Sports

Golfer's Elbow is Painful

There comes a point in every winter where even a sunny day at the slopes isn't enough to keep you from imaging rolling hills of green. If you're a golfer, and you're lucky, you have may already escaped winter to enjoy a golf holiday in a warmer locale. If, like most of us, you are still weeks away from smacking around your first ball on the greens, then you're in the perfect position to do some strengthening and take some preventive steps to keep yourself free of injury when golf season gets going.

The most common injury we see in the physio clinic as driving ranges around the Okanagan open each spring is the dreaded Golfer’s Elbow. Medically known as medial epicondylitis, Golfer's Elbow is a repetitive strain injury characterized by pain around the bony part on the inside of your elbow and typically flares up in the early season. The problem afflicts not just golfers, but also gardeners clenching their trowels, and tennis players and other racket sport enthusiasts who repeatedly use their wrists or clench their fingers. Golfer's Elbow, affecting the inside of the elbow is not the same thing as Tennis Elbow, which refers to an injury on the outside of the joint, although both syndromes affect athletes in both sports--sometimes simultaneously, in opposite arms, particularly for golf.

The twisting and clenching can lead to micro-damage of the muscles and tendons that help move the wrist and fingers. If the injury is left uncared for, the pain will often spread down the forearm to the wrist, many times leaving the sufferer with a pronounced weakness on grasping objects.  Golfer’s Elbow may develop from a sudden impact or force during play, or more commonly it may appear gradually over time. Typically, the damage is the result of excessive or repeated stress on muscles and tendons that are either too weak or tight, or from a greater biomechanical problem involving decreased range of motion of the joints at the elbow and wrist.  Individuals who have suffered with Golfer’s Elbow will be the first to tell you that activities like swinging a golf club, shaking hands, or even turning a doorknob will invariably make the pain worsen almost instantaneously.

So what can you do to avoid getting Golfer's Elbow in the first place? Pre-season, you can work on strengthening your wrist flexor muscles--the ones on the inside of your forearm. Start by taking a three-to-five-pound weight and do three sets of ten "wrist curls." Rest your arm on a table with your wrist hanging off the edge, palm face up, and gently curl the weight upwards, away from the floor. Work your way up to a slightly heavier weight if needed, and increase to three sets of twenty, and always remember to stretch your forearms out between sets. This same exercise reversed (wrist face down) is good for warding off Tennis Elbow.

If you've already got some early symptoms, don't despair. Contrary to popular belief, Golfer’s Elbow is not an injury that should keep you off the course this spring, as long as it is well managed from the start.

In the initial phase of Golfer’s elbow, there are several things to keep in mind.  First off, it is important to rest the elbow by reducing any aggravating activities; continuing to play when injured will only make the condition worse. Second, ensure that you are controlling the inflammation by icing the affected area on a regular basis.  Third, to control pain and inflammation further, speak to your pharmacist or physician about taking over-the-counter anti-inflammatories: in certain circumstances these medications can greatly speed up recovery.

If the elbow is improving, gradually return to sport, making sure to warm up and stretch out the affected area before any activity.  In the event that the pain does not resolve or quickly returns on your return to activity, it would be prudent to contact your Physiotherapist for a proper diagnosis of injury and its cause, so that they can correct any biomechanical deficiencies and guide you through a series of stretching and strengthening exercises to hasten your recovery. An elbow brace may also be an option to help reduce pain during the early stages.

Depending on the severity of the condition and how long you let it go, the pain and dysfunction may last anywhere from a couple of weeks or several months. After recovering enough to resume play, gradually increase the amount of games you play per week, thereby allowing the injured area to accommodate to the increasing stress.  Always remember, sharp pain in the elbow or forearm is a sign that you are doing too much too soon.  So, too, is that horrible nagging pain that lingers for hours or days after activity: don’t delude yourself into thinking that it’s just normal muscle soreness. If not recognized early and treated appropriately, Golfer's Elbow can quickly become a chronic condition that is very difficult to get rid of, and can lead to a frustrating summer off the links.

Tyler Dyck is a Fellow of the Canadian Academy of Manual and Manipulative Physical Therapists, a certified Intramuscular Stimulation (IMS) practitioner, and a partner at Sun City Physiotherapy. He can be reached at Sun City's downtown location, 861-8056.  Sun City Physiotherapy will be hosting a free lecture on getting prepared for the golf season at the end of March at their downtown clinic; please call for details.

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