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Golfer's Elbow
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The term “golfer’s
elbow” is a lay-term for a condition whose medical name is medial
epicondylitis of the elbow. Although often found in golfers, it can occur in
individuals who never play golf. It is usually an overuse injury to the
tendons on the inside aspect of the elbow. These are the same tendons that
allow one to actively bend the wrist forward. If you lay your forearm on a
counter with the palm facing up and then lift the clenched fist off the
counter, you are using the muscles that we are talking about. These muscles
originate as tendons off of a small area on the inside aspect of the elbow.
If you extend your arm in front of you so that the palm is facing up to the
ceiling, this is the part of the elbow on the same side as your little
finger. In golfer's elbow this inside aspect of the elbow is the area of maximum pain. The
pain can sometimes radiate down the forearm a little bit. There is usually no
numbness or tingling involved with this condition. |
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What causes golfer’s
elbow? The start of golfer’s elbow is thought to be an injury that causes a
small tear in the origin of these muscles. Sometimes this is a one-time
injury. More commonly, however, it is a repetitive overuse injury. Once the
injury occurs, instead of normal healing response, the body sometimes creates
an ongoing process in which the tissue is not repaired but actually partially
degenerates. This is why this problem can be so persistent. |
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Most of the time, this
can be treated without surgical intervention. However, it can take up to two
years in order for this to occur. In order to treat this successfully, we
need to avoid the offending activity. If you are a golfer, you may need to
modify your grip and/or correct abnormal mechanics in order to take the stress
off the injured area. Some players might even need to restrict playing for a
time, and then slowly return to those activities which do not cause them
discomfort. Also, the way we grasp or lift things may need to be modified in
order to decrease discomfort in this area. |
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Unlike lateral
epicondylitis (tennis elbow), bracing is not typically used to decrease stress
on the injured area. The reason for this is that medial epicondylitis occurs
next to an important nerve (the ulnar nerve). Trying to take stress off the
injured tendons by applying a brace here risks compressing this nerve. |
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The mainstay of
treatment for golfer’s elbow consists of an exercise program. The exercises
are designed to stretch and strengthen the injured area in order to stimulate
a correct healing response. These exercises are done with high repetitions of
about 20-25 per set and about 3-5 sets per workout. These should be done
daily, and one should use very light weight. The average individual should
use no more than 2 to 3 lbs. A very strong individual should use no more than
5 to 10 lbs. |
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Also unlike tennis
elbow, injection of corticosteroids into the inflamed area is usually not
undertaken. Again, the nearby ulnar nerve makes injections into this
area of the elbow risky.
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Very rarely,
conservative treatment fails and painful golfer’s elbow persists causing
discomfort and limited function. In these cases, surgical procedures can
be performed. However,
it can take many months to recover from this surgical intervention. During
this time, activities performed with that arm are restricted. |
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Exercises for golfer's elbow and tennis elbow: |
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