Golfer’s elbow, more technically called medial epicondylitis, is a similar type of condition to tennis elbow or lateral epicondylitis, but is less common. Since there is little or no swelling present in these syndromes, they are called tendinopathies, where degeneration of the tendon happens and gives symptoms. Typical aggravating factors are racquet sports, golf and sports which involve throwing, though other sports folks may be affected such as weight lifters, archers and cricket bowlers. The muscles which flex and rotate the forearm originate over the medial epicondyle, the bony prominence on the inside of the elbow, with the tendon anchored into the bone by the tendinous insertion.

The agony occurs close to this and should be because of a deteriorative process occurring in the tendon, as little swelling has been noted in cases like these. High pressures happen in the cocking phase of a throw and in the successive acceleration, and in the golfing swing from high backswing down to near the ball strike.

Golfer’s elbow isn’t as common as tennis elbow but is the commonest cause of medial elbow pain with about half as many girls affected as men. The third to 5th decades of life are the commonest periods for discomfort onset and 60% of golfer’s elbow happens in the dominant hand. An acute onset of pain is reported in a 3rd of patients, with the other two-thirds developing over a period of time.

Patients bitch of aching pain over the front of the inner epicondyle, worse with repeated wrist flexion and better with rest. Pain can occur in the shoulder, elbow, forearm or hand, with weakness in the lower arm and hand also. The physio palpates the ulnar nerve in the groove behind the elbow, called the’funny bone’ when it’s hit. An example is modifying the golf swing mechanics to avoid setting the difficulty off continuously. The patient is taught to avoid irritating positions and activities, such as leaning on the elbow if there’s nerve involvement. As the problem settles and becomes sub acute the aims change to improving flexibility by stretching, accelerating strength and ordinary activities. Once the difficulty is chronic the programme continues with reduced utilisation of the splint and re-introduction of sporting activities.

Scientific work shows that steroid injections can be useful in the early stages of golfer’s elbow to reduce agony and the time to recovery, but they’re also utilized in chronic eventualities. The surgeon takes away the unusual tendinous tissue and if the ulnar nerve is concerned may move it around to the front of the elbow from its posterior groove.
Correction of sporting method,eg the golfing swing, is best achieved by engaging a pro instructor who can also advise on stretches, fitness work and muscle strengthening. Sportsmen should warm up well before sport and stretch effectively later, selecting good method and choice of appropriate kit. Doctors and therapists may wish to monitor patients, particularly sportsmen, awfully meticulously as they tend to continue to perform through the discomfort.

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Tags: Golfer's elbow, golfing swing

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