Opinion

Alexander: ‘Golfer’s elbow’ hindering your golf game?

Posted 1/18/22

You are humming along, just finished playing a round of golf, when you pull up to the cart drop-off. You reach to grab your bag off the cart and wham, pain on the inside of your elbow makes you drop …

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Opinion

Alexander: ‘Golfer’s elbow’ hindering your golf game?

Posted

You are humming along, just finished playing a round of golf, when you pull up to the cart drop-off. You reach to grab your bag off the cart and wham, pain on the inside of your elbow makes you drop the bag right back onto the cart.

“What the heck was that pain? Did I break something? How am I going to get this golf bag to my car?”

Those are some common questions I have heard from some of my golf patients who ask themselves “what in the world?” when they get a sudden jolt of pain on the inside of their elbow, sometimes radiating downwards all the way into their forearm. It comes as a shock. It can develop over time and come on gradually or it can catch you by total surprise. Definitely not how you envisioned spending the day on the golf course or the feeling you thought they would have as you shot throughout the day.

But, I have some good news for you. I know what the likely culprit is and I can help.

The pain is most likely coming from something called golfer’s elbow. It is unfortunately a fairly common injury that a lot of golfers get. If you have played enough golf, I am sure you have heard of the term or have experienced some lighter version of this pain. For example, soreness on the inside of the elbow after hitting two practice rounds during the week to get yourself ready for a charity (supposed to be non-competitive) golf tournament over the weekend. Or maybe you have put yourself in a tough situation under a tree. You are not looking to take a drop so you tried chopping the ball out onto the fairway. Instead of hitting the ball, you make excellent contact with the tree root. Even if you are not willing to admit it publicly, I’m guessing you know how awesome that feels.

If you have experienced this before or are experiencing this pain now, you are not alone. golfer’s elbow (aka medial epicondylitis/epicondylalgia) is a form of tendinopathy and it is the most common cause of medial elbow pain. It is seen in 10%-20% of all epicondylitis diagnoses. And, it is most common in adults older than 40.

Presentation:

  • Pain on the inside of the elbow, especially during maximal gripping or explosive motions (i.e. golf swing).
  • Usually in the trailing arm for golfers (right arm for right-handed golfers, left arm for left-handed golfers).
  • Tender to touch around the inside of your elbow, more prominently around the bone.
  • Pain when performing resisted wrist flexion activities.

Mechanism of injury:

  • Overuse: This typically occurs when you suddenly increase your swings in a given time period, especially off hard surfaces such as mats. This is the most common form of golfer’s elbow because of all the amateur golfers there are. The amateur golfer spends most of the week sedentary and then picks up his sticks, expecting to play at least one round over the weekend when the weather is nice. This leads to a sudden increase in activity that the muscles surrounding the elbow they were not ready for because they had not been previously training that motion.
  • Traumatic: This pain occurs when you hit the ground fat, digging the sand wedge into the sand, or hitting a tree or cart path. Basically, when you swing and come to an abrupt stop. This puts a tremendous amount of tension on the tendons in your elbow. The torque on those tendons is maximized when you forcefully contact the golf ball or whatever else is in the path of your swing at that moment (ie: not the golf ball as intended). Pain is a physical response to those tendons absorbing that shock from the point of impact when the golf club meets an opposing force.

Being able to differentiate between the two mechanisms will significantly enhance your treatment plan as these injuries are not the same.

Why worry about golfer’s elbow?

As mentioned, golfer’s elbow is a form of tendinopathy. Tendinopathy occurs due to a microtrauma to the tendon which can be a direct result of a pattern of overuse or more uniquely from a specific traumatic injury that occurred during a particular swing. The body, and in this case more specifically the tendon, is actually really great at trying to repair itself on its own. Imagine getting a paper cut on your finger — the same basic principles apply. Our body does a great job of utilizing various biological systems that work in unison to optimize functions. Our body tries its best to repair the microtrauma immediately, but if you keep injuring the tendon with the same repetitive motions over and over again, it can have a hard time keeping up with the repairs.

If you think you have golfer’s elbow, it is imperative to seek treatment right at the first signs of pain/discomfort. Tendinopathy can be progressive and make it harder to treat. But do not be discouraged. Your golf season is not over just because you are feeling this pain in your elbow.

If you are looking to get your swing back, complete a pain-free round of golf and be able to still pick up your bag at the end of your round, please reach out and schedule a consult to see what kind of golfer’s elbow you may have. If you want to learn more about the aches and pains of your game, check out our website at sparkperformancept.com. I have written a few articles that are specific to you, the golfer.

Don’t let golfer’s elbow be something that keeps you off the green. Send me an email at salexander@sparkperformancept.com and give me a call at 480-452-9191 to schedule an appointment with me so I can help keep you from being the designated golf cart driver instead of enjoying a great game with your golf buddies.

Editor’s note: Dr. Steven Alexander is owner and lead physical therapist at Spark Performance & Physiotherapy, 6056 E. Baseline Road Suite No. 147 in Mesa.

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