Have you ever suffered pain in your elbow, particularly during a round of golf, or after a few rounds in a short period of time?
If so, there’s some chance it was a condition called golfer’s elbow causing the problems. As you may have guessed, the condition is known as golfer’s elbow because the motion of a golf swing is often a contributing factor to it.
In scientific terms, golfer’s elbow is the tendinitis of the medial epicondyle. Most of you probably don’t know what this means, so I’ll explain further.
The medial epicondyle is a small bony bump on the inside of your elbow, and is the point of attachment for a bunch of tendons in the forearm which help to operate your fingers and wrist. When someone has golfer’s elbow, this point of attachment becomes inflamed, causing pain when certain movements are performed.
As you may have guessed, this can be problematic for golfers, as many of the muscles used in gripping the club and performing a swing can be compromised by this inflammation in the elbow.
It isn’t a problem exclusively reserved for golfers, and there are many other groups within society which are prone to the condition. People who work in certain manual trades, for example, often suffer from it as a result of the need to regularly grip objects.
It is, however, very commonly seen in those who play the game a lot, and can have a direct impact on your ability to play to your best. For that reason, it’s best to have a bit of an understanding about how it happens, how to diagnose it, and what to do if you do suffer from it.
The Definitive Guide to Golfer's Elbow
Symptoms of Golfer’s Elbow
Golfer’s elbow can present itself in a variety of different forms. Generally, these symptoms aren’t excruciatingly painful, but they can be irritating and prevent you from properly performing a range of tasks that you would normally be able to do without a second thought.
Unfortunately, one of these tasks is playing golf, with the inflammation of the medial epicondyle causing pain both when you grip, and when you swing.
Much of the pain will occur at the site of inflammation. This means the inside of your elbow will feel sore and tender, particularly when you make a gripping motion with your hand.
This, of course, means that every time a sufferer of golfer’s elbow makes their normal gripping motion prior to making a golf swing, they’ll feel pain in their elbow. Not an ideal setup for an important shot!
Unfortunately, this pain is not entirely limited to the elbow, and in many cases it will also extend further down the forearm.
The problem may also present itself in the form of stiffness, particularly when making a hard gripping motion, and again, this is something which can make it difficult to swing a golf club in the way you normally would.
Golfer’s elbow can also cause you to lose a little bit of strength in your hands and wrists.
This, of course, can have a major impact on your golf swing - though maybe if you are prone to gripping the club too tightly, maybe this could actually be a benefit! Realistically though, no one wants to have to deal with these symptoms when playing golf, and it can make it much more difficult to enjoy the game and put up a decent score.
Another symptom is numbness and tingling within the fingers. This can feel a little like pins and needles, but can be identified as separate through its persistence.
Generally pins and needles in the hand will only occur after you cut off the blood flow to the region, and will go away relatively quickly. Golfer’s elbow, unfortunately, is not so forgiving. Further helping us to identify golfer’s elbow through numbness and tingling is the exact location of these feelings; the ring finger and the little finger are most prone to the sensation.
These symptoms may present themselves even when you aren’t doing anything to aggravate them, but generally the pain, tenderness or stiffness will intensify when performing certain movements or exercises.
Swinging a golf club is just one such example. More everyday movements such as shaking hands, turning a doorknob, or throwing a ball can all contribute to the symptoms of golfer’s elbow rearing their head. Simply bending your wrist downwards against resistance can cause pain, as can rotating the wrist inwards.
Clearly, it’s a pretty irritating condition, and has the capacity to permeate your everyday life.
Somewhat counter-intuitively though, there is usually no pain as a result of elbow movements. Occasionally some specific movements can cause discomfort at the point of inflammation, but as a general rule, the symptoms of golfer’s elbow don’t present themselves strongly when the sufferer bends their elbow.
There can also be some referred symptoms as a result of the condition. Sometimes, sufferer’s of golfer’s elbow will have stiffness and tenderness in their neck - obviously well away from the actual site of the problem! There can also be pain throughout the median nerve. For those of you who aren’t doctors, this is a large nerve which runs right down the upper arm, forearm, and into the hand.
Generally, the pain which arises from golfer’s elbow becomes worse as the condition develops. It is a progressive problem, and usually begins as a slightly irritating sensation. As it gets worse though, this niggle will turn to discomfort, and the discomfort eventually to pain.
Clearly, there is a pretty wide range of symptoms which can arise from tendonitis in the medial epicondyle; aka golfer’s elbow. Most of them are confined to the region which is affected, with the elbow, forearm, hands and fingers the areas most likely to be affected.
