Swing and a Miss for Elbow Pain

Following up on our last article for tennis elbow, we have another common elbow pain in the form of golfer’s elbow, otherwise known as medial epicondylitis or medial epicondylalgia.  Golfer’s elbow will typically lead to pain on the inside of the elbow, and as the name implies is quite common in golfers. Golfer’s elbow can occur in any activity that involves a lot of gripping, and is also quite common in throwing sports or manual labor jobs.

Golfer’s elbow is typically brought on by repetitive, high velocity forces going through the elbow.  These forces are referred to as valgus forces, meaning the elbow joint is moving closer to the mid-line of the body relative to the wrist and shoulder joints around it.  This force puts more stretch on the structures of the inside of the elbow, namely the flexor tendons of the wrist, but there are some ligaments and a nerve that can be affected here as well.  The commonly known Tommy John surgery is reconstruction of the ligaments in this area of the elbow. If you’ve ever hit the “funny bone,” that’s the ulnar nerve, which is a little more exposed in the inner elbow.  Here’s a nice image that shows the muscles and nerve in this area.

As you can see, pain in the middle of the elbow can come from a lot of stuff, but for the sake of this article we’ll assume it’s the tendons/muscles that are getting irritated.  In terms of treatment, things will be fairly similar to what we do for tennis elbow. Eccentric exercises are a useful tool in building up the tendons. The article on tennis elbow has a good summary on how to perform them, so refer to that (linked here) for number of reps and general instruction.  The difference is that the eccentrics will be performed in a different direction, which is shown here.  There are other things that are generally helpful for golfer’s elbow, including:

  • Massage/soft tissue work – Improving soft tissue mobility of the wrist flexors can make a big difference in the perception of pain.  Try using your other hand to massage the muscles on the inner side of the elbow all the way down to the wrist.  In an area as small as the forearm, it shouldn’t take more than 2-3 minutes. You could also try rolling a tennis ball over the area.  1-2 times per day is plenty for this, but more isn’t going to hurt anything. Chances are if you feel the need to do more, you need focus on something else, like…
  • Shoulder strengthening – Just like tennis elbow, golfer’s elbow is due to excessive force being transferred through the elbow.  Improving strength in the shoulder is a way to reduce the amount of force that gets transmitted through the elbow by using the larger (and stronger) muscles of the shoulder complex.  Try movements like rows or chest presses.  Aim for 2-4 sets of 8-15 reps, making sure those last couple reps are challenging.

Another consideration that’s beyond the scope of this article is simply what your form looks like with the activity that you’re performing.  If your elbow pain is actually from golf, you probably want to have someone check out your golf swing to see why the elbow is getting ticked off.  The same could be said with throwing, hammering, etc.

If your having trouble figuring out your elbow pain, get help!  Physical therapists and occupational therapists are the go-to people for figuring out upper body pain.

Got questions?  Feel limited in what you’re able to do?  The staff at Limitless Physical Therapy in Eugene, OR can show you how to discover your future without limits.

***The above information, including text, images, and all other materials, is provided for educational purposes only, and not as a replacement or supplement to professional medical advice.  Please contact a certified healthcare professional or your primary physician for any personal concerns.

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