Sore Inside Elbow
Did you know that pain on the inside of the elbow might be something called golfers elbow?
The strange part is it isn’t only golfers who are looking for treatment of the condition.
Affecting thousands of golfers every year, golfer’s elbow can be extremely frustrating and debilitating if left untreated.
The injury is not just limited to golf players though, many tennis players, baseball players, squash and badminton players also suffer from the problem.
To help you understand the injury better and how best to treat it, I have outlined all you need to know below about golfer’s elbow.
What is Golfer’s Elbow?
Golfers elbow is medically known as medial epicondylitis or medial epicondylalgia.
It is a common condition in which pain develops on the inside (medial aspect) of a person’s elbow. It is a tendinopathy of the origin of the flexor/pronator tendons at the elbow. If severe, the pain can sometimes extends down the forearm and into the person’s wrist.
The injury is very similar to that of tennis elbow whereas in that case the pain is felt on the outside (lateral aspect) of the elbow instead.
The pain is caused by micro-tears to specific elbow tendons.
This occurs in either the tenoperiosteal junction (tendon to bone attachment) or the musculotendinous junction (muscle to tendon attachment). Painful inflammation of the affected tendons is the result and this can cause many golfers to stop altogether when not treated properly.
Since the soft tissue injury is classified as a tendonpathy, that means it can include tendonitis (inflammation) or tendonosis (degeneration) of the tendons.
The ICD 10 code is M77.0 for medical insurance billing purposes.
Symptoms of Golfer’s Elbow
The symptoms of golfer’s elbow are fairly specific. So you, or your chiropractor, should have no trouble in diagnosing the issue.
Common symptoms that sufferers describe can include:
Pain, bruised feeling, or tenderness to touch on the bony prominence on the inside of your elbow.
The elbow pain typically worsens with certain movements of the wrist, fingers or arm like gripping.
Your elbow may possibly feel stiff on bending it.
It might be painful to make a clenched fist.
Weakness in the hands or wrists joints when active.
Numbness or tingling. Although not as common, numbness or tingling is often felt in one or more fingers when active.
Remember, the pain from golfers elbow is not just restricted to playing golf or racket sports.
Paul Bradshaw, ex-PGA pro and Editor-in-chief at Golf Assessor told me his mistake was he played through the pain for many months, thereby extending his recovery period.
When he had the condition, he could barely lift his golf bag with his right arm, even before he hit a ball. Certain movements would may bring on the pain suddenly such as lifting, twisting, hitting, shaking etc…
If you feel the pain start, you need to stop what you’re doing immediately!
Causes of Golfer’s Elbow
Example of a Non-Overlapping Baseball Grip in Golf
As the name suggests, golf is certainly one of the major causes of golfer’s elbow due to the stress the elbow tendons are put under through each swing, particularly if a non-overlapping (baseball style) grip is used.
Poor technique is certainly one of the factors as a smooth, compact swing will always be less stressful upon your elbow.
However, many people develop golfer’s elbow having never played the game.
The damage upon the tendons is generally related to excess or repeated stress. The inital cause of the damage is generally linked to excess, or repeated, stress through forceful wrist and finger motions.
This can be caused by repetitive motions such as:
Improper hitting a ball.
Failing to warm up (and cool down) correctly can also have a major impact upon developing the condition. Weight training and climbing are two examples where warm-up technique is key.
The easiest way to test is through a simple physical examination.
Since the pain originates from the wrist flexor and pronator tendons then resisted wrist flexion, or pronation, muscle testing can reproduce the patients pain.
There is no specific named orthopaedic tests.
Palpation of anatomical landmarks can pin point the painful location over the:
The medial epicondyle of the humerus bone or,
The flexor-pronator mass.
The flexor-pronator mass is made up of these five muscles:
Flexor Carpi Radialis
Flexor Digitorum Superficialis
Flexor Carpi Ulnaris
Do you need an x-ray, MRI or ultrasound scan?
X-rays will not show the soft tissue damage, whereas an MRI can help for a chronic pain situation or for other differential diagnosis like an ulnar collateral ligament tear (a.k.a “Tommy John” ligament in baseball).
Other conditions to consider when someone has pain over the inside of the elbow include:
Cubital tunnel syndrome,
C5-C6 cervical radiculopathy.
The pain of golfer’s elbow shouldn’t stop you from enjoying the golf course or any other activities you love.
The key though is catching it early and treating early!
A good rest period and appropriate treatment will see you back in the ‘swing’ of things in no time.
Self-Treatment at Home
#1 Rest from Activity
I know this can be hard, particularly for athletes, professional or amateur, but a period of rest from sport helps cure the issue. How long you need to stop playing depends. However, make sure you don’t rush back into the activity.
#2 Ice the Elbow.
When the tendons become torn, the area suffers acute inflammation. One of the best ways to treat this is with a good old-fashioned ice pack like this one from Amazon. You could try massage an ice cube directly over the painful area too. Make sure to ice the area at least 3-4 times per day for 15-20 minutes. Keep this up for a week & see how it feels.
#3 Try an Elbow Brace
Some people swear by the brace treatment solution. The idea of the epicondyle brace is to wear it as a counter force, thereby, taking some of the load off your elbow tendons. Be warned though, this is a not a solution to rest. This golfers elbow strap from Amazon should do the job.
#4 Pain Relievers
You can try over the counter NSAIDs (non-steroidal anti-inflammatories) from your local pharmacy like diclofenac sodium or ibuprofen. They can help reduce swelling and pain levels. However, this is a quick fix to cover up pain and won’t speed up healing! At times, even a cortisone injection is needed.
#5 Strengthening Exercises
This exercise is both good to do when you are in pain, but also you can use it to try prevent golfer’s elbow from happening. The Reverse Tyler Twist exercise is a good remedy for the problem. It also helps in avoiding getting it again in the future by strengthening the muscles & tendons. You can see how to do the recommended exercise in the step by step instruction video below.
Reverse Tyler Twist Exercise
This is the reverse of the same rehab exercise used to treat tennis elbow.
All you will need is a Flexbar from Theraband to do this golfer’s elbow exercise.
Start with an easy level red Flexbar first then progress to intermediate level green Flexbar then finally to hardest level blue Flexbar.
Step by Step Instructions
Hold onto one end of the Flexbar with the painful elbow and wrist flexed (i.e. palm facing you)
Grasp the other end of the Flexbar with the non-painful elbow and wrist facing down to the floor
Twist the Flexbar with the hand on the non-painful side. The aim is to keep the painful side palm facing you and not moving.
Slowly extend both your arms out in front of you. This is to create elbow extension on both sides.
Now slowly bend the painful side wrist into extension (i.e. away from you)
Done. Now repeat from step 1 again for another repetition. Aim to try do 15 reps of 3 sets per day.
You may need hands on care to assist you if things are not coming right by yourself.
Start with a manual therapist like a chiropractor, physiotherapist or osteopath
Try kinesio tape strapping
Ask about Active Release Technique, IASTM or Dry Needling (acupuncture) treatments
Consult a sport doctor for PRP injections or an orthopaedic surgeon for a corticosteroid injection
There is no getting around it, golfer’s elbow is a frustrating and painful injury that stops thousands of people from enjoying the activities they love.
With good rest from aggravating activities & proper physical therapy manual treatment though, the injury shouldn’t take you out of action for too long & help avoid any thoughts of needing elbow surgery.
Golfer’s Elbow Treatment Guide
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