Treating Golfer's Elbow - Trigger Point Therapy
Golfer's Elbow Inflammation
How to Apply Stretching, Ice, and Heat Following Treatment for Triceps Trigger Points - Dr. Jonathan Kuttner
Studies have shown that pain on the medial epicondyle (Golfer’s Elbow) is about twice as common in men than women
Golfer’s Elbow (medial epicondylitis) is a condition that causes pain and inflammation in the tendons that connect the elbow to the forearm.
It occurs around the bony bump on the inner side of your elbow. The pain may also be felt into the forearm and wrist.
Golfer’s Elbow will usually develop as a result of overuse of the muscles in the forearm that enable you to rotate your arm, flex your wrist, and grip with your hand.
You don't have to play golf to suffer from this condition although golfers are commonly affected.
By repeatedly effecting the same golf swing, considerable stress is placed on the related muscles, tendons, and joints. This over time can cause injury from tiny tears in the tendons.
What Are the Symptoms of Golfer’s Elbow?
In most cases, the pain develops slowly and gradually over weeks and months in the elbow area. It is less common for the symptoms to occur suddenly.
You may feel stiffness in your elbow and it may be painful to make a fist. Pain and tenderness will be felt on the inner side of the elbow and sometimes the forearm too.
Some will experience numbness and tingling often into the 4th and 5th fingers. Your hand and wrist may feel weaker too.
The pain can be anything from mild discomfort to severe, and it may affect your sleep. It will increase when forcibly trying to stabilize or move the wrist.
Your pain will feel worse when;
- shaking hands
- using tools
- gripping objects e.g. cutlery, pen, computer mouse
- fully extending your arm
- turning a door knob
Trigger Points in the Triceps are often associated with Golfer's Elbow
Who Is Prone to Golfer’s Elbow?
Golfer’s Elbow affects around 1-3 percent of people in the USA.
Studies have shown that pain on the medial epicondyle (Golfer’s Elbow) is about twice as common in men than women.
Sufferers tend to be between the ages of 35 and 50.
Older golf players tend to be more prone due to the continuous repetitive movements over time leading to wear and tear of the tendons.
Less experienced players may also be more likely to get Golfer’s Elbow due to poor technique when over-gripping causes increased strain on the tendons.
Anyone who participates in activities that require repetitive and vigorous use of the forearm muscle, especially while gripping something, are more susceptible to this condition.
This broadens its reach to a variety of professions including cooks, cleaners, butchers, gardeners, assembly-line workers, bowlers, and pitchers.
If your forearm muscles are unfit and you suddenly start to play a racquet sport or take on a new DIY project, you are also more likely to get Golfer’s Elbow.
Differential Diagnosis - What Else Could It Be?
Here is a list of other conditions which can mimic a Golfer’s Elbow if you are concerned please check with your doctor or therapist:
• Problems with the radial head of the radius bone at the elbow joint
• Problems with the discs in the neck C6/7 neuropathy (cervical disc)
• Osteoarthritis of the inner side of the elbow joint
• Ulnar collateral ligament injury
• Cubital tunnel syndrome (ulnar nerve compression syndrome)
• Guvon’s canal syndrome (ulnar nerve compression syndrome)
Trigger Point Therapy
There are well established trigger point treatment protocols that have mostly been developed within elite athletics.
These protocols include the identification and treatment of the trigger points, combined with stretching, muscle energy techniques (MET's), and strengthening exercises.
In most cases, Golfer's elbow is associated with trigger points in the triceps, and forearm flexor muscles.
Hot and Cold (ice) Therapy
Ice or cold therapy, is more effective at treating tendonitis when symptoms first develop. Ice helps to constrict blood vessels to reduce swelling and inflammation resulting from tissue injury.
Cold therapy can also reduce muscle spasms and numb pain. Cold therapy includes using cold packs, bags of ice or fluids like ethyl chloride.
Always place a thin cloth between your skin and the ice pack to avoid tissue damage. Limit cold therapy to 15 to 20 minutes at a time, as longer exposure can also lead to tissue damage in some cases.
Heat opens up blood vessels and increases blood flow to your injured elbow joint, which promotes healing. It alleviates symptoms such as pain, stiffness and fluid build-up, or edema, in the tissues.
However, you should not apply heat to a new injury; wait three to four days before using it or until any swelling subsides.
You can choose from a variety of heat therapies such as using a heat pack; soaking your elbow in warm, moving water, such as in a hot tub; using infrared heat or heated wax; or applying a medicated heat rub. Never apply heat to any area with an open wound.
A Golfer’s Elbow often involves a swollen tendon (tendinopathy). Whilst many think of tendons as soft tissues or muscles, our advice is to view tendinopathy more as a fracture!
This means treating it with respect and not overloading it. Tendons don’t respond well to sudden or rapid change so build up your rehabilitation exercises slowly.