GOLFER'S ELBOW
What is it?
Golfer’s elbow is an injury to the muscles that flex down your wrist and fingers as opposed to extending them (
tennis elbow). The site of injury is typically the medial epicondyle, a bony bump on the inside of the elbow where these muscles attach with tendons.
Golfing is only one occupation known to cause repetitive use or straining of normally healthy tendons. Car mechanics and dentists are also at risk as their occupations require low grade but persistent tugging of the tendon attachment causing tiny micro tears in the fibres over time. This makes them inflame and weaken and movements which are performed using these tendons are very painful. See
RSI for more information.
The condition affects mainly the dominant hand and males and females equally.
What is chronic Golfer's elbow?
Chronic Golfer’s Elbow however, is associated with degenerative changes in the muscle tissues located at the medial epicondyle. Although for a long time this was thought to be related to inflammation from overuse, this is now known not to be the case. One of the main characteristics of chronic golfer's elbow is the absence of inflammation. Rather, when the muscles are in poor health, such as arthritis or illness, these muscles are easily injured which if not treated can eventually lead to chronic golfer's elbow.
The main symptoms of golfer's elbow are pain localised to the inside elbow, painful myofascial bands or trigger points in the muscles involved and painful bending and twisting actions at the wrist. Stretching the wrist backwards can make the muscles painful and tug at their attachment.
How is it diagnosed?
Golfer’s elbow is clinically diagnosed by your Hand therapist or doctor. After listening to your symptoms and knowing the types of movements you are performing, as well as some confirmatory clinical tests, a provisional diagnosis of Golfer’s Elbow can be made.
An ultrasound scan or MRI are the best tests to identify any tendon tears or inflammation but X-rays are of little diagnostic benefit.
Are you sure it is Golfer's elbow?
A significant percentage of people diagnosed with golfer’s elbow may feel pain in the medial elbow, but do not actually have golfer’s elbow. There is a high incidence of medial elbow pain that is referred to your elbow from a cervical spine (neck) injury.
The most common neck joint that refers to your medial elbow is Cervical 6 or 7, which transmit their pain signals along the median nerve to the medial epicondyle.
Pain could be as a result of median nerve entrapment at the neck or ulnar nerve compression at the elbow (
cubital tunnel syndrome).
It is extremely important to have your neck and upper limb neurodynamics assessed by an experienced Hand therapist to confirm or exclude any neck dysfunction or neural tightness (tension). Failure to do so, will result in a lack of symptom improvement and the development of chronic golfer’s elbow pain syndrome.
Treatment
Untreated golfer’s elbows can last anywhere from 6 months to 2 years. Studies have shown that effective treatment will require more than muscle massage or stretching exercises alone as these do not carry over into the work place or golf course. In fact, the condition is prone to recurrence if the causing actions are not modified early in the treatment cycle.
Steroid injections are often administrated in the absence of Hand therapy but again this is only ever a temporary solution.
Treatment at Hand Kinetics
Because Golfer's elbow has a huge impact on your ability to perform everyday actions at home and in work and in sport, at Hand kinetics you can expect an analysis of your arm and hand actions to find the root cause. You will be advised what modifications to make to your everyday activities so you continue to enjoy the activity pain free.
Hand therapy at Hand Kinetics with include incremental exercises, myofascial massage, acupuncture and electro-therapies.
Treatments may involve some of the options below depending on your individual circumstances:
- Soft tissue massage
- Trigger point release
- Taping of the muscles involved
- Strapping the elbow
- Splinting the wrist
- Thermal therapies
- TENS for pain relief
- Neurodynamics
- Exercise and stretching
- Dry needling
- Therapeutic ultrasound
Hand Kinetics Telephone: 0044 28 417 72301
www.handkinetics.com
contactus@handkinetics.com
