Golfer's elbow: Cause, Symptoms, Treatment, Exercise

What is a Golfers elbow?

Golfers elbow

Golfer's elbow, also known as medial epicondylitis, is a condition that affects the tendons that connect the forearm muscles to the elbow. It is characterized by pain and tenderness on the inner side of the elbow, where the tendons attach to the bony bump called the medial epicondyle. 

This condition is commonly seen in people who play golf, hence the name, but can also occur in people who perform repetitive gripping activities, such as tennis players, carpenters, and painters. Symptoms of golfer's elbow include pain, tenderness, and stiffness on the inner side of the elbow, as well as weakness in the wrist and hand. 

Treatment options include rest, ice, compression, and elevation (RICE), physical therapy, and in some cases, medication or surgery.

Related Anatomy

To understand golfer's elbow, it's important to know the related anatomy. The elbow joint is formed by the humerus bone of the upper arm and the radius and ulna bones of the forearm. 

The tendons that connect the forearm muscles to the elbow joint attach to bony bumps on the humerus called epicondyles. In the case of golfer's elbow, the tendons that attach to the medial epicondyle become inflamed or damaged due to repetitive stress or overuse. These tendons are responsible for flexing the wrist and fingers and rotating the forearm, which are common movements performed in golf, tennis, and other activities that involve gripping and twisting motions. 

The muscles involved in golfer's elbow include the pronator teres, flexor carpi radialis, and palmaris longus. Other structures in the area include nerves such as the ulnar nerve and blood vessels such as the brachial artery.

Causes of Golfers elbow

Golfer's elbow is caused by overuse or repetitive stress on the tendons that attach to the medial epicondyle of the elbow. Some common causes of golfer's elbow include:

• Repetitive gripping: Repeatedly gripping and twisting actions, such as those used in golf, tennis, or weightlifting, can strain the tendons in the forearm.
• Improper technique: Using improper technique while performing sports or activities that require repetitive elbow movements can increase the risk of golfer's elbow.
• Age and gender: This condition is more common in people aged 40 and above and is also more common in men.
• Occupational hazards: Certain occupations that involve repetitive gripping or twisting actions, such as carpentry, plumbing, and painting, can increase the risk of golfer's elbow.
• Trauma: A direct blow to the elbow or a fall on an outstretched arm can cause golfer's elbow.
• Overloading: Overloading the forearm muscles by lifting heavy objects, performing excessive wrist curls or forearm exercises can increase the risk of golfer's elbow.

Medical conditions: Certain medical conditions, such as rheumatoid arthritis, gout, and thyroid disorders, can also increase the risk of golfer's elbow.

Symptoms of Golfers elbow

The main symptom of golfer's elbow is pain and tenderness on the inner side of the elbow, where the tendons attach to the medial epicondyle. Other symptoms of golfer's elbow may include:

• Weakness in the wrist and hand: You may have difficulty gripping objects or performing everyday activities that require wrist or hand movement.
• Stiffness: The elbow joint may feel stiff and may be difficult to move.
• Numbness or tingling: In some cases, you may experience numbness or tingling in the fingers, especially the ring and little fingers.
• Pain that worsens with activity: The pain may be mild at first but can become more severe with continued use of the affected arm.
• Pain that radiates down the arm: The pain may radiate down the arm towards the wrist and fingers.
• Pain when bending or twisting the wrist: You may experience pain when bending or twisting the wrist, as these movements put additional strain on the affected tendons.
• Pain when lifting or carrying objects: You may experience pain when lifting or carrying objects, as these actions also place stress on the affected tendons.

If you experience any of these symptoms, it's important to see a healthcare provider for an accurate diagnosis and treatment plan.

Risk factor

There are several risk factors that can increase the likelihood of developing golfer's elbow. These include:

• Age: As mentioned earlier, golfer's elbow is more common in individuals over the age of 40.
• Gender: Males are more likely than females to develop golfer's elbow.
• Sports participation: Individuals who participate in sports that involve repetitive gripping and twisting actions, such as golf, tennis, and weightlifting, are at increased risk.
• Occupational hazards: Certain occupations that require repetitive gripping and twisting actions, such as carpentry, plumbing, and painting, can increase the risk of golfer's elbow.
• Poor technique: Using improper technique while performing repetitive elbow movements can increase the risk of golfer's elbow.
• Weak forearm muscles: Weakness in the forearm muscles can make the tendons more vulnerable to injury and increase the risk of golfer's elbow.
• Medical conditions: Certain medical conditions, such as rheumatoid arthritis, gout, and thyroid disorders, can also increase the risk of golfer's elbow.
• Genetics: There may be a genetic predisposition to developing golfer's elbow, although more research is needed to fully understand this connection.

It's important to note that not everyone with these risk factors will develop golfer's elbow, and some individuals may develop the condition without any identifiable risk factors.

Differential Diagnosis

There are several conditions that can cause similar symptoms to golfer's elbow. A healthcare provider may perform a thorough examination and consider other possible diagnoses before confirming a diagnosis of golfer's elbow. Some of the conditions that can be considered in the differential diagnosis of golfer's elbow include:

• Tennis elbow: Tennis elbow, also known as lateral epicondylitis, is a condition that causes pain and tenderness on the outer side of the elbow. This condition is caused by overuse or repetitive stress on the tendons that attach to the lateral epicondyle of the elbow.
• Cubital tunnel syndrome: Cubital tunnel syndrome is a condition that occurs when the ulnar nerve, which runs through a narrow tunnel in the elbow, becomes compressed or irritated. This can cause pain, numbness, and tingling in the elbow, hand, and fingers.
• Radial tunnel syndrome: Radial tunnel syndrome is a condition that occurs when the radial nerve, which runs through the forearm, becomes compressed or irritated. This can cause pain and weakness in the forearm, wrist, and hand.
• Osteoarthritis: Osteoarthritis is a degenerative joint disease that can affect the elbow joint, causing pain, stiffness, and limited range of motion.
• Bursitis: Bursitis is a condition that occurs when the bursae, small fluid-filled sacs that cushion the joints, become inflamed. This can cause pain, swelling, and limited range of motion in the affected joint.
• Fracture: A fracture or break in the bones of the elbow can cause pain and limited range of motion in the joint.
• Tendinitis: Tendinitis is a condition that occurs when a tendon becomes inflamed, causing pain, swelling, and limited range of motion in the affected joint.

