Diagnosis: Golfers Elbow

 In Exercise and Health

How Golfer’s Elbow Presents

  • Do you have pain on the inside of your elbow?
  • Does the pain come on worsen when you bend your elbow, or try to grip or squeeze something?
  • Does the pain come on worsen when you turn your forearm inwards (e.g. when turning a the taps)?
  • Does the pain come on worsen when curl your wrist?
  • Do you feel you can’t use your full strength when gripping?
  • Does the pain radiate down the inside of your forearms towards your fingers?
  • Do you sometimes get tingling sensations in these areas?
  • Does your elbow feel stiff when you bend or straighten it?

If you experience any (or a combination) of these symptoms, you may have Golfer’s Elbow, or medial epicondylalgia in medical speak.

Golfers Elbow

Golfer’s Elbow (author: www.scientificanimations.com source: WikiMedia Commons)

How Golfer’s Elbow is Diagnosed

Your skilled physiotherapist can diagnose for Golfer’s Elbow with the Golfer’s Elbow Test (a clinical diagnosis). This is a simple procedure where he or she supports your elbow with one hand, and uses the other hand to face your palm up, extend your wrist and straighten your elbow. He may then resist you in bending your elbow and wrist. If these movements produce your pain, then that is a positive diagnosis for Golfer’s Elbow.

Your physiotherapist will also perform other clinical tests to rule out other causes of elbow pain. Golfer’s Elbow generally doesn’t appear as an abnormally on radiographs (such as X-Rays, MRI’s, ultrasound) so these aren’t essential, but may be helpful in ruling out fractures or arthritis.

Causes of Golfer’s Elbow

Golfer’s Elbow is an overuse injury. In other words, it’s caused by too many repetitions of the same movement. Some common activities that cause Golfer’s Elbow are:

  • Swinging a golf club, racquet or bat
  • Pitching or throwing a ball
  • Rock climbing
  • Lifting weights (especially bicep curls with poor technique)

If you bend your elbow to 90 degrees, you’ll notice quite a bony ‘bump’ on the inner side (called the medial epicondyle). This is where the tendons of the forearm muscles that flex your wrist and fingers attaches to. Activities that require repeated flexion and extension of the elbow along with flexion of the wrist produce micro tears in these tendons. Without sufficient rest, the damage builds up over time to a point where you’ll start to feel pain. The tendons can be sore to touch just in front of the medial epicondyle.

Golfer’s Elbow is an overuse injury which is caused by too many repetitions of the same movement. #performbetter @pogophysio Click To Tweet

Treatment of Golfer’s Elbow

Conservative Treatment:

  • Give it a rest! To prevent further damage to the tendons and encourage healing, it’s important to stop the activities that cause the pain. Note, you don’t need to stop all activities, just the painful ones.
  • Ice it! Applying ice to the painful area for 15 – 20 mins at a time, 3 to 4 times a day can be highly effective in reducing the pain.
  • Move it! Your physio will give you tailored exercises to allow you to move your elbow and wrist through full range without pain.
  • Stretch it and Strengthen it! If these treatments are effective in reducing pain, your physio will prescribe you a tailored stretching and strengthening routine to help the healing tendons become more robust.

Surgical Treatment

If you don’t get any benefit after 6 – 12 months, then surgery may be recommended, with the main goal of relieving pain

Wayne Wu
Student Physiotherapist

References

  1. Delport S, Toye A, Blommaert D, De Maeyer A, Lower R. Medial Epicondylitis. Physiopedia; 2016 [updated 2016; cited 2016 27 September]; Available from: http://www.physio-pedia.com/Medial_Epicondylitis.
  2. Dutton M. Dutton’s Orthopaedic Examination Evaluation and Intervention. 3rd ed. China: McGraw-Hill Education; 2012.
  3. Mayo Clinic Staff. Golfer’s elbow. Mayo Clinic; 2015 [updated 2015 August 25; cited 2016 27 September]; Available from: http://www.mayoclinic.org/diseases-conditions/golfers-elbow/basics/definition/con-20027964.

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