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Elbow pain is a frequent complaint amongst golfers. Two of the most common causes of elbow pain are ‘tennis elbow’ and ‘golfer’s elbow’. Interestingly, tennis elbow occurs 6 times more frequently than golfer’s elbow and usually affects the lead arm. Furthermore, both of these conditions can significantly affect a golfer’s ability to play and practice. It's painful and some golfers may be unable to pick up a club or a tennis racket for 6 months or more.
Despite the fact that these conditions occur frequently, both are still poorly understood and often poorly managed. Golfers with tennis elbow will experience symptoms around the outside part of the elbow, whereas those with golfer’s elbow will have symptoms around the inside of the upper part of the forearm or elbow. The most common symptoms are pain and weakness when gripping your club.
The anatomical structures at fault are the common extensor tendon in tennis elbow and the common flexor tendon in golfer’s elbow. The extensor muscles bend the wrist backwards (extension) while the flexor muscles bend the wrist downwards (flexion).
The pain associated with tennis elbow is a result of the pathological breakdown of the common extensor tendon. This basically means there is a disruption of the collagen fibres that make up the tendon. This occurs where the extensor tendon attaches on the lateral, or outside part, of the elbow.
During the golf swing the wrist extensor muscles maintain the lead wrist in a slightly extended position during the downswing and through impact. In order to maintain this position, the wrist extensor muscles contract with a significant amount of force. It is these large forces which contribute to the breakdown of the extensor tendon at its origin.
A number of factors can cause tennis elbow in golfers, including:
- Overuse such as practising too much without sufficient rest or recovery periods in between.
- A sudden de-acceleration - such as hitting the ball fat or hitting a tree root.
- Poor grip or gripping the club too tight.
- Prolonged hitting off mats.
- Using grips that are slippery or worn.
- Other non-golfing related causes (golfer's elbow is the condition - golf is not always the cause)
This list is by no means exhaustive, but keep it in mind if you suspect you are developing the early signs of tennis elbow. As initial symptoms are often mild, many golfers continue to play through them and aggrevate the problem. It is vital to manage the problem as soon as symptoms are experienced. Progression to a chronic condition will result in significant time away from golf.
If you experience symptoms of what you think is acute ‘tennis elbow’ (i.e. symptoms <6 weeks), try to rest for a few days and trial ice over the area.
Massaging the area can help to alleviate pain and improve flexibility. However, it is important to be gentle and to avoid massaging the area too aggressively, as this can cause additional irritation and inflammation. It is also a good idea to consult with a healthcare professional before attempting self-massage for golfer's elbow or any other condition.
The key to nonsurgical treatment is to keep the collagen in your tendon from breaking down further so adequate rest as soon as you start to feel pain is critical to speedy recovery.
You should also consider whether any of the above causes may be contributing to your problem and attempt to address them. If there is no change within a week, seek help from a health professional with a good understanding of the golf swing.
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