Golfer’s elbow, like tennis elbow, affects the forearm muscles near the elbow. If you lay your forearm out on the table in front of you, palm up, the bony area on the inside of the elbow is known as the medial epicondyle. A sheath housing several tendons attaches to the bone here and acts as an anchor point for muscles that flex the elbow, wrist and hand, and rotate the forearm. The formal name for golfer’s elbow is medial epicondylitis or epicondylalgia because of the anatomical location near the medial epicondyle.

While tendons are strong, they can become irritated or inflamed in response to certain activities. Repetitive wrist or elbow flexion or forearm rotation such as when golfing, can stress the tendons at their attachment point leading to the symptoms of golfer’s elbow. Here are some important facts about golfer’s elbow:

Tendons are built to withstand a great deal of force but repetitive stress that exceeds the tolerance of the tendon can lead to injury

Golfer’s elbow can have several causes-

• Ramping up a new activity too quickly
• Muscle length impairments around the wrist and forearm
• Muscle strength impairments around the wrist, forearm and elbow
• Inefficient movement patterns during sport or activity
• Biomechanical errors

SYMPTOMS OF GOLFER’S ELBOW

Golfer’s elbow can often be diagnosed based on symptom presentation. You may have golfer’s elbow if you experience any of the following symptoms:

• Pain, burning or aching on the inner elbow or along the forearm extending toward the wrist
• Pain on the inner elbow or forearm that worsens with flexion of the elbow, wrist or fingers or rotation of the forearm.
• Elbow stiffness
• Grip weakness
• Forearm weakness

If you decide to work with a physical therapist to help correct your Golfer's elbow issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

PHYSICAL THERAPY TREATMENT FOR GOLFER’S ELBOW

As noted above, the approach to managing chronic or acute cases of golfer’s elbow often differ. If you have a new or newly-exacerbated case of golfer’s elbow, inflammation around the tendon is likely present. While your physical therapy program will always be individualized, below are physical therapy treatments often prescribed to address acute golfer’s elbow:

• Education on the likely cause as well as the pathophysiology of golfer’s elbow
• Recommendations on activity modification and rest to allow inflammation to subside
• Application of modalities such as ice, ultrasound, electrical stimulation or laser therapy to manage pain and inflammation
• Recommendations on the use of splints, taping or bracing as needed to minimize discomfort and allow for healing in the acute phase

As inflammation subsides, or in the case of a chronic golfer’s elbow where tendon degeneration is the primary issue, addressing contributing factors and improving tendon stiffness are the primary goals of physical therapy. Below are common physical therapy treatments to address this type of golfer’s elbow:

• Soft tissue mobilization using tools like ASTYM or Graston to remodel the injured tendon and encourage collagen production
• Exercises to enhance tendon stiffness and make it more resilient to stress
• These are often eccentric-focused exercises with special parameters around pain and symptom-provocation
• Exercises to address strength, muscle length and neuromuscular control around the elbow, forearm and wrist
• Training in movement technique and biomechanics to reduce repetitive stress on the tendons during sport, work or daily tasks
• Graded return to full activities