What is Golfers Elbow?

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Medial epicondylitis, also known as golfer’s elbow, is a painful condition in which the tendons connecting the forearm to the elbow have become damaged due to injury or overuse. Previously thought to be a form of tendonitis, or inflammation of the tendon, medial epicondylitis is now considered to be a form of tendonosis in which the collagen fibers making up the tendon have deteriorated. Patients with this condition experience pain on the inside of the elbow that may radiate into the forearm. This pain results when the epicondyle puts pressure on the ulnar nerve, a nerve in the forearm. Most often, medial epicondylitis can be treated successfully by simple measures like resting the arm and applying ice. In some cases, however, it requires surgical correction.

While it may be caused by a single injury, medial epicondylitis is usually caused by repetitive gripping, flexing and swinging of the arm. These actions, common in golfers, cause the targeted tendons to stretch and tear. Medial epicondylitis is also frequently diagnosed in baseball pitchers, bowlers, tennis players, swimmers and individuals who do painting, raking or hammering since all of these activities involve similar arm motions. This condition is much more common in men than in women, but much less common in either than tennis elbow.The difference between the two conditions is that tennis elbow occurs on the outside of the elbow while golfer’s elbow occurs on the inside.

SYMPTOMS AND DIAGNOSIS OF MEDIAL EPICONDYLITIS

Symptoms of medial epicondylitis may appear suddenly or gradually. These symptoms may include:

  • Pain on the inside of the elbow or forearm
  • Weakness or stiffness in the wrists and hands
  • Tingling or numbness in the hand or fingers, particularly the ring finger or pinkie

The pain of medial epicondylitis may worsen with certain actions, such as swinging the arm, squeezing the hand, turning a doorknob or lifting something heavy, especially when the palm is facing downward.

DIAGNOSIS OF MEDIAL EPICONDYLITIS

Medial Epicondylitis is diagnosed through physical examination, the use of X-rays and, on occasion, other diagnostic tests such as MRIs or ultrasound.

TREATMENT OF MEDIAL EPICONDYLITIS

There are several simple treatment options for medial epicondylitis. The treatments for medial epicondylitis may include:

  • Resting the arm
  • Wearing a bandage or splint on the wrist or elbow
  • Icing the affected region
  • Taking over-the-counter pain relievers
  • Doing therapeutic exercises
  • Receiving electrical stimulation treatments
  • Taking prescribed corticosteroids orally or by injection
  • Receiving shock wave treatments of the area

The symptoms of medial epicondylitis may resolve in weeks or may persist for months. As the pain subsides, a physical or occupational therapist may suggest different ways of moving the arm to avoid a recurrence of symptoms. If the condition lasts more than 3 to 6 months, becoming chronic, surgery may be considered.

SURGICAL REPAIR OF MEDIAL EPICONDYLITIS

There are several types of surgery performed to repair medial epicondylitis. Such surgeries may be performed arthroscopically or as open surgery and are normally done outpatient with a local anesthetic. They usually take between 3 and 4 hours to complete. Most patients may return to a relatively normal routine in about 4 weeks, but may have residual discomfort, weakness or numbness for several months following surgery. Post-surgical physical therapy is usually required. Types of procedures used for surgical repair of medial epicondylitis may include:

Tendon Debridement – in which only the affected tissues within the tendon are removed, or debrided

Medial Epicondyle Release or Epicondylectomy and Ulnar Nerve Release – in which the medial epicondyle is removed, allowing the ulnar nerve to glide freely, releasing it from what is known as ulnar nerve entrapment

Ulnar Nerve Transposition – in which the forearm muscles are cut and temporarily disconnected from the epicondyle so that the ulnar nerve can be moved from behind the elbow to in front of it

RISKS OF SURGICAL REPAIR OF MEDIAL EPICONDYLITIS

While the surgical procedures discussed are considered safe, there are potential risks with any surgery which may include:

  • Excessive bleeding
  • Blood clots
  • Adverse reactions to anesthesia or medications
  • Post-surgical infection
  • Breathing problems

Risks of the specific surgeries discussed may include a condition known as chronic regional pain syndrome, or CRPS. This complication, which is rare, may cause ongoing swelling, pain, skin discoloration and stiffness.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Preventing Injuries While Golfing

Golf is a popular sport and offers a range of health benefits. Regular golf can help improve stamina, cardiovascular fitness and muscular endurance. For example, the average golfer playing an 18-hole game walks about seven kilometers. While the risk of injury from playing golf is low compared to other sports, common golf injuries include injuries to the lower back, shoulder, elbow, wrist, head and eye.

