Tuesday, April 5, 2011

Tennis Elbow In The Golfer (confusing, I know)

Tennis Elbow seems to be the injury of choice for golfers in our clinic lately. Don't let the name fool you - a golfer can certainly develop Tennis Elbow. Actually, Tennis Elbow seems to be more common in golfers than tennis players! This condition can make it difficult to swing a club comfortably and, in some cases, force the player to sit out of the game altogether. With the golf season in full-swing (pardon the pun), neither of these options is appealing to most players. So, let's talk about what Tennis Elbow is and how you can prevent it from hindering you this season.

The Mayo Clinic defines Tennis Elbow as a painful condition that occurs when tendons in your elbow are overworked, usually by repetitive motions of the wrist and arm. This is mostly true. But overuse is not the only culprit; misuse is just as troublesome. The pain that you feel on the outside of the elbow is coming from the tendons that attach to the bones. These tendons are also attached to the muscles that make your wrist extend, or bend up. This is important because it is this motion that can cause the condition. It is most common to see Tennis Elbow in the left arm of a right-handed golfer. Also, these players typically complain that they have lost distance, have begun to slice the ball, catch the ball "fat", and/or hit high, weak shots that tend to go to the right. There is one major move that golfers make that can lead to these problems:

Can you see the problem? It is called "scooping the club" and it can lead to all of the shot pattern problems described earlier as well as Tennis Elbow. This move puts a large amount of stress on the muscles that extend the left wrist. When the problem occurs in the left elbow of a right-handed player, it is typically an injury of misuse, not necessarily overuse.

The solution? Stop scooping! Ok, I understand that this is far easier said than done. But in order to prevent the recurrence of pain, it is a must-do. Check with your local golf instructor for drills and swing keys that allow the hands to be ahead of the clubhead at impact. This will reduce the amount of load that is placed on the elbow muscles (and vastly improve shot results at the same time). But what if a player currently has Tennis Elbow? Is there anything that they can do now to improve their condition until the swing change takes place? Yes! The following are good tips to decrease the pain associated with Tennis Elbow:

1) Use ice, NOT heat. Some patients believe heat is the best option for all muscle pain. Au, contraire. A good rule of thumb is if the condition is painful, use ice. If pain is present, then inflammation is not far behind. Heat increases inflammation leading to more pain about two hours after the application of heat. Heat feels good while it is being applied, but leads to more pain afterwards. Ice should be applied for 10-15 minutes and then removed for 45-50 minutes. This cycle can be repeated three times in the morning and three times at night. (Disclaimer: Do not apply ice for more than the prescribed time. It can burn you just like heat).

2) Use a wrist-rest at the keyboard. Once pain is present in the elbow, it does not take much to produce more pain. Typing at a keyboard can force a person to overuse the wrist extensors.

3) Compression bands can help, but should only be used as a temporary solution. Eventually the goal is to address the culprit of the pain and alleviate it permanently. But until that can happen, a compression band can provide some relief to the elbow.

4) Avoid tons of full-swing shots. Use this opportunity to polish up on your short game instead of pounding 200 balls as hard as you can on the driving range. You can still play, just don't over-do it.

5) Avoid sleeping with your arms above shoulder level. We spend as much as 33% of our lives sleeping. It is important to ensure that your sleep position is conducive to the health of your body. Some elbow pain has been linked to sleeping with arms overhead.

If you have any questions, please contact us at Germantown Golf Fitness in Germantown, TN. Our phone number is (901) 590-1065.

All the best,

Nathan Williams, DC, MS, CGFI-MP2