Golfer’s Elbow: Signs and Symptoms, Causes, Risks, Complications, Diagnosis, Treatment and Prevention

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A golf player who suffer from golfers elbow

1Overview

The joints in the body are important for balance, strength, and movement. They are there to aid in moving the various parts of the body, walking, running, sitting, lying down, and even lifting objects. Can you imagine the body without joints?

The elbows are important joints in the body. Though they are not responsible for carrying the body’s weight like the hips, knees, and ankles, they are important for the movement of the hands like lifting, writing, holding or grasping.

One of the conditions that can affect the elbow is a golfer’s elbow. This condition is usually caused by the overuse of the muscles in the forearm that allow you to rotate the arm, flex the wrist and grip. Activities that involve the repeated gripping, flexing or swinging can cause stress fractures and tiny tears in the tendons, leading to pain and inflammation.

Golfer’s elbow is similar to the tennis elbow, which happens on the outside area of the elbow. Like tennis elbow, golfer’s elbow is not also limited to just golfers. Tennis players and other people can also develop a golfer’s elbow when they perform repeated activities like using the wrist and clenching the fingers.

Also, golfer’s elbow occurs due to the overuse of a group of tendons that help bend the fingers and wrist. The tendon changes its own structure and can’t cope with the forces of everyday life puts upon it.

2Signs and Symptoms

A golfer’s elbow may have the following signs and symptoms:

Pain and tenderness – The pain is located on the inner side of the elbow, and it may sometimes extend along the inner side of the forearm. The pain can become worse by bending the elbow or gripping objects.

Stiffness – The affected elbow can become stiff, and it may become painful to make a fist.

Weakness – You may experience weakness in the wrist area and suffer from a reduced strength of the grip.

Tingling and numbness – The tingling sensation and numbness may radiate to the finger from the elbow and forearm. The pain can come on either gradually or suddenly and might worsen when one shakes hands, turn a doorknob, swing a golf club or racket, lift weights, flex the wrist, and squeeze a ball.

3Causes

A golfer’s elbow affects both men and women, and it is commonly seen among people between the ages of 30 and 50. Also called medial epicondylitis, golfer’s elbow is caused mainly by activities that require excessive or repetitive bending of the wrist.

It is also caused by the damage to the tendons and muscles that control the fingers and wrist. This is usually related to repeated or excess stress, caused by forceful finger and wrist motions. An improper golf swing is also a common cause, but other sports activities and occupational-related activities can also cause the problem. Furthermore, direct trauma or injury to the elbow as a result of a fall or sudden blow can cause pain and inflammation, too. There are many activities that can cause a golfer’s elbow, including:

Golf – As its name indicates, golf elbow is common among people who play golf. Swinging or gripping clubs improperly or too hard can take a toll on the arm’s muscles and tendons.

Throwing sports – The improper pitching and gripping in baseball or softball can cause a golfer’s elbow. Javelin, archery, and football can also cause a golfer’s elbow.

Racket /Racquet sports – The excessive topspin can put a strain and hurt the elbow. Using a racket/racquet that is too small or heavy can also lead to pain and injury.

Weight training – Lifting weights with improper technique may lead to a golfer’s elbow.

Other activities that require excessive and repeated bending or straightening of the elbow can cause a golfer’s elbow. These activities include hammering, raking, painting, using a computer, typing on the computer, cooking, chopping wood and plumbing.

4Risk Factors

The risk of developing a golfer’s elbow can increase due to the following factors:

  • Doing repetitive activities for at least two hours a day
  • Being 40 years old and above
  • Obesity or being overweight
  • Smoking

5Complications

If the condition is left untreated, golfer’s elbow may lead to:

  • Limited range of motion
  • Limited movements
  • Weakness of the arm and hand
  • Chronic elbow pain
  • A fixed bend or contracture in the elbow
  • Impairment in various activities like sports and lifting

6Diagnosis

The doctor will first take a detailed medical history, asking questions about the symptoms, when they started, the severity of the pain and how the pain affects the patient’s activities.

After the detailed medical history interview, the doctor will conduct a comprehensive physical assessment to help diagnose golfer’s elbow. The doctor may examine the elbow, arm, and hands, asking the patient to move.

The doctor will evaluate the pain and stiffness by applying pressure to the affected area and will ask you to move the fingers and wrist in various ways. If there is a positive pain, the person has a golfer’s elbow.

The doctor can also recommend having an X-ray of the elbow. The X-ray is usually recommended to see the bones and if the cause is arthritis or stress fractures. Imaging tests can also be used such as computed tomography (CT) scan that can show detailed photos of bones and soft tissues. Another imaging test is the magnetic resonance imaging scan (MRI) that can help

7Treatment

Apply the PRICE principle on the elbow – protection, rest, ice, compression and elevation when the injury is painful. Protect the area from further damage and injury.

Rest the injured area by avoiding certain activities like repetitive movements until the pain is gone. If you return to activity as soon as possible, it might make the pain worse.

Apply cold compress on the affected area by placing ice packs on the elbow for about 15 to 20 minutes at a time, for about 3-4 times a day for several days. Protect the skin by wrapping the ice with a thin towel. Do not apply the ice directly on the skin.

Wrap the affected area with an elastic bandage to compress the area. This will promote healing as the circulation to the area will be increased. Use a brace, called a counterforce brace on the affected arm. This will help reduce muscle and tendon strain.

Elevate the area to promote venous return and promote faster healing. This will reduce inflammation in the area. Take over-the-counter OTC pain relievers and anti-inflammatory drugs to relieve pain and swelling.

Physical therapy can help relieve pain and fasten the recovery process. Pain relief treatments prescribe exercises can reduce stress to the elbow, reduce the risk of recurrent and speed up recovery.

Lastly, stretch and strengthen the affected area to help reduce chronic tendon irritation. Furthermore, reduce the load on the tendons in the elbow. You can use a splint to immobilize the area.

Conservative therapies usually work for golfer’s elbow, but if you’re having pain even after long months, you may need to opt for surgery. The surgery will involve the removal of the damaged tendon, reduce pain and promote healing. The recovery from surgery may take at least three to six months.

Medial epicondylitis release is a surgical operation that helps treat certain problems caused by golfer’s elbow. This surgery is important to regain full function of the elbow and a pain-free use of the joint.

During the surgery, the doctor will start by making an incision in the elbow. This will be over the area of the medial epicondyle. The soft tissues are moved to the side, and the doctor will cut the flexor tendon. He will then remove the damaged parts of the tendon or the scarred tissues. The doctor will then suture the incision, and the patient is on the road to recovery.

The recovery of the surgery depends on the patient. The pain will disappear after recovery, and the patient will need to come back for follow up consultations to ensure that the condition will not come back or recur. Moreover, simple exercises will be prescribed to make sure the elbow can be moved without discomfort or pain. Recovery may take weeks to months, depending on how fast the patient’s wound and tissues would heal.

8Prevention

  • Strengthen the forearm muscles by performing simple exercises that can help the muscles absorb the energy from abrupt physical stress. You can use a tension ball or light weights.
  • Stretch the muscles every before activity or exercise. Walk, jog or perform warm-up exercises for the muscles.
  • Practice proper body mechanics. Whatever sport or activity you are performing; you need to check your form to prevent muscle overload.
  • Use proper equipment when performing activities. Also, in the house, replace old and heavy equipment with lighter equipment. In sports activities, replace heavy rackets with modern ones, which are lightweight.
  • Properly lift the items like keeping the wrist strong, rigid and stable to decrease the force to the elbow.
  • Know when to rest. If you’re tired and you feel pain, rest for a while before going back to the activities.