Golfers Elbow

If a person performs an activity in excess of what this muscle group is used to then the tendon undergoes a reactive adaptation where there is localised pain and potential swelling around the outer part of the elbow where these tendons attach. A few days of relative rest and pain relief will allow this tendon time to settle however if the tendon continues to be loaded then it will progress through the next two stages of tendon disrepair and then degenerative tendon where there are structural changes within the collagen matrix and the ingrowth of blood vessels into the tendon in an attempt to assist repair.

The most common reported symptom is pain on the inside of the elbow which can radiate both up the inside of the arm or down the inside of the forearm and occasionally pins and needles felt in the ring and little finger. Pain can be produced during gripping activities during activities of daily living, such as lifting a kettle.

A thorough history of the present condition with the patient mentioning some of the symptoms already mentioned plus on physical examination there will be pain when the inside of the elbow is palpated and also upon resisted / repetitive wrist flexion and pronation (turning the palm upwards). There may also be reduced range of motion at the wrist and / or elbow.

During the initial assessment it is important that any other potential diagnosis, such as referral from the neck, is excluded. Once a diagnosis has been formed, Physiotherapy can help in a number of ways:

• Education and advice
  
• Activity modification
  
• Screening the whole upper limb for any deficit
  
• Manual therapy
  
• Use of clasps / supports / Taping
  
• Graded exercise programme
  
• Cryotherapy
  
• Electrotherapy / Therapeutic Ultrasound
  
• Muscle Energy Techniques (MET’s)