Professional athletes need to take proper care of their health and fitness because they are more susceptible to various injuries during the course of their activities. Over-use of a body part may lead to stress injuries and these are the ones which can pose threats to the career of an athlete. An athlete, therefore, needs to maintain optimum fitness levels while preventing the risks of injuries.
Golfer's elbow is one of the most common elbow injuries. It is an over-use type injury affecting the wrist flexor muscle origin at the medial epicondyle and hence also known as medial epicondylities. Golfer's elbow is comparatively less common than tennis elbow, but commonly seen in those athletes who are involved in golf, tennis, squash, baseball, cricket and javelin throwing. In majority of cases, this condition involves the dominant arm.
What are the Clinical Features of Golfer's Elbow?
- The primary complaint is a gradual onset of medial elbow pain usually without limitation in range of motion, strength or sensation.
- The pain may be aggravated by gripping, repetitive wrist activity or by lifting.
- Localized tenderness is often present on the inner side of the elbow at the medial epicondyle.
- Resisted wrist flexion and forearm pronation will reproduce the primary complaint.
How is Golfer's Elbow Diagnosed?
Golfer's elbow is mainly detected on the basis of history and common physical tests. Along with this, imaging techniques can be deployed to check the severity of the condition and the level of degeneration. A history of advanced-level activity in which the elbow undergoes valgus (medial) stress, such as in golf or pitching or other throwing activities may also throw a hint on the existence of the condition. The pain is felt along the medial (inner) elbow, which gets worsened by throwing and resisted wrist flexion. X-rays can detect the calcification of ligament. Magnetic resonance imaging (MRI) is useful in those cases where the diagnosis is less certain or in situations in which conservative management has failed.
The Treatment of Golfer's Elbow
As in case of soft tissue injuries, initial management of golfers elbow is based on the same principle of rest and management of pain and inflammatory reaction.
- Analgesic and anti-inflammatory medications along with temporary counterforce bracing can serve the purpose of initial management.
- Physical therapy management like application of ice to relieve pain and inflammation, tapping to support and prevent stressful movement are also employed.
- Electrotherapy modalities like ultrasound and laser and electrical stimulation can be applied to promote healing and to relieve pain. In some cases, corticosteroid injections around the area of the involved tendons may provide relief if the pain is severe.
- Once the pain and the inflammation come under control, active rehabilitation is initiated along with stretching exercises for flexors and pronator group. Isometric exercises are initiated to strengthen the muscles of the forearm especially the flexors.
- Once the strength improves, more intensive resistance exercises are started. Further modification and enhancement of the throwing technique are then initiated.
The cases in which conservative management fails with at least 6 months of supervised attempt, the doctor usually recommends surgical intervention, involving identification and excision of torn and scar tissue along with the repairing of tendon.
Outcome of the Treatment
Both conservative and surgical approaches lead to excellent results in about 90 percent of the cases.
How Can You Prevent Golfer's Elbow?
Prevention is always better than cure and prevention relies on optimal pitch or stroke technique, adequate conditioning and proper stretching and warm-up prior to any specific activity or sport.
Over-use injuries like tennis elbow or golfer's elbow can come in the way of an athlete's career. If left neglected, these injuries can shatter his dreams! Early intervention can make a significant difference. The success rate is quite high and advanced medical as well as physical therapy treatments can allow an athlete to get back to his active life once again.
