Golfer’s Elbow

Condition

Golfer’s elbow is a condition that causes pain where the tendons of your forearm muscles attach to the bony bump on the inside of your elbow. The pain might spread into your forearm and wrist.

Golfer’s elbow is similar to tennis elbow, which occurs on the outside of the elbow. It’s not limited to golfers. Tennis players and others who repeatedly use their wrists or clench their fingers also can develop golfer’s elbow.

The pain of golfer’s elbow doesn’t have to keep you off the course or away from your favorite activities. Rest and appropriate treatment can get you back into the swing of things.

Symptoms

Golfer’s elbow is characterized by:

  • Pain and tenderness on the inner side of your elbow. Sometimes the pain extends along the inner side of your forearm. Pain typically worsens with certain movements.
  • Stiffness. Your elbow may feel stiff, and it may hurt to make a fist.
  • Weakness. You may have weakness in your hands and wrists.
  • Numbness or tingling. These sensations might radiate into one or more fingers — usually the ring and little fingers.

The pain of golfer’s elbow can come on suddenly or gradually. The pain might worsen when you:

  • Swing a golf club or racket
  • Squeeze or pitch a ball
  • Shake hands
  • Turn a doorknob
  • Lift weights
  • Pick up something with your palm down
  • Flex your wrist

When to see a doctor

Consult your doctor if rest, ice and over-the-counter pain relievers don’t ease your elbow pain and tenderness. Seek immediate care if:

  • Your elbow is hot and inflamed, and you have a fever
  • You can’t bend your elbow
  • Your elbow looks deformed
  • You suspect you’ve broken a bone

Causes

Golfer’s elbow, also known as medial epicondylitis, is caused by damage to the muscles and tendons that control your wrist and fingers. The damage is typically related to excess or repeated stress — especially forceful wrist and finger motions. Improper lifting, throwing or hitting, as well as too little warm-up or poor conditioning, also can contribute to golfer’s elbow.

Many activities can lead to golfer’s elbow, including:

  • Golf. Gripping or swinging clubs incorrectly or too forcefully can take a toll on your muscles and tendons.
  • Racket sports. Excessive topspin can hurt your elbow. Using a racket that’s too small or heavy also can lead to injury.
  • Throwing sports. Improper pitching technique in baseball or softball can be another culprit. Football, archery and javelin throwing also can cause golfer’s elbow.
  • Weight training. Lifting weights using improper technique, such as curling the wrists during a biceps exercise, can overload the elbow muscles and tendons.

In addition, any activity that requires repeatedly bending and straightening your elbow can cause golfer’s elbow. This includes painting, raking, hammering, chopping wood, using a computer, doing assembly-line work and cooking. A day or two of yardwork or cooking for company usually won’t cause golfer’s elbow, though. The activity generally needs to be done for more than an hour a day on many days to cause a problem.

Treatment

The sooner you begin treatment, the sooner you’ll be able to return to your usual activities.

  • Rest. Put your golf game or other repetitive activities on hold until the pain is gone. If you return to activity too soon, you may make it worse.
  • Ice the affected area. Apply ice packs to your elbow for 15 to 20 minutes at a time, three to four times a day for several days. To protect your skin, wrap the ice packs in a thin towel. It might help to massage the inner elbow with ice for five minutes at a time, two to three times a day.
  • Take an over-the-counter pain reliever. Try ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, others) or acetaminophen (Tylenol, others).
  • Use a brace. Your doctor might recommend that you wear a counter force brace on your affected arm, which might reduce tendon and muscle strain.
  • Stretch and strengthen the affected area. Your doctor may suggest stretching and strengthening exercises. Physical or occupational therapy can be helpful, too. A type of strengthening (eccentric) that lengthens the tendon of the wrist extensor muscles has been shown to be particularly effective in treating chronic tendon irritation.
  • Reduce the load on your elbow tendons. Wrap your elbow with an elastic bandage or use a splint.
  • Gradually return to your usual activities. When your pain is gone, practice the arm motions of your sport or activity. Review your golf or tennis swing with an instructor and make adjustments if needed.
  • Ask your doctor when surgery is appropriate. Surgery is seldom necessary. But if your signs and symptoms don’t respond to conservative treatment in six to 12 months, surgery may be an option. A new procedure involves minimally invasive, ultrasound-guided removal of scar tissue in the region of the tendon pain. More study is needed.

Other treatments used include corticosteroid injections, which have not been shown to be an effective long-term treatment. (1p7) A newer treatment being tried is platelet-rich plasma. This involves drawing a small amount of your blood, spinning it down and injecting it into the tender area. More studies are needed.

Most people will get better with rest, ice and pain relievers. Depending on the severity of your condition, the pain may linger for months to years — even if you take it easy and follow instructions on exercising your arm. Sometimes the pain returns or becomes chronic.

Source: Mayo Clinic

Staff

Matthew Wert, MD
Orthopedics
Patrick Jean-Pierre, MD
Internal Medicine, Anti-Aging Medicine

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