As spring ushers in summer and the warm weather continues, more rounds of golf are bound to be played. Now, unless you’ve kept up your normal volume in the simulator or have travelled to warmer weather to continue swinging, ramping back up too quickly may present some challenges. Namely, Golfer’s Elbow. Golf may be a game of finesse and precision, but its repetitive motions can sometimes lead to this common ailment. Despite its name, this condition isn't exclusive to golfers; it can affect anyone who engages in activities that involve repetitive gripping or wrist flexion. So, what exactly is golfer's elbow, and how can you manage and prevent it?
What is Golfer's Elbow?
Golfer's elbow, medically known as medial elbow tendinopathy, is a type of tendinopathy that affects the tendons on the inside of the elbow. These tendons connect the muscles of the forearm to the bony bump on the inside of the elbow. The repetitive stress placed on these tendons, often from activities like golfing, tennis, weightlifting, or even repetitive computer use, can lead to inflammation and microtears, causing pain and tenderness. Pain is typically reproduced with pinpoint pressure to this set of tendons, stretching, or loading of these tendons through activities like resisted wrist flexion, resisted pronation, or gripping.
Why Does it Occur?
The primary cause of golfer's elbow is overuse or repetitive stress on the tendons of the forearm muscles. This can result from activities that involve gripping, twisting the forearm, or flexing the wrist repeatedly. Poor technique, inadequate warm-up, overtraining, and lack of proper recovery can exacerbate the risk. Essentially, the stress applied to this area via the activity or activities you were performing exceeded the capacity these tendons had to adapt and recover from the activity. Simply put, you did too much, too soon.
Prognosis and Treatment
The prognosis for golfer's elbow varies depending on the severity of the condition and how promptly it's treated. In most cases, conservative treatments are effective in relieving symptoms and promoting healing. Your first line of defense should be load management and activity modification. What does this look like? This could mean less rounds played per week, reduction in total time spent in each session, reduction of the time spent on the range, or lowering of overall intensity while playing. Next, you should monitor your pain response after loading the area. A good rule of thumb is to maintain less than or equal to a 4/10 pain when performing activity and that pain should not increase above that level over the subsequent 24 hours. If it does, that’s ok, you haven’t done any additional damage, your body is simply telling you it can’t tolerate that amount of stress. Take note of this and do slightly less the next time. Finally, you need to begin to gradually strengthen the area that hurts to build the capacity to tolerate the activity you enjoy. Include things like wrist curls and grip strengthening exercises, but also include exercises to strengthen the muscles in and around the shoulder, like the muscles of the rotator cuff. What about injections though?? Although there isn’t as much research on medial elbow tendinopathy, it is reasonable to believe that we can compare it to lateral elbow tendinopathy where there have been more studies performed. Research is pretty consistent in showing that cortisone shots or corticosteroids may be beneficial in the short term but lead to worse outcomes in the medium and long term for that condition and so we can likely confer it would not be recommended for this condition. Finally, the use of ice, compression sleeves, or an elbow strap may help reduce the symptoms temporarily but should not be viewed as long term solutions. For this, refer back to the beginning of this paragraph.
Prevention
To manage golfer's elbow effectively and prevent its recurrence, consider these strategies:
1. Warm-up: Always warm up before engaging in activities that involve repetitive arm movements. Gentle stretching and exercises can prepare the muscles and tendons for action and then begin to lightly perform the activity you are getting ready to participate in. This may include hitting a small bucket of balls on the practice range or chipping and putting around the green.
2. Strength training: Incorporate exercises that target the muscles of the forearm and wrist into your fitness routine. Strengthening these muscles can help prevent overuse injuries. Don’t forget to also strengthen the back and shoulders, as they play a large role in managing the swing of the club.
3. Moderation: Avoid overtraining and give your body adequate rest between sessions to allow for recovery. Ensure you are taking in enough protein to help your body refuel and repair the tissue breakdown that occurs when playing a round of golf and prioritize getting 8 hours of sleep.
4. Use of equipment: When engaging in activities like golf, ensure that equipment such as clubs are properly fitted and suited to your size and strength. This plays a huge role in proper swing mechanics and may be the reason certain tissues are overloaded during a round.
By understanding the causes of golfer's elbow and implementing appropriate prevention and management strategies, you can minimize its impact on your daily life and enjoy your favorite activities pain-free. If you take these measures and are still having trouble staying on the course and managing your symptoms, come in and let us help you get out of pain and back to striping that ball down the fairway.
References:
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