Golfers Elbow

Introduction

Golfer's elbow is a condition that causes pain where the tendons of your forearm muscles attach to the bony bump on the inside of your elbow. The pain might spread into your forearm and wrist. Golfer's elbow is similar to tennis elbow, which occurs on the outside of the elbow. It's not limited to golfers. Tennis players and others who repeatedly use their wrists or clench their fingers also can develop golfer's elbow.

Causes

Golfer's elbow, also known as medial epicondylitis, is caused by damage to the muscles and tendons that control your wrist and fingers. The damage is typically related to excess or repeated stress, especially forceful wrist and finger motions. Improper lifting, throwing or hitting, as well as too little warm up or poor conditioning, also can contribute to golfer's elbow.

Besides golf, many activities and occupations can lead to golfer's elbow, including:

ü Racket sports. Improper technique with tennis strokes, especially the backhand, can cause injury to the tendon. Excessive use of topspin and using a racket that's too small or heavy also can lead to injury.

ü Throwing sports. Improper pitching technique in baseball or softball can be another culprit. Football, archery and javelin throwing also can cause golfer's elbow.

ü Weight training. Lifting weights using improper technique, such as curling the wrists during a biceps exercise, can overload the elbow muscles and tendons.

ü Forceful, repetitive occupational movements. These occur in fields such as construction, plumbing and carpentry

Risk Factors

You could be at higher risk of developing golfer's elbow if you're:

ü Age 40 or older

ü Performing repetitive activity at least two hours a day

ü Obese

ü A smoker

Sign & Symptoms

ü Pain and tenderness, plus occasional swelling on the bone and muscles on the inside of the elbow.

ü Pain that is made worse by gripping and repetitive wrist movements

ü Aching pain in your forearm or wrist

ü Tightness in the forearm muscles.

ü Pain when you try to make a fist.

ü Difficulty performing common daily tasks like turning a door knob, opening a jar, chopping vegetables, or wringing out a dish cloth.

ü Reduced grip strength.

ü Tingling or numbness in your hand – usually the ring and/or little finger.

Diagnosis

They will carry out a comprehensive, subjective and clinical assessment to obtain an accurate diagnosis.

The clinical examination may include:

ü Assessing range of movement of the hand, wrist and elbow.

ü Looking for redness or swelling around the elbow

ü Gently feeling around the elbow joint and along the forearm muscles to pinpoint the location of your pain.

ü Assessing your grip strength.

ü Measuring muscle length and flexibility

ü Looking more globally at other areas that might also be affected or contributing to your symptoms, such as your neck, back and shoulder.

Imaging test may include:

* X-ray: may be requested to exclude other causes of elbow pain like bony abnormalities, osteoarthritis or fractures, but it has little diagnostic benefit if golfer’s elbow is suspected.

* Ultrasound scan: is the easiest and most sensitive way to identify any tendon degeneration, tears or inflammation. An ultrasound scan is reserved for patients if; we are unsure of a diagnosis, are suspicious of a large tear and/or those who still experience pain despite treatment.

Treatment

There is unlikely to be one single cure for Golfer’s elbow. People will respond differently to various types of treatment, so it is important to apply as many different approaches as possible.

* Rest

Rest from activities that cause pain. If you continue to use your wrist then your injury could become chronic. Therefore it will be much more difficult to treat.

This may mean simply adapting your training to avoid overstressing the elbow. Or for more serious injuries, a period of complete rest might be required. In particular, avoid gripping anything tightly or opening heavy doors.

* Ice/cold therapy

Apply a cold therapy and compression wrap for 10 to 15 minutes every hour. After the first few hours, this can be reduced to 3 to 4 times a day as required.

* Elbow brace/support

Wear a brace or elbow support. This will provide protection and help prevent further injury.

* Heat

After the initial acute phase (which may take anywhere from 2 days and 2 weeks), apply heat and wear a heat retainer or elbow support.

* Medication

A doctor may prescribe NSAIDs (Non-Steroidal Anti-inflammatory Drugs) which can help reduce pain and inflammation, especially in the early stages.

* Electrotherapy

A physiotherapist or similar may use electrotherapy, such as ultrasound or laser treatment to help reduce pain and inflammation.

* Massage

Sports massage can help with Golfer’s elbow rehabilitation, but only after the acute stage, and for stubborn injuries that fail to heal. Cross-friction massage applied to the tendon can help stimulate healing.

Also, massage to the muscles of the forearm can help reduce tension and improve their function. Long-term, this should help reduce the strain on your tendon at the elbow. Apply cold therapy after a massage treatment.

* Injections

A steroid injection may be considered if more conservative treatment is not effective. It may heal quickly within two weeks.

* Exercises

Stretching is an important part of the rehabilitation process and should begin as soon as pain allows and be continued throughout the rehabilitation program and beyond.

As it is an overuse injury, overdoing the strengthening exercises too soon could slow or prevent the healing process.

* Golfer’s elbow surgery

The surgical treatment of golfer’s elbow consists of recessing and releasing the portion of the injured tendon.

The frayed part of the tendon is removed (released) from the bone. There are more modern techniques used to perform the operation using endoscopic or arthroscopic techniques.

Prevention

ü Strengthen your forearm muscles

ü Stretch before your activity

ü Fix your form

ü Lift properly

Reference:

https://complete-physio.co.uk/golfers-elbow-also-known-medial-epicondylitis/

https://www.sportsinjuryclinic.net/sport-injuries/elbow-pain/medial-elbow-pain/golfers-elbow

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