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A Guide to Golfers Elbow 

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And How To Start Easing Pain Today

Golfers elbow, or medial epicondylitis, is a common yet painful condition that affects many golfers at some time while they play.  However, this frustrating condition can effect anybody, not just golfers. It is characterized by pain on the inner side of your elbow and forearm making simple tasks challenging, and sports like golf, tennis or weight lifting painful. In this comprehensive guide we will go over what golfers elbow is, a thorough golfers elbow treatment and how to keep it away for good!

What is Golfer’s elbow? 

A Golfer’s elbow is an irritation of the tendons of the wrist flexors on the inside part of your elbow (standing up with your hands down and palms facing out, the part of your elbow that is closest to your side). In comparison to its more well known counterpart “Tennis elbow” which affects the lateral elbow, Golfers elbow is 5x less common resulting in a scarcity of quality knowledge from friends and coworkers when it comes to effective treatment options. This makes working with a healthcare professional even more important than most other orthopedic conditions. Typical recovery time of golfers elbow could be anywhere between 6 months to a year however need for surgical intervention are very uncommon. 

Symptoms of Golfers elbow:

  • Medial elbow pain that may radiate down the inside of your forearm
  • Decreased grip strength – Dropping objects you are normally able to handle well due to pain, weakness, or you just can’t generate enough force
  • Elbow stiffness – bending and straightening your elbow can become challenging which can make everyday activities even more difficult
  • Numbness and tingling – in some instances, individuals may experience numbness and tingling in their pinky, ring and middle fingers as the tissues around the irritation, especially the nerves, get irritated as well

The Cause for Golfers elbow

The primary cause of golfer’s elbow is overuse and repetitive stress on the forearm muscles and their tendons, specifically, the common wrist flexor tendon and the pronator teres at the medial epicondyle of the elbow.  Activities that involve gripping and swinging like golf and tennis, athletes involved in overhead throwing, manual labor intensive work, office workers that spend most of their day typing, weight lifting, and lifting heavy weights in life all can contribute to golfers’ elbows. Other potential causes may include non optimal technique, improper equipment and inadequate warm up. 

Tendon Talk

Before we talk about things to do for your golfers elbow, we should discuss what not to do first. Tendons do not get better by resting! While you might get away with rest in cases of general reactive tendinopathy (not golfers elbow), not loading your tendon will never help as it further decreases the tendon’s capacity to tolerate load. In our experience, most patients involved in golf, overhead activities, or racquet sports report pain improvement when they stop their sport but actually experience more pain when they attempt to pick up their sport again after the break.

Furthermore, research has shown that practitioners are unable to affect the pathologic part of tendons. This means that treatments targeted at attempting to affect the “damaged” or “inflamed” part of the tendon should not be considered. Things like the RICE protocol (Rest, Ice, Compression, Elevation) braces for golfers elbow, Kinesiotape and other modalities may help certain individuals however these should not be the focus of your recovery. 

Actionable advice

If you’re suffering from golfers elbow, here are some actionable tips to help alleviate the condition and promote recovery. 

  • Decrease aggravating high and fast load activities:
    • Normally, tendons act as springs where they store and release energy quickly. This is the main driver of tendon overload. This is why most people with golfers elbow are overhead athletes, golfers or racquet sport players who make use of the elastic action of the tendon at the elbow and wrist when throwing or hitting a ball. 
    • While it’s not necessary to stop ALL high and fast load activities it is recommended to reduce volume. 
    • Adjust 1 or all of these parameters to your symptoms
      • Frequency – Holes per week, 
      • Duration – How long each round, game or match lasts 
      • Reps and Intensity – How many swings or throws per session and what percentage of those are higher effort. 
  • HEAVY and SLOW loading
    • Like in other tendinopathies, the basics for tendon rehab are slow and heavy resistance exercises during the early rehab phase. Simple forearm curls with a dumbbell are a great way to safely load the wrist flexors
      • Windshield wipers with a broomstick, hammer etc can also be helpful to strengthen the pronator teres muscle which is also involved in medial elbow pain.

  • It is very important to mention cadence of reps matters, so sticking with a 3 seconds up and 3 seconds down cadence should keep you from going too fast. 
  • Pick a significant weight that is challenging but you can still do reps of 8-12 with. Mild 1-2/10 pain is ok but anything over a 3 may be too much pain requiring you to reduce your volume, speed or load. 
  • Shoulder and mid back strength
    • Just like we stated in our tennis elbow blog (5 Tips on How To Get Rid of Tennis Elbow), Golfers elbow can be related to weakness in the shoulders and mid back causing increased load and stress to structures in the elbow, wrist and forearm. This is why it may be a good idea to focus on shoulder and mid back strengthening while reducing your playing volume. 
    • Specifically focusing on shoulder abduction like lateral raises
    • ,

External rotation exercises like a high cable row

 And shoulder extension like cable pull downs.

  • Doing these shoulder exercises should not hurt your elbow so if they do, reduce the weight or volume of exercise you’re performing. 
  • Ulnar nerve
    • It is possible that the ulnar nerve can be affected in addition to the tendons of your elbow. Therefore, focusing on getting movement and blood flow to the nerve that runs along the inside of the elbow may be a good idea. Starting with ulnar nerve glides and then transitioning to tensioners as shown can ease nerve pain and allow more mobility along the inside of your elbow. 

The tips outlined in this article are some of the most common techniques we use with our patients to help their elbow and get them back on the course. This information is educational only and should not be attempted without a proper examination from a golf specialist physical therapist. If you’d like to get a more specific treatment plan for your specific elbow issues, working with a physical therapist familiar with the intricacies of golfers elbow can speed up your recovery as soon as possible. Don’t delay the treatment you need to get rid of that pesky elbow pain. Call us at (720) 651 – 0674 or sign up for a free discovery visit to assess your elbow today!

KinetikChain Physical Therapy

We Help People In Denver Quickly Recover From Pain Or Injury So They Can Stay Active In Their Favorite Sport/Hobby, Continue Exercising, And Get Back To What They Love To Do.

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