It's important to consult with a healthcare provider for an accurate diagnosis and appropriate treatment plan.

Diagnosis

A diagnosis of golfer's elbow is usually made based on a physical exam and a review of the patient's medical history. During the physical exam, the healthcare provider will examine the affected elbow, looking for tenderness and pain on the inner side of the elbow. They may also perform certain maneuvers to assess the strength and range of motion in the affected arm.

In some cases, imaging tests such as X-rays or MRI scans may be recommended to rule out other conditions or to further evaluate the extent of the injury. Blood tests may also be ordered to rule out other medical conditions that may be causing the symptoms.

It's important to seek medical attention if you are experiencing pain, tenderness, or other symptoms in the elbow, as these symptoms can be caused by a variety of conditions and may require different treatment approaches.

Treatment of Golfers elbow

Treatment for golfer's elbow typically involves a combination of rest, medication, physical therapy, and in some cases, surgery. The goal of treatment is to relieve pain, reduce inflammation, and promote healing.

Some common treatments for golfer's elbow include:

• Rest: Resting the affected arm and avoiding activities that cause pain or discomfort can help reduce inflammation and promote healing.
• Medications: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help reduce pain and inflammation. In some cases, your doctor may prescribe stronger medications or corticosteroid injections to reduce inflammation.
• Physical therapy: Stretching and strengthening exercises can help improve flexibility and reduce the risk of future injury. A physical therapist may also use techniques such as massage, ultrasound, or electrical stimulation to promote healing.
• Brace or Splint: Wearing a brace or splint on the affected arm can help provide support and reduce stress on the affected tendons.
• Surgery: In severe cases where other treatments have not been effective, surgery may be recommended to repair or remove damaged tissue.

In addition to these treatments, your healthcare provider may also recommend lifestyle changes such as modifying your activities, using proper form and technique during activities, and wearing protective equipment such as elbow pads or wrist braces to prevent future injury.

It's important to work closely with your healthcare provider to develop a treatment plan that is tailored to your individual needs and goals.

Physiotherapy treatment

Physiotherapy is an important part of the treatment plan for golfer's elbow. A physical therapist can help develop a personalized treatment plan that may include:

• Range of motion exercises: Stretching and range of motion exercises can help improve flexibility and reduce stiffness in the affected arm.
• Strengthening exercises: Strengthening exercises can help improve the strength of the muscles and tendons in the affected arm, which can help reduce pain and prevent future injury.
• Manual therapy: Manual therapy techniques such as massage, myofascial release, and joint mobilization can help reduce pain, improve range of motion, and promote healing.
• Ultrasound or electrical stimulation: These therapies can help reduce pain and inflammation and promote healing.
• Ergonomic assessment: A physical therapist can assess your work environment and suggest modifications to your posture or work habits to reduce the risk of future injury.
• Activity modification: Your physical therapist can help you modify your activities to reduce stress on the affected arm and prevent further injury.

It's important to follow your physical therapist's instructions carefully and consistently to ensure the best possible outcome. Physiotherapy is often a long-term process and may require several sessions over a period of weeks or months to achieve the desired results.

How to Prevent Golfers elbow?

There are several steps you can take to prevent golfer's elbow:

• Warm up properly before physical activity: This can help improve blood flow to the muscles and tendons and reduce the risk of injury.
• Use proper technique: Using proper technique and form during physical activity can help reduce stress on the tendons and muscles in the elbow.
• Strengthen your forearm muscles: Strengthening your forearm muscles can help improve your grip strength and reduce the risk of injury.
• Take breaks and rest: Taking frequent breaks during activities and resting the affected arm can help reduce the risk of injury and promote healing.
• Use proper equipment: Using equipment that is properly fitted and appropriate for the activity can help reduce the risk of injury.
• Avoid repetitive activities: Avoiding activities that involve repetitive gripping or twisting motions can help reduce the risk of injury.
• Maintain overall fitness: Maintaining overall fitness and flexibility can help reduce the risk of injury and promote healing.

By taking these steps, you can help reduce your risk of developing golfer's elbow and other types of overuse injuries. If you do experience pain or discomfort in the elbow, it's important to seek medical attention and follow appropriate treatment recommendations.

Conclusion

In conclusion, golfer's elbow is a common condition that causes pain and tenderness on the inner side of the elbow. It is typically caused by overuse or repetitive strain on the tendons and muscles in the forearm. Treatment for golfer's elbow may include rest, medication, physical therapy, and in some cases, surgery. 

Physiotherapy is an important part of the treatment plan and can help improve range of motion, reduce pain and inflammation, and promote healing. To prevent golfer's elbow, it's important to warm up properly before physical activity, use proper technique, strengthen forearm muscles, take breaks and rest, use proper equipment, avoid repetitive activities, and maintain overall fitness. 

If you experience pain or discomfort in the elbow, it's important to seek medical attention and follow appropriate treatment recommendations.