© Roland Jeffery Physiotherapy 2011 Ph (09) 444-7643 Website www.rjphysio.co.nz

Golfer’s Elbow. What is golfer’s elbow? Golfer’s elbow, or medial epicondylitis, is similar to tennis elbow. The main differences between golfers and tennis elbow are the location of the pain and the activity that leads to the injury (See Figure 1 & 1A). Both conditions are predominately caused by overuse of the muscles and tendons of the forearm, leading to inflammation and pain around the elbow joint.

Golfer’s elbow was often thought to be a form of tendonitis. Tendons attach muscles to bone (See Figure 2). Because of the forces exerted through muscles, often the tendons often become “over worked” and inflamed when a particular activity is repetitive. This is usually at the bony prominence where the tendon attaches to the bone. However, it is now thought that golfer’s elbow is not simply an inflammation of the

tendons around the elbow. Rather, the problem is thought to be more of a degenerative process, either the result of injury, or through repetitive or overuse. The symptoms may be the result of an incomplete healing response in an area that does not have good blood flow and therefore has difficulty accessing the nutrition and oxygen necessary for healing. This leads to degeneration of the tendon causing small tears and ruptures.

Figure 1: Location of Medial Epicondylitis. Figure 1A: Medial Epicondylitis.

Figure 2: Elbow Tendons.

© Roland Jeffery Physiotherapy 2011 Ph (09) 444-7643 Website www.rjphysio.co.nz

The medical name for golfer’s elbow (medial epicondylitis) comes from the name of the bony prominence where the tendon inserts (medial epicondyle) and where the inflammation causes the pain (See Figure 1A). The pain is usually at the elbow joint on the inside of the arm and occasionally a shooting sensation down the forearm may be felt while gripping objects.

What causes golfer’s elbow? The cause of golfer’s elbow can vary from a traumatic event (such as a fall or collision when playing football) to more commonly, a repetitive stress injury where an action is performed repeatedly and pain gradually develops. Golfer’s elbow is most common at the beginning of the golf season, or when a repetitive activity is increased in intensity or duration. Golf is one of the common causes of these symptoms, but many other throwing sports and work-related activities can cause the same problem. Often, tight muscles or joints, as well as poor technique, can contribute to golfer’s elbow. Do football players get golfers elbow? Golfer’s elbow is not a common condition in football. Football players are more likely to develop golfer’s elbow when playing other sports such as golf or while working! What are the symptoms of golfers elbow? The pain associated with golfers elbow usually has a gradual onset, but may also come on suddenly, for example in a fall while playing football. The player will notice pain on the bone (medial epicondyle) on the inside of the elbow (See Figure 1A), and weakness in the wrist. The player will also have pain on the inside of the elbow when the wrist is bent forwards and pain on the inside of the elbow when trying to bend the fingers against resistance. If the player pushes on the inside of their elbow they will feel a sharp pain on the bony part of the elbow. Players with the golfer’s elbow will also experience pain on the inside of the elbow that is worsened by grasping, turning, carrying and gripping objects (See Figure 4). What can the player do? The player can ice the injury and rest from any activity that causes pain. Rest is a very important component in the healing of this injury. Stretching the wrist can also help lengthen any stiff or tight muscles (See Figure 5). Golfer’s elbow may heal quickly but often a player could suffer with this problem for a long time. When the symptoms have settled down, it is essential that the elbow is fully rehabilitated and strengthened to help avoid the injury in the future. Seeing a physiotherapist or sports doctor is important.

Figure 4: Cause Golfers Elbow.

© Roland Jeffery Physiotherapy 2011 Ph (09) 444-7643 Website www.rjphysio.co.nz

What can a sports injury professional do? A sports doctor or physiotherapist will examine the elbow and design the best management plan. Initially, a sports doctor may prescribe anti-inflammatory medication. A physiotherapist may apply ultrasound, use massage therapy or acupuncture and give advice on rehabilitation. This may include stretches, strengthening exercises and help with modification of technique – either at work or in sport. Sometimes a sports professional will advise the wearing of a brace or support to protect the tendon whilst healing and strengthening (See Figure 6). Strengthening exercises, such as eccentric exercises will almost always be given. If the symptoms do not heal, a sports doctor may inject the tendon with steroid or the own players blood to help with the pain and inflammation, and help speed up the healinh process.

Figure 5: Stretch. Figure 6: Sports Brace.