Many recreational golfers may experience pain on the inside of their elbows. This condition usually presents with tenderness and also with restricted wrist motion in the direction of the palm. It happens when the muscles that bent the wrist or elbow become inflamed or irritated. Generally the inflammation occurs with repeated movements of the wrist and elbow joints.
Though the disease named golfers’ elbow but it can happened with the people who are working for a long time on desktop also with home makers.
Overview of the disease:
Patient complains pain around the elbow joints in both Golfer’s elbow and tennis elbow cases. In tennis elbow the pain occurs on the outside of the elbow and in golfer’s elbow the pain occurs on the inside of the elbow.
Causes:
- Forceful and repetitive occupational movements.
- Improper pitching technique.
- Improper technique when lifting weights.
- Excessive use of wrist and elbow.
Risk factor:
- Golfers.
- Age over 40.
- Obesity.
- Smoker.
- Diabetes.
Sign & symptoms:
- Pain usually felt inner side of forearm.
- Tenderness.
- Stiffness.
- Numbness or tingling sensation.
- Weakness may develop in hands or wrist.
- Sometimes local temperature may raise or patient may have a fever.
Clinical examination:
At first patient indicates pain on medial epicondyle. There is also some physical tests to confirm Golfer’s elbow. Such as:
- Palpation
- Cozen’s te
- Mill’s test:
- The patient should be seated on a chair and his/her fingers should be placed on a flexed position in a table. The examiner palpates the medial epicondyle with one hand and grasps the patient’s wrist with his/her other hand. The examiner then passively supinates the forearm and extends the elbow and wrist. A positive test would be a complaint of pain or discomfort along the medial aspect of the elbow.
- Resisted extension of middle finger.
Investigation:
- X-ray : To check out the bony conditions of the patient.
- CT scan
- MRI.
- Musculoskeletal ultrasound: To check out ligament, muscles and tendons tear.
Treatment:
Acute phase : In an acute condition patient needs to take rest and icing the area 10-15 minutes for two times a daily.
Chronic phase: In chronic condition patient must concern with a physiotherapist for better solution.
A physiotherapist will apply two types of treatments. They are:
Manual:
1: Activity modification: A physio will find out the improper techniques for which he/she suffers from the disease. Also the physio will correct his/her functional techniques .
2: Range of motion improving exercises: After checking ROM of the affected region physio will improve the condition of restricted motion.
3: stretching exercise:
4: Strengthen muscle: Because of restricted movements the flexor group of muscles develop weakness. So it’s very important to strengthen them.
Electrical:
- UST- It is a sound wave which passes through in deep tissues and make a resonance that increase blood circulation and release pain.
- TENS- Electromagnetic wave that helps to reduce pain.
- HIL- Helps in deep penetration and reduce pain.
- ESWT- Incase of chronic condition ESWT helps to create micro trauma and also helps in automatic healing.
Prevention:
- Stretch before start activity.
- Use of proper techniques during playing or other activities .
- Avoid excessive weight lifting.
- Avoid overuse of elbow.
- Use of elbow brace during playing.
Complications:
The most common complication of golfer’s elbow patient is persisting pain. Also may develop ulnar neuropathy, ulnar collateral ligament injury and other associated conditions including carpal tunnel syndrome, rotator cuff tendinitis etc.
