Tennis elbow and golfer’s elbow

Golfer’s elbow is a condition that affects the flexor muscles of the wrist and causes pain and inflammation to their tendons that is mostly felt along the inside of the forearm and up towards the inside of the elbow. It is common in golfers who use a tight grip while moving the club and thus apply excessive strain to the tendons of the flexor muscles – those that curl the wrist and close the fingers to make a fist. The strain is greatest at or near the top of the backswing and at the downswing just before it hits the ball. Golfer’s elbow affects not just golfers, but also baseball throwers who put a load on the elbow by straightening too forcefully, and on weightlifters when ‘rotating out’ during a snatch lift.

Tennis elbow is very common among tennis players, although it also affects people who do not play tennis at all such as bricklayers, typists and cleaners. Tennis elbow is an overuse injury caused by bending the wrist backward (extending it) as in tennis, badminton or squash. This affects the extensor muscles and tendons of the wrist and pain and inflammation are mostly felt along the outside of the forearm and up towards the outside point of the elbow.

Both of these injuries can occur suddenly after one game or perhaps after lifting a heavy object, or more common symptoms can occur within 24-72 hours of intense or unaccustomed training, such as playing with a new heavier tennis racket, playing with new and heavier golf clubs or even prolonged time spent at the computer or washing dishes.

The treatment principles for golfers elbow and tennis elbow are very similar even though we are aiming to stretch and strengthen opposing muscles with each condition.

You may be prescribed anti-inflammatory medications and in the most severe of cases, surgery may be necessary. In some cases, steroid injections may be recommended.

Recovery time may be a relatively quick 4-6 week period, but often the problem lingers much longer as the wrist continues to be used daily and is not given sufficient rest and healing time.

In the acute stages of golfer’s and tennis elbow, it is best to use the RICE formula.

  • Rest. It is important to rest the wrist to allow the injury to heal.
  • Ice. This should be applied regularly in the first 2 to 3 days to reduce pain, inflammation and swelling.
  • Compression. Wearing an elbow brace or bandage helps to reduce the load and allow the tendons to heal.
  • Elevation. This reduces swelling and inflammation.

When you come for physiotherapy treatment, we will help you identify the mechanism of injury and develop techniques to prevent future injury.

Physiotherapy intervention focuses on pain management and reduction of inflammation and we may use any one of many treatment techniques to achieve these aims such as soft tissue massage, transverse frictions, trigger point therapy, ultrasound, laser, strapping with sports tape, and gentle passive stretching and joint mobilisation. Once the acute symptoms have settled down we begin strengthening exercises. Isometric exercises (contracting the forearm without movement) will be performed initially for strengthening followed by graded resistance exercises. We sometimes use equipment such as Theraband, Theratubing and Theraputty with exercises to help you to increase wrist, forearm and grip strength. As with any injury, a gradual return to previous activity is encouraged.

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