Golfer’s elbow, medically referred to as medial epicondylitis, is a condition that causes discomfort, stiffness, and tenderness in the flexor muscles of the forearm and inner of the elbow joint.
An overuse injury is the most common cause of a golfer’s elbow. Other causes include general wear and tear of the tendons, muscles, and bone in this region, which is responsible for gripping and wrist flexion.
A golfer’s elbow is like a tennis elbow also known as lateral epicondylitis, which actually happens on the outside of the elbow. It is not all about golfers. Tennis players and those who often clench their little fingers or use their wrists may often experience a golfer’s elbow.
Golfer’s elbow pain should not have to drive you away from the course or from your favorite hobbies. Instead, rest and proper care will help you re-enter the workforce.
How do you determine if you have a golfer’s elbow?
A golfer’s elbow is much less frequent than a tennis elbow (pain over the outside elbow). Ironically, the majority of people we see with this disorder have never even touched a golf ball! So, it is not necessary that this condition only has to appear in golf ball players.
A golfer’s elbow is sometimes characterized as a burning sensation on the inside of the elbow. At first, symptoms of the golfer’s elbow are sporadic and appear when doing manual activities such as searching, holding bags, or weightlifting in the gym. Early signs usually last for a few weeks if aggravating conditions are eliminated (i.e., the activities that cause the pain). We recognize, however, that this is not always true. With time, flareups may become more severe, resulting in increased pain thresholds that impair all everyday activities.
Common symptoms of a golfer’s elbow
Common symptoms of golfer‘s elbow are:
- Pain on the inside of your elbow – this spot is usually very tender to the touch and extremely sore if struck by anything.
- Gripping, dragging, and handling movements cause pain.
- A sense of weakness when it comes to gripping tasks or forming a fist.
- Experiencing discomfort while doing activities such as opening and shutting jars or pouring kettles.
- Repetitive activities such as elbow flexing, golf swing, sawing, grinding, and screwing cause pain.
- Pain is associated with grip-intensive sports and throwing sports such as golf, javelin, archery, and tennis.
- The onset of a golfer’s elbow pain might be abrupt or gradual. Certain actions, such as golf club swinging, may exacerbate the pain.
How is the golfer’s elbow diagnosed?
If you believe you might have a golfer’s elbow, it is advised that you see an orthopaedic doctor.
Your physician will diagnose the golfer’s elbow at your initial consultation. Your clinician will conduct a thorough examination and will ask about the accurate history of your symptoms, eliciting information about how your suffering began and what aggravates or alleviates your symptoms.
Next, a series of clinical examinations will be performed to determine your back, forearm, elbow, and grip strength. Additionally, he will palpate (feel) your elbow to determine the source of your discomfort.
The consistency of your tendon and the seriousness of your injury will be determined using real-time diagnostic ultrasound imaging. Ultrasound may diagnose tendonitis, tendinopathy, and/or tendon tears or ruptures. Accurate diagnosis is critical to ensuring that you get the most appropriate care possible.
How is the golfer’s elbow treated?
According to the national institute of health sciences( NHS), Golfer’s elbow may be a sluggish healer, which is why it is important to begin therapy as soon as possible. The vast majority of golfer’s elbow patients react favorably to conservative care.
Treatment options include rest, icing, medication, bracing and physical therapy.
Rest. Put your golf game and other repetitive movements on hold, until the pain subsides. If you return to activity too quickly, your condition may deteriorate.
Apply ice to the injured area. Apply ice packs to your affected area for 15 to 20 minutes, 3 to 4 times per day. To protect your skin from over burning of your skin from ice packs, cover ice cubes in a small towel. Additionally, it may be beneficial to massage your inner elbow with ice for 5 minutes, 2 or 3 times a day.
Medications: A doctor may recommend non-steroidal anti-inflammatory drugs (NSAIDs) to decrease pain and inflammation. These medications are also available without a prescription. Consider taking ibuprofen (Advil), acetaminophen (Tylenol, others), and naproxen sodium (Aleve). In case of only pain, your doctor may prescribe painkillers such as paracetamol.
Steroid injections are rarely used in this case because they do not provide long-term pain relief. Platelet-rich plasma is a novel therapy currently being tested. This includes taking a tiny amount of blood and injecting concentrated platelets and other anti-inflammatory substances into the affected area. This treatment requires additional research to determine its efficacy.