This can present in a number of ways, from pain to weakness to tingling, all of which are sensations people would rather not have. At best they’re annoying, and at worst they’re pretty painful, and all of them are signs of golfer’s elbow.
Other symptoms can impact other parts of the body, as mentioned, as far away from the site of the problem as the neck.
Of course, many of these symptoms are your body’s way of telling you that something is wrong, but when you start feeling pain in your elbow as soon as you pick something up, it would be nice to be able to tell your body that you already know!
The stiffness, tingling, and loss of strength are the physical result of the condition, and are the symptoms of the condition which are most likely to impact your score out on the golf course.To know how to best avoid it it’s necessary to understand the causes of golfer’s elbow, which is what we’ll cover in the next section of this definitive guide.
Causes of golfer’s elbow
There are a number of reasons why individuals can develop golfer’s elbow, but essentially, most of them boil down to overuse. Overuse of the involved tendons can occur from a number of different movements, but there are a couple which are more commonly the predominant cause for the development of the condition.
Repeated bending of the wrist is one such example, and is one which highlights why golfers are so prone to the condition. Swinging a golf club involves continual bending of the wrist; your backswing, your downswing and your follow through all require wrist flexion to be properly executed.
Think about how many times you do this in a single round - depending on how good you are, you could easily be taking upwards of 50 full swings a round. Of course, you also need to add in all the practice swings you make - for the average player this is probably one, sometimes two per shot. Don’t forget the warm up you had before the round, where you maybe hit 50 balls.
All up you’re potentially looking at close to 200 full swings in a single day of golf, with each of them resulting in a number of wrist bends. It’s not surprising the involved tendons get a little sore.
Other similar sports, in particular racquet sports, demand similar actions which also result in continual wrist flexion, combined with constant gripping.
Sports like tennis and squash use similar movements as golf and as a result can also cause golfer’s elbow. Interestingly enough, there is another condition known as tennis elbow, which is essentially the same thing except the inflammation is in the tendons on the outside of the forearm.
Despite that, tennis players are still particularly vulnerable to golfer’s elbow - figure that one out!
As mentioned though, it isn’t only golfers who get golfer’s elbow, and it isn’t only golf which can cause it. There are many other activities and actions which increase your likelihood of developing the condition.
For example, throwing can be a major cause of it. This is, of course, a major part of many sports. Imagine the schedule of a baseball pitcher. Not only do they throw hundreds of balls throughout the course of a game, their training schedule is invariably centered around throwing.
In any single week, a pitcher playing a high level of baseball might throw thousands of balls per week, which obviously increases their likelihood of getting the condition.
Activities which require you to continually bend and straighten your elbow can also cause inflammation. This covers a wide range of activities, but generally you won’t suffer from the condition unless you are undergoing such an activity on a regular basis.
Raking the leaves in your backyard, for example, requires significant bending and straightening of your elbow. That alone won’t normally be enough to cause golfer’s elbow though, as you’ll usually only be doing it for a relatively short period of time, and once every few days at most - unless you live under a large number of very big trees!
Weight training is another activity which can cause golfer’s elbow due to the continued bending of the elbow which it demands, and the regularity with which some people undertake the activity. Many people undertake this training upwards of three times per week and sometimes nearly every day, meaning the demand on the upper limb can be pretty significant.
Even more so, people who work in a profession which demands them to make these strenuous movements on a repeated basis are often very prone to the condition. Manual occupations like carpentry, construction, or virtually any physical trade jobs, often demand people to repeat the same action over and over again on a daily basis.
Take, for example, a painter, who might spend up to eight hours a day repeatedly bending and straightening his elbow. Do this five days a week for an extended period of time, and there is a significantly heightened chance of developing golfer’s elbow.
Clearly many of these causes result from activities which are unavoidable. If you’re a bricklayer, the simple fact is that you’re going to be regularly doing things with your arms which will put you at higher risk.
If you paint for a living, your elbow is going to get a workout on a regular basis, and it’s going to be much more likely that you develop golfer’s elbow.
Consider also that many people undertake many of these activities in a given week. Imagine you’re a painter who also works out, and loves a round of golf every week! That is a lot of repetitive stress on your elbow, and in these cases it’s not surprising that a bit of inflammation occurs.
The casual golfer, of course, has a little bit more say in how often they play golf compared to how often someone does their job. However, very few people are going to reduce playing a sport that they love to avoid a condition which they may never get.
To minimize the likelihood of developing it, there are some minor things you can do that can have a major impact.
The easiest, and potentially most significant, of these, is to simply warm up properly. Don’t turn up to the practice range and hit 100 balls without doing any prior warmups. Likewise, don’t turn up to the course and, with no warm up, hit hundreds of balls in a single day.
