GOLFERS ELBOW NEWS
(Medial Epicondylitis)
Tennis Elbow Outside of Elbow - The onset of pain, on the outside (lateral) of the elbow is usually gradual with tenderness felt on or below the joints bony prominence. Movements such as gripping, lifting and carrying can be troublesome.
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Golfers Elbow Inside of Elbow - The cause of golfer's elbow is similar to tennis elbow, the difference: pain and tenderness are felt on the inside (medial) of the elbow, on or around the joint's bony prominence.
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Bursitis Back of Elbow - Bursitis is usually due to excessive leaning on the joint or a direct blow or fall onto the tip of the elbow. Many times a lump can be seen and the elbow is painful at the back of the joint. |
Do you know if your condition has been properly diagnosed?
There are two additional strain related conditions which are
often mistaken for tennis elbow. Before we go into more detail on golfer's
elbow, let's go over the characteristics of all three ailments in order
to properly understand your condition.
Golfer's Elbow is also known as medial epicondylitis (inflammation
of the medial epicondyle) even though inflammation is not always present,
a point we'll discuss later on. A common source of pain is damage
to one or more of the flexor tendons, of the common flexor
tendon (see diagram above).
One must realize that Golfer's Elbow is not strictly a golf related injury. Any
activity or sport, whether it be recreational or work related, can cause this
injury. Repetitive stress and strain of the flexors can cause
micro tears to form in the tendons. The result is restriction of movement, inflammation
and pain. Even if the original injury heals, these areas are weak and prone
to tear again, which may lead to hemorrhaging and the formation of rough, granulated
tissue and calcium deposits in the surrounding tissues. In an acute injury,
inflammation forms when the body releases collagen into the injured area. The
pressure that results from this process can cut off blood flow and pinch the radial
nerve , one of the major nerves that supply the muscles of
the forearm and hand. Tingling and numbness can be felt in the forearm and
hand and many people complain that their hands are continually cold.
A fundamental factor in elbow injuries are tight, inflexible muscles, and fascial restrictions. Muscle connect to tendons which then attach to bone. When a muscle contracts, it shortens, pulling on the tendons at both ends. Fascia is a connective tissue seen throughout the body. Muscles and surrounding tissues are meant to glide freely on top of one another. When they are restricted, the joint they supply won't have it's optimal range of motion. When muscles are tight they are already putting load on the tendon from a resting position!
Of interest is how the grip mechanism plays a vital role in both tennis and golfer's elbow. When gripping an object we are contracting the flexors of the hand and slightly stretching the extensors. Then we ask our muscles to extend or flex the hand at the wrist. You can imagine why a tendon would tear when
a.) the muscles are tight putting load on the tendon
b.) the tendons tighten when gripping
c.) the tendons are then ask to stretch past their extreme when flexing the wrist
Think of the tendon/bone attachment as the "weakest link", most injuries occur
in that area.
Conventional treatment for Golfer's Elbow may include non-steroidal anti-inflammatory drugs (NSAIDS). As previously mentioned, inflammation is not always present. That may sound strange because the suffix "itis" pertains to inflammation. Tissue can receive tears that are not traumatic enough to cause the vascular disruption necessary for an inflammatory response, in that case a more appropriate suffix would be "osis", meaning condition of (tendonOSIS). So why give anti-inflammatory medication when inflammation isn't present? Good question. Unfortunately, tennis elbow is often mistreated and misdiagnosed. These conditions can linger on for several months, even years, if not properly treated.
Conditions that are acute and involve inflammation are
typically "easy" to treat and patients recover in a relatively short
period of time (4-6 weeks), where as non-inflammatory conditions tend
to take longer (3-12 months).
Unexplained elbow pain may be as a result of crystal deposits which may form in the elbow joints as a result of conditions such as: gout and arthritis, or as a side effect from drugs or other medications. These individuals have a high density of impurity in their blood (may be caused improper digestion of uric acid). Over time the accumulation of such impurities can crystallize and form deposits in the elbow joint. Deposits then block the circulation to the attached tendons, which in turn causes pain and loss of elasticity in the tendons.
Golfers Facts
- Each year, approximately one person in every 25 will seek
medical help for a "sports" injury, but not all of those injuries are
sustained while playing sports. Any repetitive physical activity even
walking, can injure muscles and joints
- Sports injuries are most commonly caused by poor training methods,
structural abnormalities, weakness in muscles, tendons, ligaments,
and unsafe exercising environments.
- According to Statistics Canada about 2.3 million Canadian adults
suffer from repetitive-strain injuries, and almost one-third of them
live with chronic pain.
- Cumulative trauma disorders due to performance of repetitive tasks account for more than 50% of occupational illnesses in the United States and Great Britain (1992).
Additional Links of Interest