Golfer's Elbow Treatment and Rehabilitation

Golfer’s elbow, medically referred to as medial epicondylitis, is a common elbow condition caused by overuse injuries. While it is less common than Tennis elbow, or lateral epicondylitis, Golfer’s elbow accounts for approximately 10% to 20% of all epicondylitis. Studies suggest that Golfer’s elbow is prevalent within 0.4% of the population.

What is Golfer’s Elbow?

Golfer’s elbow is a condition that causes pain and inflammation to the tendons connecting the forearm to the elbow. This condition is typically caused by an overuse of the forearm, wrist and arm, resulting in tiny tears in your tendons, causing wrist, elbow and forearm pain. The pain caused by Golfer’s elbow generally begins at the bony bump on the inside of your elbow and can radiate outwards, spreading into your forearm and wrist. While Golfer’s elbow sounds like a sports injury, approximately 90% of people with Golfer’s elbow develop it as a result of non-sports related reason.

What Causes Golfer’s Elbow?

Golfer’s Elbow is generally caused by overuse injury, where repeated movements, especially forceful wrist and finger movements lead to excess or repeated stress, damaging your muscles and tendons. In addition, poor form when lifting, throwing or hitting, or failing to warm up appropriately before vigorous sporting activities may contribute to the development of Golfer’s elbow.
Common activities and occupations involved in the development of Golfer’s elbow include:

Racket sports such as tennis or badminton. Repeated usage of improper form and strokes may cause damage to your tendon. Using a racket that does not suit you, such as one that is too small or too heavy can also result in injuries.
Throwing sports such as baseball and softball. These sports require repetitive motions from your wrist, forearm and elbow, making players prone to injuries that can contribute to the development of Golfer’s elbow.
Weight training. Improper form and technique when lifting can lead to injury. In the case of Golfer’s elbow, weightlifting activities involving the curling of the wrist may put you at risk. For example, curling the wrists when doing a bicep curl may overload the elbow muscles and tendons.
Forceful, repetitive occupational movements involving the forearm, elbow and wrist. These are common in fields such as construction, plumbing and carpentry.

Symptoms of Golfer’s Elbow

If you have Golfer’s elbow, you may experience the following symptoms:

Stiffness in the affected elbow.
Tenderness and pain on the inner side of the elbow.
Pain that is experienced when carrying out certain motions such as making a fist or swinging a golf club.
Tingling or numbness in your fingers, typically the ring and little fingers.
Weakness in your hands and wrists.

Risk Factors of Golfer’s Elbow

The following factors may increase your risk of developing Golfer’s elbow. These include:

Age 40 and above
Carrying out repetitive physical activity involving the forearm, wrist and elbow, for at least two hours a day
Being obese
Being a regular smoker

Complications of Golfer’s Elbow

Golfer’s elbow usually heals on its own with over time, given sufficient rest. However, if you choose to ignore the condition and continue to carry out vigorous physical activities involving the forearm, elbow and wrist, you may end up aggravating the injured muscles and tendons, leading to complications. Common complications of Golfer’s elbow include:

Persistent, chronic pain in the affected areas.
Reduced range of motion of the affected elbow.
Weakened grip strength.

Diagnosing Golfer’s Elbow

To diagnose Golfer’s elbow, your doctor will examine your medical history and conduct a physical examination. Your doctor may also apply pressure to the affected areas of your arm and ask you to conduct various movements to evaluate your degree of pain and stiffness. If your doctor suspects that your condition may be a result of other causes such as a fracture or arthritis, an X-ray may be suggested.

Preventing Golfer’s Elbow

While Golfer’s elbow may be unavoidable, there are some steps in which you can take to lower your risk of developing the condition. These include:

Conducting proper warmups and stretches prior to sporting activity. Paying special attention to your wrists and forearms while stretching is recommended, especially if you have had Golfer’s elbow before.
Adjusting your sporting equipment to better suit you can be helpful in preventing Golfer’s elbow. For example, using a racket that is of a suitable weight, with a proper fitting grip.
You may need to adjust your technique and form, especially if you have been playing with the incorrect technique and form. Poor form and technique will increase your risk of sporting injuries.