Do some simple elbow movements to get the tendons ready for action, and it will probably benefit you.
Risk Factors and Complications
There are a number of factors which can place certain groups at a higher risk of suffering from golfer’s elbow. Of course, the most obvious of these, and one which we touched on in the previous section, is repetitive use.
If you are someone who repeatedly performs activities which place stress on the relevant regions for extended periods of time for a number of days during the week, you have a significantly higher chance of developing symptoms of golfer’s elbow.
Unfortunately, this means that ardent golfers are more likely to get golfer’s elbow, particularly if they are playing three or four times a week. If you’re a once a week golfer, then golf alone isn’t going to cause you to develop golfer’s elbow.
It can, however, be a contributing factor when combined with other strenuous repetitive activities, such as physical labor jobs or other racquet sports.
Repetition isn’t the only factor which can place you at an increased risk of developing the condition though. Older individuals are also more likely to get it, as are smokers and obese people, while those who have had direct injuries to the elbow in the past are as well.
Some of these are, of course, not exclusive to golfer’s elbow, as these are risk factors for numerous diseases and conditions.
Since some of these factors are difficult to manage, you may like to implement some behaviors that will minimize the risk they pose. For example, if you repeatedly place strain on your forearm muscles through your work, you can attempt to balance this fact by taking frequent breaks.
If you are a smoker or overweight, or simply love to play golf as often as possible, try undertaking exercises which strengthen your forearm muscle. This can minimize the stress which repeated movements, such as those required for golf, will place on the involved tendons.
If you are unlucky enough to develop the condition, there are obviously certain things you need to do in order to reduce the impact it has on your life, and ultimately get rid of it. We’ll touch on these in greater detail in the following section, but for now we’ll take a look at some of the complications can develop if it’s left untreated, or not properly managed.
As mentioned in earlier sections, as the condition develops, the pain and discomfort it causes becomes greater, and you can end up with weakness in the wrist, hand and fingers. Ultimately, this can lead to chronic elbow pain, which can begin to really impact your life.
You can also suffer from a limited range of motion within your wrist and fingers as a result of golfer’s elbow if it isn’t managed properly. Finally, a permanent bend in your elbow can be caused by the condition, limiting your ability to properly straighten your arm.
Fortunately, these complications are relatively rare, and are easily avoided if managed properly. They certainly don’t sound particularly appealing though, so it’s important to ensure that, if you do develop the condition, you undertake the proper measures to allow your elbow to heal to the fullest extent possible, and that’s exactly what we’re going to touch on in the next section.
Golfer’s Elbow Treatment
Golfer’s elbow isn’t something that is going to miraculously heal itself with a quick fix solution, but there are plenty of things that you can implement to reduce its impact, and ultimately get rid of the problem all together.
As with most problems, there are medications which can help to minimize inflammation and reduce pain, but since we aren’t doctors we won’t delve into the specifics of these. This should also be used in conjunction with other treatments as listed below, and only on the advice of medical professionals.
The simplest way to treat golfer’s elbow is rest. This isn’t necessarily what everyone wants to hear, particularly die-hard golfers who want to be out on the course at every spare moment. It is, however, the most effective way to reduce the level of inflammation, and in turn pain.
Resting does not necessarily refer to the elbow itself, with the wrist also needing a little bit of time off to heal. This means there are a number of activities which are best avoided, rather than only golf.
In general, try to avoid any sports which are going to place undue demand on the wrist, forearm and fingers. This includes tennis, squash, and virtually all other racquet sports. This is particularly the case if you’re an avid golfer.
If you want to continue getting out on the course as often as possible, it’s best not to place even further demands on the injured area by playing other sports. In contrast, if you’re willing to spend a bit of time off the course in order to allow the condition to heal, there’s no point compromising that by playing other sports which are equally as damaging.
Likewise, if you have hobbies such as painting, building, or any other physically demanding activity, you will give your body the best chance to heal if you give them a rest for a period of time. This doesn’t mean giving them up entirely, and it’s important to remember that it’s a minor sacrifice to make now in order to ensure you don’t have to make much bigger sacrifices in the future.
Of course, if you have a job which requires you to use your wrists a lot - be it a labor job, or even a job which requires you to sit at a computer typing - then it isn’t really feasible to cut that out of your life. What you can do is ensure that you take sufficient breaks to reduce the amount of stress on your wrists and forearms, and even partake in some forearm strengthening exercises.
Physiotherapists can often be of great benefit to sufferers of golfer’s elbow as well.
