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Golfer’s Elbow – When your golf game hurts you!

WHAT IS IT?

Now that it’s summer, many people are deep into their favourite sports and recreational activities. A common result of recreational sports is repetitive strain or injury due to overuse. Two of the most common injuries that occur are tennis elbow and golfer’s elbow. Even if you don’t play tennis or golf, these injuries can easily happen to you over time.

Tennis elbow and golfer’s elbow are similar injuries in that they both involve forearm muscles. However the difference is simply where the muscles connect to the joint. More commonly known is Tennis elbow, or 'lateral epicondylitis', which affects the outside of the elbow. Almost as common, however perhaps less often talked about is Golfer's elbow or 'medial epicondylitis' which affects the inside of the elbow.

Both conditions involve inflammation due to damage to forearm muscles and to the tendons that connect at the elbow.

SYMPTOMS

Golfer's elbow can be identified by the following symptoms:

  • PAIN AND TENDERNESS: Usually felt on the inside (medial aspect) of the elbow. Pain may radiate along the inside of the forearm, and typically worsens with particular movements.
  • STIFFNESS: Your elbow may feel stiff. Making a fist may be painful.
  • WEAKNESS: You may feel weakness in your hands and wrists.
  • NUMBNESS/TINGLING: A numb or tingling sensation may radiate into one or more fingers - often the ring and little fingers.

CAUSES

Golfer's elbow 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 (see my other blog about Cumulative Microtrauma) especially forceful wrist and finger motions. Other activities that can contribute or cause golfer's elbow are: improper lifting, throwing or hitting, insufficient warmup, and poor conditioning.

TREATMENT

So what can you do about it?

  • WRIST STRETCHES: Hold your injured arm out in front of you, palm up. Using your other hand, gently pull your hand and fingers back towards your body until you feel a gentle stretch. Hold for 30 seconds, then relax. 
  • WRIST EXTENSIONS: One of the common range of motion exercises for tennis elbow is wrist extension. Begin with your elbow at a 90-degree angle, palm facing down, resting on a table’s surface. Gently extend your wrist to lift it off the table (this should not be painful). Repeat ten times. As you progress you can add weight, like holding a water bottle, to add resistance and incorporate strengthening into the exercise.
  • WRIST FLEXION: This exercise is similar to the wrist exercise above, but the palm is in the other direction. For the wrist flexion exercise, begin with your elbow at a 90-degree angle, palm facing up, resting on a table’s surface. Gently extend your wrist to lift it off the table towards the ceiling (this should not be painful). Repeat ten times. You can also add weight resistance to add strength training to the exercise.
  • GRIP STRENGTHENING: For this exercise, you will need a squishy ball or “stress ball.” Hold the ball in your hand and gently squeeze. Hold for five seconds, relax, and repeat ten times. This exercise is helpful for both tennis elbow and golfer’s elbow.
  • STRENGTH EXERCISE: A common wrist strengthening exercise you can do is (informally) known as the “hammer exercise.” You will need a hammer to use for resistance. You can use a long stick if you need to start off a bit lighter. Resting your forearm on a flat table, hold the handle of the hammer, and keep your elbow at 90 degrees. Slowly turn your hand palm-down, rotating the hammer towards the centre of your body. Next, slowly reverse the motion, rotating the hammer outwards so that your palm faces up. Rest briefly and repeat ten times.

PREVENTION

  • STRENGTHEN YOUR FOREARM MUSCLES: See the strengthening exercises above or other simple forearm exercises to improve the load capacity of your wrist and elbows.
  • STRETCH BEFORE YOUR ACTIVITY: Walk, jog, or do some jumping jacks for a few minutes to warm up your muscles. There are many mild calisthenic exercises that will do the trick. Then do some gentle warm-up stretches before you begin your game.
  • IMPROVE YOUR FORM: Whatever your sport, work with an instructor or coach to check your form. This can help prevent an overload on your muscles.
  • USE THE RIGHT EQUIPMENT: If you're using older golfing irons, consider upgrading to lighter graphite clubs. If you play tennis, make sure your racket fits you. A racket with a small grip or a heavy head may increase the risk of elbow problems.

REFERENCES

Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/golfers-elbow/symptoms-causes/syc-20372868

WebMD: https://www.webmd.com/fitness-exercise/golfers-elbow-basics

OCA website (chiropractic.ca): https://www.chiropractic.ca/blog/6-ways-to-manage-tennis-elbow-and-golfers-elbow/

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