Elbow pain impacting your golf swing? | Total Performance Physical Therapy

Elbow pain impacting your golf swing?

June 6, 2019

Golf Related Injuries:

With the recent occurrence of the U.S. Open, many individuals are probably feeling the urge to dust of their clubs and play some golf.  Before heading out to the greens it is important to be aware of common injuries that can occur in golfers and ways to help prevent them.  Low back pain, shoulder injuries, elbow injuries, and wrist injuries are all common occurrences in both professional and amateur golfers.

Medial epicondylitis is pain on the inside of the elbow, commonly called golfer's elbow.
Medial epicondylitis is pain on the inside of the elbow, commonly called golfer’s elbow.

Low back pain is the most common injury observed in golfers. During a golf swing, powerful rotation and extension happen in the back. Using proper mechanics during your golf swing can help decrease the chance of injuring tissues in your back. Proper posture and a smooth swing will help decrease the chance of golf related back injuries.

Elbow injuries are the second most common injury found in those who golf. Golfer’s elbow, or medial epicondylalgia, is an injury that can occur due to poor swing mechanics or hitting the ground before the ball. Medial epicondylalgia causes pain on the inside of the elbow joint. Less commonly seen in golfers is lateral epicondylalgia, which causes pain on the outside of the elbow.

Stretching and strengthening programs can prevent these common injuries from occurring. A proper warm up before hand can also decrease injuries in golfers.  One study found that individuals that warmed up prior to golfing had less than half the incidence of injuries compared to those who did not complete a warm up. When these injuries do occur physical therapy can help rehabilitate individuals back to prior levels of function. It is important to seek out physical therapy as soon as injuries arise in order for them to be addressed so they don’t become chronic issues. Low back pain and elbow related injuries can often become long-term nuisances if not treated right away.

Medial epicondylalgia:

In the general population, the overall occurrence of medial epicondylalgia is much less than lateral epicondylalgia. However, individuals who golf experience medial epicondylalgia at a much higher rate. Medial epicondylalgia occurs as a result of microtears that occur in the muscles that attach to the inside boney aspect of the elbow joint, or medial epicondyle. These small tears are most commonly caused by repetitive stress placed on these muscles. Medial epicondylalgia can also occur due to a single traumatic event involving the elbow, such as hitting the ground before the ball during a golf swing.

Symptoms of medial epicondylalgia

Pain on the inside of the elbow joint is the most common symptom observed in those with medial epicondylalgia. The pain can often be experienced on the palm side of the forearm from the elbow to the wrist. Individuals can also have pain in the elbow and decreased strength during wrist flexion activities as well as during activities where the individual squeezes objects with their hand. 

Treatment of medial epicondylalgia

Initially, rest and the cessation of aggravating activities are used to treat this condition. Physical therapy can be used during the initial stages to help alleviate symptoms, initiate the healing process, and begin to strengthen surrounding musculature. A physical therapist will design individually based treatment programs for those with medial epicondylalgia to focus on deficits that may be contributing to the cause of the condition. Once the initial healing takes place and the symptoms experienced by the patient are not as severe, a strengthening program will begin. This program will focus on the strengthening muscles of the forearm that attach at the medial epicondyle.

Strengthening is important to ensure appropriate healing at the tendons and other involved musculature occurs. By loading the tendon with appropriate strengthening exercises it will allow the tissues to withstand forces that will be placed on it during everyday use and recreational activities. First, the tendons will be loaded using minimal force and then progressing to increased forces being placed on the tendon. Concentric training as well as eccentric training will be used to strengthen the involved muscles. Concentric training involves exercises where the muscle contracts by shortening in length while eccentric training involves the lengthening of a muscle while placed under tension. Injuries occur most frequently during eccentric contractions so it is important to train your muscles eccentrically to help prevent injuries from occurring. Modalities such as hot packs, cold packs, electrical stimulation, and ultrasound are also used in this condition to facilitate the healing process. Once strength gains are made a physical therapist will progress you towards participation into golfing and other recreational activities.

Call Total Performance Physical Therapy today to resolve your golfing pains!