strong grips (throws, passing, pins and/or chokes). This is a good time to develop or practice no-gi variations to give your forearm muscles a break. Many grips for judo throws can be substituted for underhooks and overhooks.

2) Tap sooner to armbars: These same forearm muscles also act as dynamic stabilizers to resist elbow hyperextension and elbow valgus forces. These tendons and muscles may have micro tears from too many overstretched elbows.

3) Pay attention to other activities that involve heavy grips. This often includes heavy resistance training, however it could be a task for your job. Repetitive job stress + repetitive gripping stress may be what overloads the tissue.

4) Once you have modified the activity to reduce irritation you can perform high volume low load forearm strengthening.
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Extreme gripping, plus heavy strengthening and tapping late to elbow attacks is a recipe for developing epicondylitis.
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Disclaimer: Not all forearm pain is epicondylitis! A good healthcare professional will rule out all other potential diagnoses, such as radiculopathy, peripheral nerve entrapment or referred pain from another area.

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