Treatment Methods for Golfer’s Elbow

Rest

The first step to treating any injury is to rest the affected areas of the body. Giving your arm a break is essential in preventing further injuries or additional strain and starting off the recovery process of your injured muscles or tendons.

Ice

Applying ice packs to your injured arm with pressure can help to alleviate symptoms of pain. Ice packs should be applied for up to 20 minutes at a time, three to four times a day. You may want to wrap the ice packs in a thin towel to protect your skin.

Use a brace

Using a counterforce brace on your affected arm can help with reducing tendon and muscle strain. The counterforce brace can work as a short-term relief for your Golfer’s elbow while you work on long-term solutions such as physiotherapy for your condition. Ensure that your brace fits well for optimal results. The brace should not be worn too tightly, and you should not feel pain while wearing it.

Anti-inflammatory medication

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and diclofenac can be effective in relieving symptoms of pain.

Injections

Cortisteroid injections may be prescribed as short-term pain relief for your Golfer’s elbow. Multiple injections, however, are not recommended due to the risk of side-effects.

Surgery

If conventional treatment methods do not work for your Golfer’s elbow, even after a prolonged period of time over six to twelve months, surgery might be an option. The surgical procedure may involve the removal of damaged tissue, build-up of scar tissue, or extra bone which may be pressing on the tendon.

Physiotherapy for Golfer’s Elbow

Physiotherapy can be an effective treatment method for Golfer’s elbow, especially for cases where the condition persists even after a prolonged period of rest and causes chronic pain. Physiotherapy employs targeted exercises, manual therapy, and modalities to address golfer's elbow. These treatments aim to strengthen muscles, reduce inflammation, and improve mobility in the affected area, promoting healing and reducing pain.

Manual Therapy and Exercises

Hands-on techniques such as soft tissue massage, joint mobilisation, and myofascial release are used to alleviate muscle tension, improve blood flow, and promote healing in the elbow. Strengthening and stretching exercises may also be prescribed to improve flexibility and strength in the forearm muscles while reducing strain on the affected tendon.

Deep Tissue Massage

Deep tissue massage can be an effective form of treatment for your Golfer’s elbow. It targets the deeper layers of your muscles to relieve and treat muscle and tendon pain, stiffness and injuries. Deep tissue massages involve the use of deep, slow, long pressure to press into the deeper layer of your muscle or tendon. Lotion and cream will be used during your deep tissue massage for optimal effects.

Ultrasound Therapy

Ultrasound therapy involves the use of high-frequency sound waves to generate heat deep within the tissues of the affected area. In the case of golfer's elbow, ultrasound therapy can help promote blood flow, reduce inflammation, and accelerate tissue healing. The heat generated by ultrasound can also help to relax muscles and alleviate pain in the affected tendon.

TENS Therapy

Transcutaneous Electrical Nerve Stimulation delivers low-voltage electrical impulses through electrodes placed on the skin near the site of pain. These electrical impulses can help to block pain signals from reaching the brain, providing relief from discomfort associated with golfer's elbow. TENS therapy also stimulates the release of endorphins, the body's natural pain-relieving chemicals, further reducing pain perception. TENS is a non-invasive and drug-free treatment option that can be used alone or in combination with other physiotherapy modalities to manage symptoms of golfer's elbow.

TCM for Golfer’s Elbow

TCM utilises acupuncture, herbal medicine and cupping therapy to alleviate symptoms of golfer's elbow. By restoring balance and harmony within the body, TCM aims to reduce pain, inflammation, and promote healing in the affected tendon.

TCM Acupuncture

Acupuncture involves the insertion of fine needles into specific acupuncture points to stimulate Qi flow and promote healing. It can help reduce pain, inflammation, and improve blood circulation around the elbow joint.

TCM Herbal Medicine

TCM herbal remedies may be prescribed to address underlying imbalances and alleviate symptoms of golfer's elbow. Herbal formulas may include herbs with anti-inflammatory and pain-relieving properties.

TCM Cupping Therapy

Cupping therapy involves placing cups on the skin to create suction, which helps increase blood flow, reduce muscle tension, and alleviate pain. Cupping therapy can be beneficial in relieving symptoms of golfer's elbow and promoting tissue healing.

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