Both tennis and golfers elbow are injuries that occur to tendons within the elbow complex. In simple terms tennis elbow also known as lateral epicondylalgia is an injury to the tendons on the outside of the elbow. Golfers elbow or medial epicondylalgia is an injury to the tendons on the inside of the elbow.
Firstly, just to clear something up, it is important to note that although you can sustain these injuries through playing sport, you do not need to play tennis or golf to get either of these injuries. In fact only 5% of people suffering from tennis elbow have the injury as a result of tennis!
So, what actually is golfers and tennis elbow at a pathophysiological level?
Lateral Epicondylalgia, or tennis elbow, is the most common overuse injury in the elbow. It sees the wrist extensor tendons (note: a tendon connects a muscle to a bone) become thickened and angry due to repetitive stress and overload of hand-dominate activities. People participating in racquet sports, such as squash, badminton and baseball, as well as swimming and field throwing events commonly suffer from this injury, due to the common movement of wrist extending backwards against force. However, people who perform computer-based jobs, and heavy lifting jobs are also susceptible for this condition due to the repetitive gripping, supination (twisting) and forceful extension of the wrist and hand that occurs in these jobs.
Signs and symptoms of tennis elbow include tenderness and pain on the outside of the elbow. Pain can be reproduced with extension of the wrist and third and forth fingers. The pain can radiate up and down the arm along the forearm and patient often have reduced grip strength and range into their wrist and hand. We’ll get to treatment answers soon…
Medial epicondylalgia is less common than its counterpart lateral epicondylalgia accounting for around 9-20% of elbow pain cases. It is known as golfers and pitchers’ elbow because it is commonly seen in throwing based sports such as javelin, baseball, American football and of course golf. But, still 90-95% of cases do not involve sports people. Commonly golfers elbow occurs in repetitive wrist movement-based jobs such as carpentry, plumbing, and butchery. In these jobs heavy gripping, swinging of the arm with hammers and cleavers and use of the hands causes excessive repetitive stress on the wrist flexor tendons, and in turn an anrgy, thickened and painful tendon is created (called tendinopathy or medial epicondylalgia).
The signs and symptoms of golfer’s elbow include a gradual onset of pain over time, pain and tenderness on the inside aspect of the elbow that radiates up and down the arm. Usually common on the ulnar side of the forearm (little finger side) and occasionally the pain can go into the fingers. Most patients complain of difficulty with gripping, stiffness in the elbow joint, weakness in the hand and numbness and tingling into the fingers. Generally, pain is bought on by resisted wrist and finger flexion (making a fist) and turning the hand outwards.
How do we treat golfers and tennis elbow?
Our expert team of physiotherapists are highly trained to treat and diagnose both injuries. Generally, the treatment of these two injuries follows a similar path of following evidence-based tendon loading protocols which is individualised to you, your tendons level of angriness and your movement goals. The best evidence-based treatment involves rest, gentle isometric (static) exercise and ice in the early stages. Progressions to normal loading are then guided by symptoms to return people to their normal activities. Patients can sometimes find relief in taping and bracing, however this does not fix the injury rather reduces the symptoms.
If you or someone you know is suffering from elbow pain please get in touch with our team at the Optimal Health Lab, so that we can assess diagnose and treat your injury to get you back to doing what you love! You can book online via our website or call us to find a suitable booking on 9431 5955.
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