If you’ve ever experienced pain on the inside of your elbow you may be surprised to learn that Golfer’s elbow (also known as Thrower’s elbow) is a condition that develops when the tendons (connecting the muscles to the bone) on the inside of the forearm near the elbow become inflamed, irritated, and painful due to repetitive motions at the elbow, forearm, wrist, and hand. Medically called medial epicondylitis it is commonly diagnosed in individuals who perform repetitive motions or activities that involve gripping, twisting, or throwing, such as swinging a golf club or tennis racket. Even normal everyday activities such as doing yard work or using a computer can cause the condition. Men over the age of 35 are most commonly affected. Physical Therapy can help to decrease pain, increase range of motion and strength, and return you to your prior level of function.
WHAT EXACTLY IS GOLFER’S ELBOW (MEDIAL EPICONDYLITIS)?
Golfer’s elbow is caused by repetitive use of the elbow, forearm, wrist, and hand that causes the tendons on the inside of the elbow to become inflamed, irritated, and painful. The painful muscle group functions to bend (flex) the wrist, thumb, and fingers and rotate the wrist and forearm so the palm faces down (pronation). These muscles come together and attach to a bony prominence (medial epicondyle) on the inside of the elbow. Pain generally occurs at the site where the tendon connects to the bone. Repetitive forces can cause the tendon to tear away from the bone if left untreated. This muscle group travels across both the elbow and the wrist and stabilizes the elbow while allowing for wrist movement. Because they are two-joint muscles serving multiple joints, they are more susceptible to injury.
WHAT ARE THE SYMPTOMS OF GOLFER’S ELBOW?
Individuals with Golfer’s elbow may experience:
- Pain along the inside of the forearm with elbow, wrist, or hand movements
- Pain/numbness/tingling that travels down the inside of the elbow into the hand and fingers with gripping or squeezing motions
- Swelling and soreness to the touch along the inside of the forearm
- Loss of grip strength
- Stiffness in the elbow
HOW IS GOLFER’S ELBOW DIAGNOSED?
Your first course of action when it comes to getting a diagnosis is to see your Physical Therapist. They should conduct a thorough and comprehensive evaluation which includes a detailed medical history, such as when and where the pain started, as well as other symptoms you are feeling, job duties, and any hobbies that may have initiated the symptoms. They should then check for range of motion and strength of your elbow, forearm, wrist, and hand, evaluate your posture, and look for any muscle imbalances and weakness from your shoulder blade all along your arm and down into your wrist and hand. Your Physical Therapist should then find the areas that are sore to touch and measure for any signs of swelling in the elbow and forearm. Specific manual resistance tests should also be conducted to determine the exact cause of your problem.
HOW CAN PHYSICAL THERAPY HELP?
It is extremely important to seek treatment as early on as symptoms present as tendons do not have a great blood supply. As mentioned earlier, an irritated and inflamed tendon, if left untreated, can begin to tear, leading to a more serious condition. Your Physical Therapist should work with you to design a treatment plan for Golfer’s elbow that is specific to your goals and condition. Your individualized treatment program may typically include:
- Pain Management–In severe cases, it might be advised to rest the elbow and not perform work or sport activities that cause pain and irritation. Some home treatments may include the use of ice, ice massage, or moist heat for pain relief. A brace or splint may or may not be indicated.
- Manual Therapy–Hands-on techniques such as joint mobilization, soft tissue massage, and passive range of motion/gentle stretching of the elbow, forearm, and wrist may be utilized by your Physical Therapist. Treatment may also extend to your shoulder and thoracic spine as tendons along the inside of the elbow can be influenced by muscle imbalances up and down the kinetic chain.
- Range of Motion Exercises–You will learn self-stretches and mobility exercises to help your wrist and elbow maintain proper movement.
- Strengthening Exercises–As your pain diminishes, your Physical Therapist should determine which strengthening exercises are appropriate for you, based on your specific condition. These exercises may include resistance bands, weights, medicine balls, and gripping exercises to challenge your weaker muscles. It is imperative that you perform a home exercise program even after you have been discharged from Physical Therapy. This will allow you to continue strengthening your elbow, forearm, wrist, and hand.
- Functional Training–As your symptoms get better, your Physical Therapist will help you to return to your prior level of function. This functional training will allow you to place less stress and strain on the medial tendons by modifying specific movement patterns. You and your Physical Therapist will work together in helping you to achieve your specific goals to allow you to safely return to your previous level of performance as quickly as possible.
- Patient Education–Your Physical Therapist should advise you on making proper adjustments in how you perform certain tasks, as well as making suggestions to improve your form and reduce any chance of injury. Adjustments made in your throwing motion, golf swing, or work tasks can help to alleviate pressure placed on the tendons of the forearm region.
CAN GOLFER’S ELBOW BE PREVENTED?
Being aware of your daily movements and understanding the risk of injury can go a long way in preventing the onset of Golfer’s elbow. Individuals should:
- Maintain shoulder, elbow, forearm, wrist, and hand muscle strength
- Use proper body mechanics and posture when lifting heavy objects to reduce joint strain
- Perform gentle forearm muscle stretches before and after performing tasks
- Maintain proper form and technique when performing repetitive motions during work tasks or sports movements (like golf swings)
If you or someone you know has signs and symptoms of Golfer’s elbow, don’t wait to take action. Call my office at once at (302)691-9055 or visit my website at www.wildermanpt.com to schedule your FREE 30 minute consultation to see how Physical Therapy can help you. Don’t delay–call now!