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Golfers' Elbow, Elbow Tendonitis, and Elbow Pain

Brad Walker provides a guide to the treatment and prevention of a golfer's elbow.

Several conditions affect the elbow area. The three most common conditions are "lateral epicondylitis" (tennis elbow), "medial epicondylitis" (golfers' elbow), and medial collateral ligament sprain (throwers elbow).

The first two conditions are very similar. However, the first affects the outside of the elbow (lateral), and the second affects the inside of the elbow (medial). For this newsletter. We will stick with the treatment of medial epicondylitis for this newsletter, or as it is more commonly known, golfers' elbow.

What is a Golfers Elbow?

Before we can understand just what a golfer's elbow is, it is crucial to understand the elbow joint's structure and how the muscles, tendons, ligaments, and bones help the elbow joint function.

As you can see from the diagram to the right, many muscles and tendons make up the elbow joint and forearm.

The diagram shows the anterior (or front) view of the forearm.

The left picture shows the muscles and tendons closest to the skin's surface, while the picture on the right shows some of the muscles and tendons deeper within the forearm.

Three bones make up the elbow joint.

They are the "Humerus," the "Ulna" and the "Radius."

Now that we can see how the elbow functions, let us look at what a golfer's elbow is.

Elbow Muscle Group picture used from 'Principles of Anatomy and Physiology' - Sixth Edition. By G.J. Tortora and N.P. Anagnostakos. Published by Harper & Row - 1990

Golfers elbow occurs when there is damage to the muscles, tendons, and ligaments around the elbow joint and forearm. Small tears, called micro tears, form in the tendons and muscles which control the movement of the forearm. They cause a restriction of movement, inflammation, and pain. These micro-tears eventually lead to the formation of scar tissue and calcium deposits. If untreated, this scar tissue and calcium deposits can pressure the muscles and nerves to cut off the blood flow and pinch the nerves responsible for controlling the muscles in the forearm.

Causes

The most common cause of golfers' elbow is overuse. Any action that places a repetitive and prolonged strain on the forearm muscles, coupled with inadequate rest, will strain and overwork those muscles.

There are also many other causes, like a direct injury, such as a bump or fall onto the elbow. Poor technique will contribute to the condition, such as using ill-fitted equipment, like golf clubs, tennis racquets, work tools, etc. In contrast, inadequate levels of general fitness and conditioning will also contribute.

Symptoms

Pain is the most common and obvious symptom associated with a golfer's elbow. Pain is most often experienced inside the upper forearm but can also be experienced anywhere from the elbow joint to the wrist.

Weakness, stiffness, and a general restriction of movement are also quite common in golfers' elbow sufferers. Even tingling and numbness can be experienced.

Prevention

Several preventative techniques will help prevent golfers' elbow, including bracing and strapping, modifying equipment, taking extended rests, and even learning new routines for repetitive activities. However, I feel three preventative measures are far more critical and useful than any of these.

Firstly, a thorough and correct warm-up will help to prepare the muscles and tendons for any activity to come. Without a proper warm-up, the muscles and tendons will be tight and stiff. There will be limited blood flow to the forearm area, which will result in a lack of oxygen and nutrients for the muscles. This is a sure-fire recipe for a muscle or tendon injury.

Before any activity thoroughly warm up all the muscles and tendons used during your sport or activity.

Secondly, flexible muscles and tendons are essential in the prevention of most strain or sprain injuries. When muscles and tendons are flexible and supple, they can move and perform without being overstretched. If however, your muscles and tendons are tight and stiff, it is easy for those muscles and tendons to be pushed beyond their natural range of movement. When this happens, strains, sprains, and pulled muscles occur.

To keep your muscles and tendons flexible and supple, it is important to undertake a structured stretching routine. For a comprehensive reference of over 100 clear photographs of every sports-related stretch, consider getting a copy of my book - The Stretching Handbook.

And thirdly, strengthening and conditioning the forearm and wrist muscles will also help prevent golfers' elbow. There are several specific strengthening exercises you can do for these muscles, but instead of going into the details here, I have found another website that has already done all the hard work.

The website, www.physsportsmed.com/issues/may_96/nirscpa.htm, explains several exercises you can do, both with, and without weights, and includes diagrams and comprehensive explanations of each exercise. Although the site is specifically about tennis elbow, the exercises also relate very well to golfers' elbow.

Treatment!

Golfers elbow is a soft tissue injury of the muscles and tendons around the elbow joint, and therefore should be treated like any other soft tissue injury. Immediately following an injury, or at the onset of pain, the R.I.C.E.R. regime should be employed. This involves Rest, Ice, Compression, Elevation, and Referral to an appropriate professional for an accurate diagnosis.

The R.I.C.E.R. regime must be implemented for at least the first 48 to 72 hours. Doing this will give you the best possible chance of a full recovery.

The next phase of treatment (after the first 48 to 72 hours) involves several physiotherapy techniques. The application of heat and massage is one of the most effective treatments for removing scar tissue and speeding up the muscles and tendons' healing process.

Once most of the pain has been reduced, it is time to move on to your treatment's rehabilitation phase. This phase aims to regain the strength, power, endurance, and flexibility of the muscle and tendons that have been injured.


Article Reference

This article first appeared in:

  • WALKER, B. (2007) Golfers Elbow, Elbow Tendonitis, and Elbow Pain. Brian Mackenzie's Successful Coaching, (ISSN 1745-7513/ 44/ July-August), p. 3-4

Page Reference

If you quote information from this page in your work, then the reference for this page is:

  • WALKER, B. (2007) Golfers Elbow, Elbow Tendonitis and Elbow Pain [WWW] Available from: https://www.brianmac.co.uk/articles/scni44a2.htm [Accessed

About the Author

Brad Walker is a prominent Australian sports trainer with more than 15 years of experience in the health and fitness industry. Brad is a Health Science graduate of the University of New England and has postgraduate accreditations in athletics, swimming, and triathlon coaching. He also works with elite level and world champion athletes and lectures for Sports Medicine Australia on injury prevention.