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Rugby 101

Injury and recovery

Anterior Elbow Impingement

Front-of-elbow pain on full extension common in tacklers and ball carriers

2 min readIntermediate

Anterior elbow impingement is pain at the front of the elbow when the arm fully straightens — common in players who fend, fall on outstretched arms, or repeatedly absorb force through a locked-out elbow. It usually involves the joint capsule or fat pad rather than the bone itself, and most cases settle with a conservative pathway guided by a physio.

What it feels like

Most players describe a sharp, pinching pain at the front of the elbow whenever they try to straighten the arm fully — pushing off the ground, fending a defender, or reaching out to make a tackle. The elbow often feels like it 'stops short' before reaching the same position as the other side, and the area can feel tender to press just above the elbow crease.

How it usually starts

  • A gradual onset of front-of-elbow pain over a few weeks rather than a single incident
  • Or a specific moment — falling on an outstretched arm — followed by ongoing end-range pain
  • Pain that is reproducible whenever the arm fully straightens
  • Loss of the last few degrees of elbow extension compared to the other side
  • Often no pain with simple bending or carrying objects

Telling it apart from other elbow problems

Rugby players get pain on the inside of the elbow (golfer's elbow / medial epicondylopathy), the outside (tennis elbow / lateral epicondylopathy), or under the nerves at the back. Anterior impingement is different — the pain is right at the front, on the crease, and is most obvious at end-range extension rather than gripping or twisting.

Where it hurtsWhen it hurtsWhat it usually is
Front of elbow on the creaseFully straightening, pushing off, fendingAnterior elbow impingement
Inside of elbowGripping, throwing, lifting palm-downMedial epicondylopathy
Outside of elbowGripping, wrist extensionLateral epicondylopathy
Back of elbow, into ring/little fingerLeaning on bent elbow, repeated flexionUlnar nerve irritation

What clinic assessment looks like

  • Comparing how far the elbow extends on each side
  • Pressing the front of the elbow to find tender soft tissue
  • Loading the elbow in end-range extension to reproduce the pain
  • Screening the shoulder and wrist to rule out referred patterns
  • Imaging (ultrasound or MRI) where symptoms persist or block extension significantly

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