Conservative care of a golfer’s elbow is best managed by a physiotherapist at a sports medicine clinic and consists of the following:
- Advice on activity modification
- Exercises to protect the forearms
- Stretching activities for the forearms
- Forearm soft tissue techniques, such as deep tissue massage
- Your physical therapist may also recommend doing strengthening exercises. For strengthening the forearm muscles using a tennis ball or light weights. Even basic workouts can aid in absorbing the energy of acute physical stress.
The quickest and most effective way to treat Golfer’s elbow is with Prolotherapy.
The structures in and around the elbow have a poor blood supply, which is why they can struggle to heal on their own or with physiotherapy. It is the oxygen and nutrients in our blood supply that help to heal these structures.
Prolotherapy involves the injection of a regenerative solution into these structures to provide a direct supply of what is required to heal and repair.
As the treatment is helping to treat the root cause of the problem, it is deemed to be a permanent fix.
Here are a few top healthcare tips you may like to try yourself:
- Modify habits that aggravate the symptoms – which could include taking frequent breaks and breaking a job down into manageable tasks.
- Purchase a splint or brace such as an ‘epiclasp’ band – this can assist in reducing elbow discomfort by using your wrist and elbow muscles.
- Stretching the wrists and elbows gently
- After things that aggravate the symptoms, place a small bag of frozen peas (wrapped in a towel) over the elbow.
What if conservative management is ineffective?
If the suffering does not improve for several months, you have a few more medication options. This includes the following:
Treatment with Extracorporeal Shockwaves (ESWT)
Shockwave therapy is a non-invasive, evidence-based treatment alternative for tendon pain that is clinically successful. It operates by inflicting coordinated microtrauma on the tendon through a series of powerful repeated sound waves directed directly at it. This initiates the body’s self-healing process. Additionally, local nerve endings are desensitized, resulting in a decrease in pain. A minimum of three sessions is required for patients (ideally one week apart).
Treatment of Ultrasound-Guided Prolozone Injections
If the discomfort persists or worsens after conservative management, an injection may be suitable for you.
Corticosteroid Injection treatment is suggested if the following conditions exist:
- Pain interferes with your ability to sleep or keeps you awake at night.
- Pain that prevents you from doing routine duties such as washing and dressing, cooking, or engaging in recreational activities
- Pain that is preventing you from participating in physiotherapy recovery
- A golfer’s elbow injection is used to alleviate the pain and inflammation associated with the condition. It creates a ‘window of opportunity for pain-free elbow rehabilitation. Within 1-2 weeks of the injection, it is advised that you begin a course of physiotherapy. Additionally, during this pandemic, a patient can join physiotherapy sessions after he/ she has been administered all covid-19 vaccines.
Prevention of Golfer’s elbow
Stretch prior to your exercise. Warm-up your muscles with a few minutes of walking or jogging. Then, perform mild stretches before beginning the game.
Adjust your form. Ask a coach to evaluate your form to prevent muscle overload, regardless of the sport you play.
Use the proper equipment. If you’re using playing equipment made up of old iron, you may want to consider upgrading to graphite clubs. Moreover, if you play tennis, ensure that your racket is according to your size. A racket with a tiny grip or a hefty head may increase the probability of elbow issues.
Lift correctly. Keep your wrist tight and stable when lifting anything, including free weights, to lessen the impact on your elbow.
Learn when to relax. Avoid overusing your elbow. Take a pause at the first sign of elbow pain.
What should I expect if I develop this condition?
The majority of individuals recover from golfer’s elbow without surgical treatment and after six weeks of arm rest, In addition, there are simple steps you may take every day to aid in the healing of your tendons. However, if left untreated, the golfer’s elbow can cause long-lasting damage, such as decreasing the range of motion in your elbow, reducing grip strength, and producing chronic pain.
The quick and efficient exercises listed above will assist you in managing the golfer’s elbow symptoms as soon as they manifest. You should repeat them a few times each.
Similarly, there are a variety of home remedies and prevention recommendations available to help keep the disease from deteriorating.
Additionally, consume a nutritious diet, get enough rest, and work out a few hours per week. Within two weeks of therapy, the symptoms should subside. If you do not see change during this time period, see your physician.
- EFORT Open Reviews. (2017). EFORT Open Reviews. https://online.boneandjoint.org.uk/doi/full/10.1302/2058-5241.2.160006
- Golf Injury Prevention – OrthoInfo – AAOS. (2015). Aaos.org. https://orthoinfo.aaos.org/en/staying-healthy/golf-injury-prevention/