AND POSSIBLE NEW TREATMENT OPTIONS
Bob Forman, M.S. Exercise Physiology
Certified Golf Fitness Instructor (adapted from golfitcarolina.com)
Golfer’s elbow, or medial epicondylitis, is the phrase used for discomfort on the medial or inside part of the elbow.
It literally is a pain due to the fact that the discomfort is usually slow to develop and can linger for quite some time.
Playing golf often worsens the condition and, for many, is the reason why they develop it in the first place.
One common cause for elbow pain is a lack of mobility in the shoulder joint, particularly external rotation, which often leads to a swing fault known as chicken wing.
Chicken winging typically refers to the target side elbow, or left elbow for a right-handed golfer, and is characterized by the elbow bending and remaining close to the body as it slides around the back on the follow-through (easier to see with a slow motion video).
To check for external rotation of the shoulder, stand with your arm straight out to the side and bend your elbow 90 degrees, palm facing forward.
Without moving your upper arm, try rotating the forearm back as far as comfort permits without bending or arching your back.
The goal would be to get about 10 to 20 degrees of movement backwards with the forearm. If you can’t budge from the starting position or if you can’t even get to the 90 degree starting position, your external rotation is limited.
If this occurs in your target arm you may be chicken winging.
If it occurs in the trail arm, right arm for a right-handed golfer, you could have that flying elbow in your backswing, a limited backswing, a swing plane change in your backswing, and/or it may force you into reverse spine.
Limited shoulder range of motion on either side increases the potential for tendinitis or other injury in the respective elbow joint.
One of the better exercises to help increase range of motion in the shoulder is the Open Book.
When performing this exercise, it is recommended to use light weight, no more than 2 or 3 lbs. Too much weight can cause injury and should be avoided.
Another possible cause for elbow pain may be from the imbalance many of us have in the forearm muscle groups.
Due to the fact that we are constantly gripping things, our flexors on the underside of the forearm tend to be stronger than our extensors on the top of the forearm.
This imbalance sets a person up for problems in the elbow joint, as well as the wrist.
Playing a repetitive sport like golf can aggravate the imbalance.
Moving the wrists in several different planes, while gripping the club during the swing, can wreak havoc on either or both the elbows and wrists.
Swinging the club 100 to 200 times during a round, including practice swings, and the result can often lead-up to the development of chronic pain.
A good exercise to help regain some of the balance is the finger extension. Close your fingers together and place a rubber band around the last knuckles.
Slowly open and close the fingers in a rhythmic fashion till fatigue is felt in the forearm (about 20 to 30 reps). The size of the rubber band will dictate the resistance, so start somewhat thin and work up to thicker bands.
If experiencing forearm pain, a forearm band can be worn to help reduce some of the stress to the joint while playing golf, exercising and/or just being physically active.
These can be purchased in most Exercise stores.
Icing the area after the activity is always a good idea, as well, to help retard the inflammatory process.
A good stretching routine and some mild strength exercises will help alleviate and/or prevent elbow pain. These should focus on improving the range of motion in the shoulder joint and diminishing the imbalance that may exist in the forearm.
A qualified golf fitness instructor can assess and design a program for you.
Be careful, though, if you already experience discomfort as elbow pain is a tender condition and could be further irritated with exercise. It might be a good idea to consult with a healthcare provider if the condition already exists.
Some treatment options that have shown up on the radar screen that could prove helpful include prolotherapy, PRP (platelet-rich plasma) therapy and flex bar.
Prolotherapy involves repeated injections of a dextrose (sugar) solution into the tendon, which acts to irritate the tendon, thereby provoking the body to send additional healing substances to the area.
PRP is a little more aggressive in that your own blood is drawn and spun, removing the healing platelets and injecting them back into the injury site.
Flex bar (photo below) utilizes eccentric contractions of the wrist flexors and pronators to promote, what researchers have found to be, effective healing.
If you cannot find one a small towel or Facecloth will work too.
If pain persists contact your healthcare provider to learn more about treatment options as we are starting to hear more about them.
One of these could be a viable alternative for you and may help you get relief sooner from the chronic discomfort. That, too, could help you get back out onto the golf course quicker.