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Health Matters - By Dr.
Neil Patrick
Tennis & Golfers’ Elbow
Even if you
don’t play tennis, or have never swung a golf club in your life, you may still
be vulnerable to tennis or golfers’ elbow. As strange as it may seem, this is
often the case with named conditions such as these. Although golfers and tennis
players may be more susceptible to these injuries, tennis and golfers’ elbows
are repetitive strain injuries that can occur with various activities involving
prolonged postures, repetitive movements, or sudden contractions of certain
muscle groups.
Tennis Elbow and Golfers’ Elbow are general terms for what
is more specifically called Lateral and Medial Epicondylitis, respectively. As
with most medical terms these intimidating words can be better understood by
breaking them down to their prefixes and suffixes. On the lower part of the
humerus bone at the elbow are two bumps called epicondyles. One is on the
inside, or medial side, and the other on the opposite lateral side. Bones have
bumps such as these so that attaching muscles have something to hold on to.
When inflammation (or “-itis”) occurs at these attachments, we have
either medial or lateral epicondylitis.
The medial and lateral epicondyles are attachments for
opposite muscle groups. The muscles that flex your wrist and fingers run up the
underside of your forearm and attach as a common tendon at the medial epicondyle.
The forearm extensors attach similarly at the lateral side. If these muscles
are over-stressed or injured they pull at their attachment site, and
inflammation occurs there. In the case of tennis elbow, this is often caused by
backhand shots, where the wrist is extended as it strikes the tennis ball,
stressing the extensor muscles at the lateral epicondyle. Golfers’ elbow is
often caused by wrist flexion at ball strike or, even worse, the wrist trying to
flex at ball strike but being forced in the opposite direction by the club head
hitting the ground. While this explains why the term tennis and golfers’ elbow
are used, the actual list of activities that can cause these injuries can be
quite extensive; from knitting to plumbing to using a screwdriver.
The symptoms of these conditions include pain just above
the elbow, as well as along the forearm, sometimes right to the wrist. The pain
often increases gradually and is worse in the morning or after rest, but can
come on suddenly and be quite severe when the muscles are stressed. Grip
strength is often reduced, and people often find it difficult and painful to
pick up objects or turn door handles.
As with other repetitive strain injuries I’ve described in
previous articles including carpal tunnel syndrome and rotator cuff problems,
conservative treatment is usually quite effective for golfers’ and tennis
elbow. Avoiding aggravating activities and icing the affected areas helps to
reduce inflammation. I have found significant results with myofascial release
(ART®) with these conditions, and modalities such as ultrasound or manipulation
can also help get you back in the game. During the healing phase, some people
find braces of benefit. Specific braces for epicondylites are available that
have a foam pad that is placed over the affected muscles, below the elbow. This
pressure point acts as a substitute attachment point for the muscles, diverting
some of the aggravating forces from the epicondylar attachments while they
heal. In particularly stubborn cases, anti-inflammatory injections or surgery
are later-stage options.
Sports such as tennis and golf require some specific
techniques, so lessons with a pro can help you develop safer and more efficient
form. For example, hitting backhand shots in tennis can be done with two hands
to lessen the force on the leading extensor muscles, or perfecting your golf
swing so you don’t take large divots will be easier on you when you play.
Whether you’re a scratch golfer or just whack a tennis ball around once a year –
or even if you have elbow pain from doing chores around the house – it’s always
better to seek professional advice or treatment before waiting until it becomes
a chronic and more stubborn issue to resolve.
Dr.
Neil Patrick is a chiropractor practicing in the Creemore Medical Centre. For
more information, or to request future topics, call 466-3447 or visit
www.creemorechiro.com. | 
