The term 'Tennis Elbow' or 'Golfer's Elbow' are simply referring to the type of pain that occurs either in the outside (lateral) or inside (medial) of the elbow.
Tennis Elbow (lateral epicondylitis) and Golfer’s Elbow (medial epicondylitis) both seem to feel like a dull ache which appears in the elbow joint and tends to worsen when the rate of activity is increased. Under normal conditions, the pain is restricted to a particular region of the elbow; this means that there is a particular part of the elbow that is so painful and in particular by gripping, bending or straightening the elbow
In severe cases, the pain may spread to the forearm or to the biceps and triceps as nerves become deteriorated. This pain is caused as a result of serious damage but can also occur due to inflammation of the nerves and soft tissue of the joint.
What are the Causes of Elbow Pain?
The majority of tennis or golfer’s elbow occur as a result of changes in the structure of the tendon. This should not be a surprise, as up to 50% of sports injuries include tendons due to lack of mobility, poor mechanics as well as excessive use and/or muscle imbalance contributing to these structural changes.
Lateral epicondylitis or tennis elbow is common in adults aged 30 to 50 years. It is an injury due to overuse and muscle strain that causes inflammation outside the elbow and forearm area. When the forehand and backhand are often used, these muscles become overworked and become inflamed. The categories of people who are prone to tennis elbow are plumbers, carpenters, painters and chefs due to the recurring nature of their occupations. Seasonal activities such as raking, gardening and cutting of wood can also cause tennis elbow.
Symptoms of Tennis Elbow
Pain can spread from the outer part of the elbow down to your forearm and wrist. This can be a permanent pain in the elbow area or you can feel it only when you perform activities that involve reaching, grasping or lifting. It is important to consult a physiotherapist in order to make sure you get the right diagnosis for the cause of your pain.
In medial epicondylitis also known as golfer's elbow, irritation of the inner side of the arm and the elbow occurs. Golfer’s Elbow can occur when you engage in activity that requires twisting or flexing (bending downwards) of the wrist. In general, it is the excessive use of forearm muscles during tasks such as gardening, digging, throwing balls, playing golf or tennis. Repeated lifting, especially when the elbow is extended and the palm is pointing downwards can also cause the golfer’s elbow. In addition to golf, other activities can lead to this condition and examples of such activities are racquet sports, baseball or softball, weightlifting, carpentry and painting among other similar activities.
Symptoms of Golfer’s Elbow
The symptoms of golfer’s elbow may include pain in the inner part of the elbow when you lift the wrist or hand, pains that occur when you twist your forearm or during making a fist movement. The affected area may swell up or become painful when touched. If the problem persists, additional symptoms may include stiffness in the elbow or weakness of the hands or wrists.
The pains that occur from golfer’s elbow may appear suddenly or gradually, however the pain can worsen when:
- Swing a golf club or racket
- Squeeze or pitch a ball
- Shake hands
- Turn a doorknob
- Lift weights
- Pick up something with your palm down
- Flex your wrist
In order to diagnose golfer's elbow, the diagnosis is based on history of illness and physical examination. To assess pain and stiffness, your physiotherapist may apply pressure to the affected area or ask to move the elbow, wrists, and fingers in different ways. Doing an X-ray may be of help to your physiotherapist in order to iron out other causes of pains in the elbow for example fractures or arthritis. More comprehensive imaging studies such as MRI can be carried out.
It is very important to commence treatment as soon as possible due to the fact that the sooner you start treatment, the sooner you will be able to continue with your daily activities.
- Rest: It is advisable for you to your golf game or other recurring activities on hold until the pain disappears. If you return to activity early, you can aggravate the pain.
- Ice the affected area: Make sure you apply ice packs on the affected elbow for a period of 15 to 20 minutes, three to four times a day for a few days. In order to protect the skin, wrap the ice packs in a fine towel. This can be helpful to massage the inner elbow with ice for five minutes at a time, two to three times a day.
- Take pain relief: Take pain-relieving drugs such as ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, others) or acetaminophen (Tylenol, others).
- Apply a brace: the use of brace may be recommended by your physiotherapist on the affected arm as this helps to reduce tendon and muscle strain.
- Expand and strengthen the affected area: Physical activities such as stretching and strengthening exercises may be suggested by your physiotherapist.
- Reduce the load on your elbow tendons: Wrap the elbows with an elastic bandage or make use of a splint.
- Return to your normal activities gradually: When the pain stops, do some arm motions of your sport or activity. Review your golf or tennis swing with an instructor and follow the necessary adjustments.
- Ask your doctor if an operation is appropriate: Surgery is rarely required. But if your signs and symptoms do not respond to conservative treatment for a period of six to twelve months, surgery may be an option. The new procedure involves minimally invasive, ultrasound-guided removal of scar tissue in the region of the tendon pain.
Other treatments used include injections of corticosteroids but it has not been proven to be an effective long-term treatment. A new treatment that is being put into practice is platelet-rich plasma. This involves drawing a small amount of blood, spinning it down and injecting into a sensitive area. Though, this requires more studies.
Majority of the affected individuals will get better when they rest, ice and take pain-relieving drugs. In some cases, pain may last for months or years depending on how serious your condition is, even if you relax and follow the exercise instructions for your arm. Sometimes the pain can return or become chronic.