Golfer's Elbow

What is it?

Lateral epicondylitis (tennis elbow) is an overuse injury to the outside of the elbow. It is the inflammation of the common wrist extensor tendon at its attachment to the outer elbow (lateral epicondyle). 

Tennis Elbow is a common condition that is present in 40% of tennis players and 15% of people working in repetitive manual trades. Sufferers are generally aged between 35-50 years however it can occur at any age. 

Symptoms 

• Pain with gripping tasks or resisted finger/wrist extension 

• Pain can be reproduced when the wrist extensor muscles are stretched 

• Tenderness over the bony epicondyles 

• Possible trigger points in the forearm muscles 

Mechanism of Injury

Golfer’s elbow is the result of repeated repetitive strong grip while swinging a golf club or racket or by using the wrist too much during these type of motions. The condition is an overuse injury of the wrist flexor tendons that attach at the inner elbow area. Common causes include:

• Unaccustomed hand use

• Excessive gripping activities

• Poor technique (eg Golf swing) – too much wrist action, jerky strokes, poor ball contact 

• Poor forearm muscle strength

• Tight forearm muscles

• Improper equipment – incorrect grip size, strings too tight or racquets/tools that are too heavy or unbalanced

Common Management Techniques

Conservative Management

• Massage and releases 

• Dry needling 

• Eccentric exercise 

• Tape/braces

• Heat or ice 

• Autologous blood injections

• Cortisone injections

• Anti-inflammatroy medications

• Electrotherapy

• Daily ice massage will help—fill a paper cup with water and freeze. Peel the top of the cup away to expose the ice and rub over the affected area in a circular motion for 5–7 minutes. 

• Modification of the activity that caused the problem and rest will help.  

Prognosis

Most cases of golfer’s elbow can be self-managed with simple things such as modification of activities, simple exercises and if necessary, painkillers. In a small number of cases injections may be done around the tendon insertion and occasionally in unmanageable cases, surgery may be an option.