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Golfer's Elbow
(Medial Epicondylitis)

What is Golfer's Elbow?

Golfer’s elbow is an injury to the muscles that flex your wrist and fingers. The site of injury is typically the medial epicondyle, a bony bump on the inside of the elbow where these muscles attach.

What are Golfer’s Elbow Symptoms?

Typically the golfer’s elbow sufferer will experience pain when performing gripping tasks or resisted wrist/finger flexion. Pain can also be present when the muscles are stretched. There will be tenderness directly over the bony epicondyle, and there may be trigger points in the wrist flexor muscles.
Some sufferers will also have neck stiffness and tenderness, as well as signs of median nerve irritation. Most elbow movements will be pain-free. Gripping is painful.

What Causes Golfer’s Elbow?

Golfer’s elbow is caused by damaged muscle tissue at the point it anchors to the arm bone at the elbow. It occurs when more force is applied to an area than the normal healthy tissues can handle.

In some cases such as Chronic Golfer’s Elbow, this can occur due to the soft tissues being in poor health, which are easily injured. Inflammation follows the injury, which leads to swelling and elbow pain.

What Causes Chronic Golfer’s Elbow?

Chronic Golfer’s Elbow is associated with degenerative changes in the muscle tissues located at the medial epicondyle. Although for a long time this was thought to be related to inflammation from overuse, this is now known to be incorrect.
Chronic Golfer’s Elbow is NOT due to INFLAMMATION!

How is Golfer’s Elbow Diagnosed?

Your golfer’s elbow is clinically diagnosed by your physiotherapist or doctor. After listening to your injury history and using some confirmatory clinical tests a provisional diagnosis of Golfer’s Elbow can be made.

An ultrasound scan or MRI are the best tests to identify any tendon tears or inflammation. X-rays are of little diagnostic benefit.

Referred Pain Can Mimic Golfer’s Elbow

A significant percentage of golfer’s elbow sufferers may feel pain in the medial elbow, but not actually be experiencing golfer’s elbow. There is a high incidence of medial elbow pain that is referred to your elbow from a cervical spine (neck) injury. The most common neck joint that refers to your medial elbow is C6/C7, which transmit their pain signals along the median nerve.

Your median nerve may also have reduced neural mobility, which can cause symptoms similar to golfer’s elbow.

It is extremely important to have your neck and upper limb neurodynamics assessed by an experienced physiotherapist to confirm or exclude any neck dysfunction or neural tension. Failure to do so, will result in a lack of symptom improvement and the development of chronic golfer’s elbow pain syndrome.

Who Suffers Golfer’s Elbow?

Golfer’s elbow occurs commonly in the community. It is present in golfer’s. However, it is common is repetitive manual trades where gripping is involved.

It can occur at any age, however, sufferers are generally between the ages of 35 and 50.

Predictably, the side affected is usually associated with handedness, but it can occur in the non-dominant arm. Males and females are affected equally.

Golfer’s Elbow Treatment

Physiotherapy has been shown to be effective in the short and long-term management of Golfer’s Elbow.

Physiotherapy aims to achieve a:

  • Reduction of elbow pain.
  • Facilitation of tissue repair.
  • Restoration of normal joint range of motion and function.
  • Restoration of normal muscle length, strength and movement patterns.
  • Normalisation of your upper limb neurodynamics.
  • Normalisation of cervical joint function.
Physiotherapy treatment can include gentle mobilisation of your neck and elbow joints, electrotherapy, protective strapping, muscle stretches, neural mobilisations, massage and strengthening. In some instances a Golfer’s Elbow Brace (which is a tennis elbow brace worn on the opposite side of the elbow) may be beneficial.
Your physiotherapist will discuss what treatment options are most suitable for you

What is Your Golfer’s Elbow Prognosis?

Untreated golfer’s elbows can last anywhere from 6 months to 2 years. You are also prone to recurrence. Studies have shown physiotherapy to be an effective way of managing golfer’s elbow when compared to steroid injections or giving of advice alone.

For more advice about Golfer’s Elbow, please ask your physiotherapist.

How can a Tennis Elbow Brace Help Golfer's Elbow?

A tennis elbow brace can be very effective from the moment you put it on for both golfer's elbow and tennis elbow. In these instances, the elbow brace will dissipate the stressful gripping forces away from your injured structures.

However, tennis elbow braces do not work in 100% of cases. In our experience, we recommend that you seek physiotherapy assistance in these cases. In stubborn cases, you have a very high likelihood of referred symptoms from your spine or from joint position abnormalities within your elbow. Only a thorough examination of your neck, shoulder, elbow and upper limb nerve structures will confirm your diagnosis and direct which treatment options will assist you the quickest.

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