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How to Fix Golfer's Elbow (Medial Epicondylitis)

elbow pain golf elbow golfer elbow golfer elbow exercise golfer elbow rehab golfer elbow treatment

If you feel pain where the tendon (medial epicondyle) attaches to the inside of the elbow – that bumpy part that tingles when we knock it. Chances are you are experiencing Golfer Elbow.

Golfer's elbow is a condition that causes pain where the tendons of your forearm muscles attach to the bony bump on the inside of your elbow. The pain might spread into your forearm and wrist. Golfer's elbow is similar to tennis elbow, which occurs on the outside of the elbow. It's not limited to golfers.


The main symptoms of golfers elbow are pain and tenderness around the bony bit on the inside of the elbow called the medial epicondyle, particularly when gripping hard with the hand. It is also not unusual to experience a general weakness in our wrists, with pain occurring when bending our wrist palm downwards against any resistance.

General Causes

  1. Repetitive stress & overload of the flexor-pronator musculature from serves.
  2. Faulty mechanics (excessive wrist snap etc).
  3. Non-optimal contributions from kinetic chain & reliance on forearm musculature for power generation.
  4. Weak forearm & scap. muscle fx.
  5. Flexibility deficits.

Initially, the pain and inflammation can be relieved through the use of non-steroidal anti-inflammatory drugs such as ibuprofen or aspirin while applying the P.O.L.I.C.E principle;

  • Protection – protect the forearm /elbow/wrist from being aggravated further.
  • Optimal Loading – this means that rather than resting the elbow and waiting, recovery can be sped up by using the muscles affected at a restricted level to help stimulate the cells in the recovery process. This always prevents the muscles from weakening and shortening
  • Ice – Use ice immediately after the injury occurs to prevent inflammation.
  • Compression – the use of a support or taping will help compress the affected area, immobilizing and protecting it also.
  • Elevation – elevate the hand /arm immediately to reduce pain and blood flow to the injured area.

Golfer's Elbow Rehab Through Strengthening by @strengthcoachtherapy

The Goal is load and strengthen.

Pain should be well controlled during this period. An occasional flare-up might happen, just stay the course. The goal here is incorporating more pronation along with the wrist flexion.

It can be helpful to consider the activities that cause symptom flare up and then use these gross movement patterns to get creative with rehab exercises. Slowly progress these and you got it figured out.

Experiment with different pronation/supination angles and find ways to load the tendon pain-free. Even if it's just isometrics at first, that's great. The load is key. Oftentimes you can't just massage and stretch this injury away.

 Tennis and Golfer's Elbow Release by @london_movement_therapy 

Hands down the best self-released for RSI/Tendonitis symptoms

Medial epicondyle Rehab by @tennisprehablab.

Flexibility deficits of elbow & wrist flexors are common & must be addressed 

Distal strengthening of flexors via isotonic & oscillatory exercise is critical to attenuation force & endurance capacity.

Proximal strengthening: Power production does not come from the forearm in a properly executed stroke but from the summation of the kinetic chain. Thus, its critical to strengthening scapular & RTC stability for distal mobility & injury prevention.

Plyo exercise helps dissipate forces & prepare flexor muscles for sport-specific demands.

FLEXIBILITY (1-2 sets 30 sec holds & STM)

  1. STM
  2. Pronated Wrist Flexor Stretch
    • Supinated Wrist Flexor Stretch (Progression)
    • Supinated & Palm fixed on the surface (Progression).

How long does it take for golfers elbow to heal?

Conservative treatments usually work for golfer's elbow. But if you're still having pain after three to six months, you may need surgery. These procedures can remove damaged parts of a tendon, promote healing, and reduce pain. 

Full recovery may take three to six months. Should your injury worsen over time or continue to cause you issues, Physiotherapy is encouraged.

 

 

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Reference

  • Golf injuries to the hand, wrist or elbow. American Society for Surgery of the Hand. http://www.assh.org/handcare/hand-arm-injuries/Golf-injury. Accessed Feb. 13, 2019.
  • Golf injury prevention. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/staying-healthy/golf-injury-prevention/. Accessed Feb. 13, 2019.
  • Barco R, et al. Medial elbow pain. EFORT Open Reviews. 2017;2:362.
  • Medial epicondylitis. Merck Manual Professional Version. https://www.merckmanuals.com/professional/injuries-poisoning/sports-injury/medial-epicondylitis. Accessed Feb. 13, 2019.
  • Jayanthi N. Epicondylitis (tennis and golf elbow). https://www.uptodate.com/ contents/search. Accessed Feb. 13, 2019.
  • Golfer's elbow. https://www.mayoclinic.org/diseases-conditions/golfers-elbow/symptoms-causes/syc-20372868. Accessed Feb. 13, 2019.

 


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