Risk factors for golfing injuries

Some of the factors that can increase your risk of a golfing injury include:

  • Time spent playing – generally, the more often you play, the higher your risk of injury. Golfers who spend more than six hours per week in competitive play are at increased risk of overuse injuries, as are professional golfers.
  • Unsupervised children – injuries to children under the age of 10 years are often the result of inadequate adult supervision (for example, children getting hit in the face by swinging clubs).
  • Incorrect technique – examples include poor swing style and hitting the ground instead of the ball. Incorrect technique dramatically increases the risk of injury. Golfers who perform correct technique are less likely to injure themselves.
  • Failure to warm up and cool down – warming up and cooling down are extremely important to reduce the risk of muscle and joint injuries.
  • Previous injury – golf can aggravate existing injuries.

Health and safety suggestions for golf

Suggestions include:

  • Make sure equipment, such as clubs and shoes, are professionally fitted.
  • Be SunSmart. Wear sun protective clothing, use SPF30+ (or higher) sunscreen and lip balm, wear an appropriate hat, seek shade where possible and wear sunglasses.
  • Insect repellent should be carried in your golf bag at all times.
  • Drink non-alcoholic fluids before, during and after the game. Take drinks with you in your golf bag to avoid dehydration during play.
  • Practice the rules and etiquette of the game. For example, make sure that no one is standing too close when you’re about to swing, and always call out ‘fore’ to warn others if your shot appears to be heading in their direction.
  • Obey all safety instructions when driving a motorized golf cart.
  • Postpone play if lightning strikes are possible.
  • Avoid placing hands in holes or areas where spiders or snakes might inhabit.
  • Supervise young children on the golf course at all times. For example, make sure they don’t stand too close when someone is teeing off and don’t allow them to fool around with golf clubs.
  • Get adequate rest between games.
  • Carry a mobile phone, wherever possible, in case of emergency.

Warming up before playing golf

Muscle strains and sprains are more likely to occur if you fail to warm up properly before play. A study of golfers undertaken by the Sports Injury Prevention Unit at Deakin University in Victoria found that less than three per cent of Victorian golfers warm up properly, while nearly half don’t warm up at all.

Suggestions include:

  • Walk briskly for a couple of minutes to raise your heart rate.
  • Warm up your neck and upper back by dropping your chin to your chest, gently rolling your head from side to side in slow half-circles.
  • Warm up your shoulders. Hold a golf club horizontal to the ground, keeping your hands about shoulder width apart. Slowly raise the club overhead, hold for a few moments and then lower. Hold the golf club in a similar way, but this time behind your back. Raise as high as you can, hold for a few moments, then lower.
  • Warm up your torso with side bends. Slide your hand down your leg to support the weight of your torso.
  • Twist through the waist – gently and slowly turn from one side to the other.
  • Go through the motions of swinging the club without actually hitting a ball. Begin with gentle half swings and work up to full swings over the course of a few minutes.

Cool down after the activity. Use the same range of stretches suggested above.

Take care of your back

Suggestions include:

  • Consider using a buggy to transport your clubs, or carry clubs using a supportive carry brace.
  • Carry out a general strength and fitness program that includes weight training or aerobic activities, such as walking or jogging, to improve muscle strength, flexibility and endurance.
  • Strengthen abdominal muscles to support your lower back. A Canadian study found that golfers with strong side abdominal muscles (obliques) have a reduced incidence of back pain.
  • Consider taking lessons with a PGA qualified coach to improve your technique to prevent injury and improve performance.

Suggestions include:

  • Don’t engage in long practice sessions, particularly if you are practicing the one shot over and over.
  • If you are practicing your putting, make sure you straighten up and stretch regularly.
  • Remember to bend your knees when picking up balls. Lift one leg off the ground as you lean over to counterbalance your weight.
  • Try not to use more force than is necessary for the swing, especially in the ‘follow through’ motion after the ball has been hit.

Treat a golfing injury promptly

Suggestions on what to do if you are injured include:

  • Stop immediately if injury occurs. Playing on will only exacerbate the injury.
  • All injured players, regardless of how severe the injury is, should seek first aid or prompt medical treatment of their injury.
  • Treat all soft tissue injures (ligament sprains, muscle strains, bumps and bruises) with rest, ice, compression, elevation (raise the injured limb above your heart) and referral to a health professional.
  • Injured golfers should not resume play until they have completely recovered from their injury.

Where to get help

  • Your doctor
  • Professional Golf Association coach
  • Physiotherapist

Things to remember

  • Common golf injuries include injury to the lower back, shoulder, elbow, wrist, head and eye.
  • Warm up thoroughly before play to reduce your risk of muscle and joint injuries.
  • Remember to bend your knees when picking up balls. Lift one leg off the ground as you lean over to counterbalance your weight.
  • Take golf lessons to improve your technique.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

GOLF INJURIES TO THE HAND, WRIST OR ELBOW

Golf Related Injuries to the Hand, Wrist, and Elbow

Description

Hand, wrist and elbow injuries are common for golfers of all skill levels. The golf swing is a complex, coordinated series of motions. Golf injuries can result from poor technique, overuse or a single direct blow, like hitting a tree root.

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