Golfers Elbow

Golfers Elbow

Article by John Miller

What is Golfer’s Elbow?

A golfer’s elbow is an injury to the muscles that flex your wrist and fingers. The injury site is typically the medial epicondyle, a bony bump on the inside of the elbow where these muscles attach.

Golfer’s Elbow Symptoms?

Typically the golfer’s elbow sufferer will experience pain when performing gripping tasks or resisted wrist/finger flexion. Pain can also be present when the muscles overstretch. There will be tenderness directly over the bony epicondyle, and there may be trigger points in the wrist flexor muscles.

Some sufferers will also have neck stiffness and tenderness, as well as signs of median nerve irritation. Most elbow movements will be pain-free. Gripping is painful.

What Causes Golfer’s Elbow?

Golfer’s elbow is caused by damaged muscle tissue where it anchors to the arm bone at the elbow. It occurs when more force is applied to an area than the average healthy tissue can handle.

In some cases, such as Chronic Golfer’s Elbow, this can occur due to the soft tissues being in poor health, which are easily injured. Inflammation follows the injury, which leads to swelling and elbow pain.

What Causes Chronic Golfer’s Elbow?

Chronic Golfer’s Elbow is associated with degenerative changes in the muscle tissues located at the medial epicondyle. While there may be inflammation early in the injury cycle, the swelling resolves, yet the pain remains. Chronic Golfer’s Elbow is NOT due to INFLAMMATION!

How is Golfer’s Elbow Diagnosed?

Your physiotherapist or doctor clinically diagnoses your golfer’s elbow. After listening to your injury history and using some confirmatory clinical tests, they’ll make a provisional diagnosis of Golfer’s Elbow.

An ultrasound scan or MRI are the best tests to identify any tendon tears or inflammation. X-rays are of little diagnostic benefit.

Referred Pain Can Mimic Golfer’s Elbow

A significant percentage of golfer’s elbow sufferers may feel pain in the medial elbow but not be experiencing golfer’s elbow. There is a high incidence of referred medial elbow pain from a cervical spine (neck) injury. The most common neck joint related to your medial elbow is C67, transmitting pain signals along the median nerve.

Your median nerve may also have reduced neural mobility, which can cause symptoms similar to a golfer’s elbow.

Please have your neck and upper limb neurodynamics assessed by your experienced physiotherapist. They will confirm or exclude any neck dysfunction or neural tension. Failure to do so will result in a lack of symptom improvement and the development of chronic golfer’s elbow pain syndrome.

Who Suffers Golfer’s Elbow?

Golfer’s elbow occurs commonly in the community. It is present in golfers. Repetitive manual trades where gripping is involved also suffer.  It can occur at any age. The most common age for golfers elbow is generally between the ages of 35 and 50.

Predictably, the side affected is usually associated with handedness, but it can occur in the non-dominant arm. Males and females are affected equally.

Golfer’s elbow can be tricky to treat since most likely there is a tendinopathy component. Please seek the advice of an elbow physiotherapist for diagnostic and golfer’s elbow treatment advice.

Golfer’s Elbow Treatment

Physiotherapy is effective in the short and long-term management of Golfer’s Elbow. Physiotherapy aims include:

  • A reduction of elbow pain.
  • Facilitation of tissue repair.
  • Full joint range and function.
  • Adequate muscle length, strength and movement patterns.
  • Normal upper limb neurodynamics.
  • Normal cervical joint function.

Your physiotherapist consultation includes your assessment and treatment options. Each golfer’s elbow is different in healing status and the functional demands placed upon it. Therefore, we’ll customise your golfer’s elbow treatment.

Physiotherapy treatment may include gentle joint mobilisation of your neck and elbow joints. Protective strapping, muscle stretches, neural mobilisations, massage and strengthening are other options. In some instances, a Golfer’s Elbow Brace (a tennis elbow brace worn on the opposite side of the elbow) may be beneficial.

Your physiotherapist will discuss what treatment options are most suitable for you.

Chronic Golfer’s Elbow

Untreated chronic golfer’s elbows can last anywhere from 6 months to 2 years. You are also prone to recurrence. Hence the term “chronic golfer’s elbow”.

For more advice about Golfer’s Elbow, please seek the advice of your elbow physiotherapist. The last thing you want is your acute golfer’s elbow becoming chronic!

Golfers Elbow Brace

golfers ebow

A golfers elbow brace or tennis elbow brace can be beneficial when you put it on for both golfer’s elbow and tennis elbow. In these instances, the elbow brace will dissipate the stressful gripping forces away from your injured structures.

However, tennis elbow braces do not work in 100% of cases. In our experience, we recommend that you seek physiotherapy assistance in these cases. In stubborn cases, you have a very high likelihood of referred symptoms from your spine or joint position abnormalities within your elbow. Only a thorough examination of your neck, shoulder, elbow and upper limb nerve structures will confirm your diagnosis and direct which treatment options will assist you the quickest.

Please seek the professional advice of your trusted elbow physiotherapist regarding your golfer’s elbow.

Elbow Pain Causes

Please visit the links below for some of the more common sources of elbow pain.

Elbow-Related Arm Pain

Neck-Related Arm Pain

Muscle-Related Arm Pain

Other Sources of Arm Pain

Common Treatments For Elbow Pain

With accurate assessment and early treatment, most elbow pain responds extremely quickly to physiotherapy that will allow you to resume pain-free and normal activities of daily living quickly. Some conditions may require diagnostic investigations such as X-rays, Ultrasound, MRI or CT scans. Fractures, dislocations and some severe or chronic injuries may require surgical opinion or intervention.

Please ask your physiotherapist for their professional treatment advice.