Golfer's Elbow (Medial Epicondylitis)

med_epicondyle.jpgMedial epicondylitis is commonly known as 'golfer's elbow'. This does not mean that only golfers have this condition. But the golf swing is a common cause of medial epicondylitis. Many other repetitive activities can also lead to golfer's elbow--throwing, chopping wood with an axe, running a chain saw, and using many types of hand tools. Any activities that stress the same forearm muscles can cause symptoms of golfer's elbow.

Chiropractic adjustments can help restore the normal alignment and motion of the elbow joint. This is sometimes called closed reduction manipulation. This is where chiropractic adjustments have an advantage over other specialties.

Chiropractic care focuses on not just relieving the symptoms, but correcting the underlying problem. Before any treatment can begin, you will begin a standardbrachial plexus_1.jpg chiropractic examination of the head, neck and upper back and entire upper extremity to check for any nervous system interference to the group of nerves called the brachial plexus. Research studies have shown that spinal adjustments to the neck are effective in treating golfer's elbow.

Exercises are used to gradually stretch and strengthen the forearm muscles. Because golfer's elbow is often linked to overuse, your chiropractor will work with you to reduce repeated strains on your elbow. You may be given tips about how to perform the movement so the elbow is protected.

What parts of the elbow are affected?

Golfer's elbow causes pain that starts on the inside bump of the elbow, the medial epicondyle. Wrist flexors are the muscles of the forearm that pull the hand forward and are on the palm side of the forearm. Most of the wrist flexors attach to one main tendon on the medial epicondyle. This tendon is called the common flexor tendon.

The wrist flexor muscles contract when you flex your wrist, twist your forearm down, or grip with your hand. The contracting muscles pull on the flexor tendon. The forces that pull on the tendon can build when you grip a golf club during a golf swing or do other similar actions.

Causes

Overuse of the muscles and tendons of the forearm and elbow are the most common reason people develop golfer's elbow. Repeating some types of activities over and over again can put too much strain on the elbow tendons. These activities are not necessarily high-level sports competitions. Shoveling, gardening, and hammering nails can all cause the pain of golfer's elbow. Swimmers who try to pick up speed by powering their arm through the water can also strain the flexor tendon at the elbow.

Symptoms

What does golfer's elbow feel like?

The main symptom of golfer's elbow is tenderness and pain at the medial epicondyle of the elbow. Pain usually starts at the medial epicondyle and may spread down the forearm. Bending your wrist, twisting your forearm down, or grasping objects can make the pain worse. You may feel less strength when grasping items or squeezing your hand into a fist.

Diagnosis

How can my chiropractor be sure I have golfer's elbow?

Your chiropractor will first take a detailed medical history. You will need to answer questions about your pain, how your pain affects you, your regular activities, and past injuries to your elbow.

lateral_elbow_xray.jpgThe physical exam is often most helpful in diagnosing golfer's elbow. Your doctor may position your wrist and arm so you feel a stretch on the forearm muscles and tendons. This is usually painful with golfer's elbow. Other tests for wrist and forearm strength are used to help your doctor diagnose golfer's elbow.

You may need to get X-rays of your elbow. The X-rays mostly help your chiropractor rule out other problems with the elbow joint.

Golfer's elbow symptoms are very similar to a condition called cubital tunnel syndrome. This condition is caused by a pinched ulnar nerve as it crosses the elbow on its way to the hand. Your doctor may suggest tests to rule out problems with the ulnar nerve. The longer you leave your pain untreated, there is more potential for long term damage. 

Treatment 

1st part of treatment:
  • It is important to reduce the inflammation and to rest the elbow as much as possible.
  • The use of ice is very effective in the first 2 to 3 days, although it is sometimes used for a longer period.
  • Research has shown that the application of physiotherapy modalities, especially low-level laser therapy (LLLT), has dramatically provided excellent results with the treatment and management of elbow, and, other joint and arthritic conditions.
  • Sometimes an elbow brace or an elbow strap may be needed, particularly if the problem persists.
  • The chiropractor will examine and treat any area relating to the function of the elbow and muscles of the forearm, such as the wrist, shoulder and neck.
2nd part of treatment:
  • It is important to increase the blood circulation to the tissues.  This can be done by alternating hot and cold and massaging the muscles to relieve stress and tension.
  • When pain has subsided, it is possible to undertake a rehabilitation program of power stretching exercise for the elbow and the affected muscles, taking care that the exercises are done slowly and carefully so as not to make the condition reoccur.

Prevention

Most tennis elbow injuries occur either at the beginning of a game of tennis (as a result of poor warm up techniques) or at the end of a game (when people are fatigued).

Always warm up and stretch muscles before exercising and cool down.

How long you decide to benefit from chiropractic care is, of course, up to you. But, for effective long term results, always follow the Chiropractor's recommendations.

That's why it is important that you call us to schedule your appointment today to get your golfer's elbow effectively treated.

Call Dr. Pisarek for your appointment and get your tennis elbow effectively treated.

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