If you are experiencing pain in your elbows and wrists, you may have an injury known as Golfer’s elbow. In this blog, Physiotherapist Luke from our Burnside practice explains Golfer’s elbow, how someone might get it, the symptoms, and how it can be treated by your Physiotherapist.
What is Golfer’s Elbow?
Medial epicondylitis (pitchers elbow, suitcase elbow or golfer’s elbow) is a condition in which muscles attaching to the medial epicondyle of your elbow can become irritated and cause pain. These muscles located on the inside of the forearm help to flex the wrist and when put under repetitive use or strain can cause tendinitis. The medial epicondyle is located on the inside of your elbow and some may recognize this area as your ‘funny bone’, although your funny bone (ulnar nerve) is simply situated between the tip of your elbow and medial epicondyle. This is similar to tennis elbow, which occurs on the outside of the elbow.
How does someone get it?
Only 1% of the population is diagnosed with golfer’s elbow, and it doesn’t just affect golfers as the name would suggest. Women and men are equally as likely to suffer from golfer’s elbow and those aged between 40 and 60 are most susceptible. Golfer’s elbow often occurs when forearm muscles are not used for a long period of time then used excessively over a short period of time. Golfers’ elbows can also occur from sustained overuse over a number of days or weeks. Jobs or activities that may result in golfer’s elbow include:
Weightlifting, Golf, Tennis, Cooking, Painting, Computer work, Mechanic & Throwing movements (baseball, javelin, shotput, discus)
Non-specific actions that may increase symptoms of golfer’s elbow include:
• Completing an activity for an extended period of time without change in wrist position
• Playing your sport or completing an activity with your wrist much longer than normal
• Rackets or equipment that is too heavy for your forearm to tolerate for long periods of time
• Rackets or equipment that is either too small or large for you – this may affect wrist positioning and cause overuse of your forearm flexors
What does it feel like?
Symptoms of golfer’s elbow can develop slowly or suddenly due to an injury. Recovery time for a golfer’s elbow is between 6-8 weeks and symptoms may be present throughout this period, although they gradually reduce. The recovery time may extend longer due to other variables such as work, sport or quality of rehabilitation. Because of this, the sooner treatment begins, sooner symptoms reduce and resolve. Signs and symptoms of golfer’s elbow include:
• Pain or tenderness on the inside of the elbow which may extend to the palm of your wrist
• Stiffness or pain with elbow and wrist movements
• Weakness or pain with gripping
• Numbness or tingling on the inside of the forearm or ring/little fingers.
How do I know if I have it?
Diagnosis of golfer’s elbow can be made by a physiotherapist based on your symptoms and findings through a physical assessment. Additional investigations such as an MRI or x-ray may also provide diagnosis of golfers elbow but may also rule out similar presenting conditions such as arthritis, elbow ligament injury, nerve compression or referred pain.
What can I do about it?
Rest / modifications
First, restrict or reduce the activities which are causing your symptoms. Unloading the affected forearm flexor muscles is important to start the process of recovery. This can be difficulty in some areas such as work or sport, where often completely cutting out the task is unreasonable or not an option. Simple adjustments of movements can completely stop tennis elbow related pain from occurring, such as using the other hand, changing exercise regime or altering strain placed on the affected muscles. Ice packs can be used if pain has flared up or straight after you first feel pain. This provided pain relief and reduction of inflammation usually within 1-2 days of the first signs of pain.
Massage / Dry needling
Another option to reduce your pain can be achieved through massage or trigger point dry needling. Either or both of these techniques focused on your forearm flexor muscles and tendons can provide symptom relief. Rocktaping or kinesio taping acts to facilitate and improve your body’s healing process while providing support to surrounding muscles and joints.
Exercise
Specific strength training and stretching of the affected muscles of golfer’s elbow will reduce symptoms when begun at the appropriate time. Once pain has diminished, this is a good time to begin exercises at the discretion of your physiotherapy to reduce your pain, while increasing your capabilities again with wrist/forearm.
Bracing / support
Appropriate bracing or taping may help reduce stress on painful areas and provide relief of pain. Common bracing options include elbow traps or braces, as well as compression garments. Similarly, taping techniques can reduce pain and increase function if required.
Of all treatment techniques and options, physiotherapy is one of the most effective. Other less common treatment options include steroid injections, medications, shockwave therapy and in some cases surgery.
I think this might be something I have, what should I do?
See a physiotherapist, the sooner the better! The earlier treatment can begin, the quicker symptoms can reduce and you can get back to doing what you love without pain!
This blog was written by Luke Mrowka (Physiotherapist), from our Burnside Physio practice.
References
Walden, E 2021, WedMD. Available at https://www.webmd.com/fitness-exercise/golfers-elbow-basics
Kiel, J, Kaiser, K 2021, Golfers Elbow. Available at https://www.ncbi.nlm.nih.gov/books/NBK519000/
Informed Health.org 2018, Golfers Elbow: Overview. Available at https://www.ncbi.nlm.nih.gov/books/NBK507002/#:~:text=Less%20than%201%25%20of%20the,equally%20likely%20to%20get%20it