Non-golfer with golfer’s elbow

Golfer’s elbow refers to a painful condition of the inner side of the elbow. Cause of the pain is usually overuse of the forearm muscles attached to the elbow. These muscles work to bend the wrist and rotate the forearm. Despite the name, it also afflicts non-golfers.

Source: Chris Scheel Golf Fitness
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Any repetitive wrist flexion activity (bending towards the palm side your hand) can lead to the development of Golfer’s elbow; activities such as golf, tennis, badminton, or games that involve repetitive throwing such as cricket and netball.

Symptoms

The main symptom for Golfer’s elbow is pain at the inside of the elbow. In addition,

The pain is felt either on or around the bony part, and sometimes spreads down the forearm.
The pain is usually worse with wrist bending or grasping/lifting activities. Sometimes fully straightening the elbow is difficult because of pain.
There may be tingling sensation, or numbness on the inside of the forearm and the last 2 fingers, and is usually worse with or after activities.
Over time, grip strength weakens.

Treatment

The management of Golfer’s elbow starts with pain control, followed by soft tissue therapy, and conditioning of the affected muscles and followed by the correction of technical faults.

Pain control & soft tissue therapy

This is the first stage. Before we proceed with the other stages of treatment, the pain needs to be under control. Initial pain and inflammation control is usually achieved by rest, icing, and use of anti-inflammatory medication (see RICER). This happens within the first 1-2 weeks. Physiotherapy treatments such as ultrasound, myofacial release & taping are helpful too.

Conditioning of the affected muscles

When pain and inflammation is under control, the stiff muscles need to be released by heat treatment, massage, and stretching exercises. (pictures) Strengthening exercises should start with pain-free movements. Important movements are gripping, bending of the wrist, and turning of the forearm. Good posture of the body and shoulders is important during exercises. For those who experience tingling or numbness of the forearm and fingers, it is because the nerve passing through the affected muscles is irritated, either by direct compression of the muscles or by the chemicals released from the inflammation of the muscles. In this case, it is necessary to gently mobilize the nerve to assist with better healing (see picture).

Functional Recovery

Technical fault in movements varies depending on the different requirements of the individuals. For example, those who play racquet sports, good wrist control during strokes are crucial to prevent overuse injury. A good technique is one in which the wrist stays neutral (bent neither to the palm nor the opposite) during strokes. Return to sports should be paced to the tolerance of the muscles, and improvement of techniques and fitness.

Stretching for Tennis Elbow video

After understanding the mechanism of the tennis elbow, the following video is a demonstration of a great stretch to release the tightness of the elbow extensor muscles.

Why Badminton Players Get Tennis Elbow?

What is Tennis Elbow?

tennis elbow
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The term “Tennis Elbow” is commonly used to describe pain located at the lateral aspect of the elbow. It is usually caused by overuse of muscles at the elbow that produces wrist extension (namely the extensor carpi radialis brevis – the ECRB), which leads to small tears and scarring of the muscles.

Signs and Symptoms

Interestingly, many people suffer from Tennis Elbow don’t actually play tennis. It could happen to any individuals whose daily activities involve repetitive wrist extension or hand gripping, such as badminton or squash players, typists, or sewers.

Symptoms of this condition may include:

Diffuse pain over lateral elbow just below the lateral epicondyle;
Reduced grip strength;
Reduced ability to lift a heavy object; or
In racquet game players, reduced ability to perform a backhand.
Some people with tennis elbow also experience tingling sensation or numbness spreading over the forearm and hand.

What else may cause elbow pain?

It is important the Tennis Elbow is diagnosed correctly for the proper treatment. Other causes of medial /lateral elbow pain may include nerve entrapment, ligament strain, radiohumeral joint synovitis, radiohumeral joint bursitis, or pain referred from neck. Your medical professional will be able to perform tests eliminate the other possible diagnosis.

The other side of the coin

Golfer’s Elbow, on the other hand, refers to pain on the inside of the elbow. The pathology and treatment of this condition are similar with Tennis Elbow except that the muscles involved now are located on the inside of the elbow.

How it is treated

Treatment of Tennis Elbow usually starts with control of the pain, such as:

Therapeutic ultrasound, heat-retaining braces;
Soft tissue therapies like deep tissue massage, trigger point treatment, myofacial release;
Stretching of the tight wrist muscles;
Specific mobilization techniques combined with gripping exercises;
Taping, corticosteroids injection, and acupuncture are sometimes helpful;
Neck and nerve mobilization can also be considered if necessary.

Strengthening of the wrist muscles can be initiated soon after the pain is better controlled. Muscles that produce wrist extension or wrist flexion need to be both addressed.

Focus should be put to achieve good control of the wrist to prevent wrist from functioning at extreme ranges, either into extension or flexion;
Racquet technique needs to be carefully assessed to correct any technical faults, especially wrist arm control in back hand strokes;
Encouraging gripping that focuses on hand muscles (the Duck grip), rather than gripping that only focuses on forearms muscles (the Finger grip).

Tennis Elbow Video

Have you ever wondered how Tennis Elbow occurs? If yes, click on the animation below to know more.

Tennis Elbow in Children?

There are some kids, between 2-5 years old, who might complain of pain over the outside of their elbow, a common site of complain for tennis elbow. However, is it possible? Chances are, the child might be suffering from either a subluxed or dislocated radial head from the annular ligament that holds the radial head to the ulnar. (more…)

Tendon Disorders: Inflammation and Degeneration

One common form of musculoskeletal injury is tendon-related disorders like tennis elbow and Achilles tendonitis. Your tendon is the connector that transfers power from your muscle generators to your skeletal structure to create movement. Under normal circumstances, healthy tendons glide easily and smoothly as the muscles contract. When tendons are injured, they cause pain, especially during movement. (more…)

What is Thoracic Outlet Syndrome?

Thoracic outlet syndrome refers to a condition whereby blood vessels and/or nerves that pass into the arms from the neck are compressed, due to narrowing of the thoracic outlet which is the space between the collarbone (clavicle) and the first rib. This can lead to pain, tingling or numbness along your neck, shoulder, arm and hand.

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