They can use forms of electrotherapy in order to reduce inflammation, subsequently minimizing the impact of your condition. If done right, this can reduce pain, and prevent you from suffering weakness in your hands and fingers.
Other than this, physiotherapists can also help by massaging the affected tendons and surrounding muscles. Often, sports massage applied to the forearm muscles can have a major positive impact, reducing the tension in the muscles and ultimately at the elbow. Like with electrotherapy, this will help to reduce the severity of the symptoms.
These physiotherapy aids cannot be expected to entirely eliminate the problem immediately, but they can certainly have a profoundly positive impact, and used in conjunction with the other forms of treatments, ultimately help to get rid of the problem.
Often, if there is significant pain at the elbow and surrounding areas, principles need to be applied to reduce the pain more immediately.
The best suggestion for doing this is to follow the PRICE principles. For those of you who aren’t familiar, this stands for protection, rest, ice, compression and elevation. This may occur after strenuous use of the damaged area; for instance, after a game of golf.
Protect it by ensuring nothing is going to cause any blunt force trauma to the damaged area. Resting it is straightforward enough, and as mentioned before is probably the single most important factor in ridding yourself of the condition.
The final three steps are straightforward enough. Apply ice to the painful area for around 15 minutes out of every hour, before reducing this to 3 to 4 times a day in the ensuing days. Likewise with compression, which can come in the form of a compression wrap around the affected area.
None of these treatments, if applied in isolation, or if applied without full commitment, are likely to result in the elimination of symptoms. Of all of those mentioned, rest is certainly the most effective one, as it will allow the affected area time to heal on its own.
It is not, however, entirely feasible for many people to completely stop using an arm and a hand, and even for those who do have the choice, they may not want to completely stop playing golf, or whatever other hobby they may have which has the capacity to worsen the injury.
In this case, the most important thing is not to continue to overuse it. If you’ve developed the condition after suddenly increasing the regularity with which you play golf to four times, a week, don’t continue to play four times a week. Try reducing this, even to a couple of times a week, and see if there is any tangible impact.
Furthermore, when the area isn’t in use, ensure you commit to the other forms of treatment. Try to give the area as much rest as possible when it isn’t absolutely necessary that you use it, and apply the PRICE principles if you’re feeling significant discomfort.
Likewise, going to see a physiotherapist in conjunction with the application of the other treatment forms can be a great step on the path to a complete cure. Not only will they be able to apply certain treatments that you can’t do yourself, but they will also be able to give you sound advice about what to do outside of the physiotherapy clinic.
As registered medical professionals, their suggestions and advice should be followed. Likely it will be similar to the treatments listed here, but they will be able to see how your elbow is reacting to the treatments its receiving, and whether anything should be adjusted in order to help it heal better.
Ultimately, treating golfer’s elbow isn’t as easy as a single solution, but it’s not extremely difficult either. The treatment is more around management than an immediate cure, and if you follow the treatment paths which you choose to take, or which are suggested to you by a physiotherapist, you will likely see a gradual reduction in the severity of the symptoms.
Hopefully, this reduction eventually results in a complete elimination of the problem.
Golfer’s elbow isn’t something that you want to be faced with, but unfortunately many golfers are. It comes about through repeated stress being placed on the elbow, forearm and hand area, which is a part and parcel of golf.
This doesn’t mean that golf is the only way the injury can occur though, and often it is a combination of factors. These can be as wide ranging as playing a lot of sport, working in a manual trade, working with a computer, or anything else which requires you to use your hands and wrists a lot.
The condition itself usually causes some pain and discomfort, but as it progresses can result in more severe pain, and some weakening and tingling at the wrists and fingers. It is a condition which develops slowly and is eradicated slowly, meaning it is unlikely to manifest itself very suddenly - nor is it likely to go away with a click of the fingers.
The disease can be managed through the implementation of a few simple steps, but if it isn’t done properly it can result in some longer term difficulties. These include chronic elbow pain, a reduced range of motion in your wrist and fingers, as well as a chronic bend in your elbow.
If you do suffer from the condition though, following a few simple steps should, at the very least, prevent it from getting worse. Seeing a physiotherapist is a great way to start, as they will be able to provide you with not only some tangible treatment if necessary, but also good advice.
Likely, the best of this will be to rest the affected area. This doesn’t mean stopping use of it completely, as generally this isn’t feasible for most people, but ensuring you don’t continue to overuse it will help it from progressing to a much more developed stage.
Golfer’s elbow can have a significant impact on not only your golf game, but your life in general. Fortunately most sufferers are able to manage it relatively well, and if the treatment steps are properly followed, you should be able to continue swinging your clubs until a ripe old age without too much trouble.