Golf Injuries & Pain

Surveys of both professional and amateur golfers have shown that the elbow is a common site of injury. The elbow accounts for about 10 percent of injuries among professionals. For the amateur, the elbow accounts for about one in three golf-related injuries. 

Several factors have been identified as risk factors for elbow injuries in golf:

• Advancing age
• Faulty swing mechanics
• Lack of conditioning
• Insufficient warm-up
• Excessive practice or play

Even though the elbow is a common injury site in golfers, most of the elbow injury research, mechanisms, and management plans have been based on racquet-sports related injuries. Research focusing on the mechanics of the elbow and related musculature allows for the accurate causes and origins of golf-related elbow injuries to be determined. Understanding how these injuries occur in golfers ensures the development of appropriate management strategies targeting golf-specific injury mechanisms. For golfers age thirty-five to fifty-five, studies show that playing more than two rounds a week is likely to increase the risk of elbow injury. Advancing age is the only risk factor we golfers don’t have at least some degree of control over. 

The vast majority of golf-related elbow injuries (for both amateur and pro) are tendon injuries (tendonitis). The most common form of golf-related elbow tendonitis occurs on the outer part of the left (lead) elbow and is referred to as tennis elbow. Less frequently, tendonitis injuries can occur to the inner portion of the right elbow (a condition called golfer’s elbow). 

The elbow is susceptible to tendonitis injuries (tennis elbow and golfer’s elbow) at the transition from backswing to downswing (left image). Vigorous muscle contraction and tendon stretching from excessive wrist motion can lead to elbow tendonitis. Atimpact (right image), the forearm/elbow tendons are also under added stress as they absorb the force of the impact with the ball. An even greater jolt is absorbed by the elbows if the club strikes the ground or an object. Signs of medial epicondylitis include pain and tenderness to palpation of the medial epicondyle, the “funny bone” on the inside of the elbow. Pain is often aggravated by resisted forearm flexion and forearm pronation. There may be trigger point referral along the radial border of the forearm into the hand.

One of the most common conditions in Golf is called “Golfers elbow”. This condition is a common term for overuse of the arm and forearm muscles that results in pain at the elbow joint. You don’t have to play golf to get “Golfers Elbow” but the term came into use because it can be a significant problem for some golfers. Golfers elbow specifically involves the area where the muscles and tendons of the forearm attach to the inside bony area (called the epicondyle) of the elbow. The condition is also referred to as medial epicondylitis. Another common condition seen in tennis is called, “tennis elbow”, which refers to the same condition as “Tennis Elbow” but occurs on the outside of the elbow joint, called the lateral epicondyle.
According to researchers, studies provide that such medial elbow injuries are thought to result from impact-based insults to the elbow, usually to the trailing arm, which is the right elbow in the right-handed golfer. It is the wrist/hand flexors and forearm pronators (mechanisms for rotation) that are injured at their insertion into the medial epicondyle. These injuries are usually of a traumatic nature and occur at the time of impact. The mechanism for injury is a sudden deceleration of the club head, leading to an increased loading of the medial elbow. The sudden club head speed reduction can be due to hitting hidden rocks, tree roots and other objects.

Leading the list of injuries is golfer’s elbow, and one of the best ways to avoid elbow problems is to strengthen the forearm muscles and slow the swing so that there will be less shock in the arm when the ball is hit by the golfer.

To avoid golfer’s elbow, the American Academy of Orthopaedic Surgeons suggests these simple exercises to help build up your forearm muscles.

Squeeze a tennis ball
Squeezing a tennis ball for five minutes at a time is a simple, effective exercise that will strengthen your forearm muscles.

Wrist curls
Use a lightweight dumbbell. Lower the weight to the end of your fingers, and then curl the weight back into your palm, followed by curling up your wrist to lift the weight an inch or two higher. Perform 10 repetitions with one arm, and then repeat with the other arm.

Reverse wrist curls
Use a lightweight dumbbell. Place your hands in front of you, palm side down. Using your wrist, lift the weight up and down. Hold the arm that you are exercising above your elbow with your other hand in order to limit the motion to your forearm. Perform 10 repetitions with one arm, and then repeat with the other arm.

For professionals, Golfer’s Elbow is generally caused by hitting repeatedly out of long and thick rough. In the amateur golfer the injury is much more common and usually caused by hitting a “fat” shot. From a golf point of view, using larger grips and more flexible shafts on clubs will reduce elbow strain, and decrease risk of injury. From a preventative and treatment point of view, a regimen including anti-inflammatory regulators such as CM8 in Flexcin is in order.