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FORE-SEEABLE TROUBLE


As spring approaches and duffers like me decide to come out of golfing hibernation, it is times like this that we tend to see a rise in orthopedic overuse injuries. Now I know that many of you have read in the multiple golfing magazines about "Improving Core strength will add 15 yards to your drive." Or "battling back pain." I figured that I would bring to light one of the injuries that do not get much attention. Maybe it's due to its association with its other country club counterpart, but lateral epicondylitis or "Tennis Elbow" can be a real pain literally and figuratively if not dealt with properly.

Lateral epicondylitis is an inflammatory condition that is associated with the wrist extensors and rears its ugly head at the lateral epicondyle or common extensor tendon; this is the little knobby bone located on the outside of your elbow. The risk of overuse injury is increased 2-3 times in those who perform repetitive motions (i.e. swinging a golf club) more than 2 hours of play per week and 2-4 times in players older than 40 years. Much of this comes down to improper technique, decreased flexibility and decreased strength. With golf, the most likely location of injury is at the left lateral epicondyle of a right handed golfer due to the increased demands for stability at impact of the ball - and the ground!

Lateral epicondylitis begins as micro-trauma to the common extensor tendon which can lead to symptoms of severe, burning pain on the outside part of the elbow. In most cases, the pain starts in a mild and slow fashion and can gradually worsens over weeks or months. The pain can be made worse by pressing on the outside part of the elbow or by gripping or lifting objects. Lifting even very light objects (such as a small book or a cup of coffee) can lead to significant discomfort. In more severe cases, pain can occur with simple motion of the elbow joint while in severe cases, the pain can radiate to the forearm.

Treatment is simple, be proactive! At the earliest onset or knowledge of symptoms, its best to begin utilizing ice and an over the counter Ibuprofen, this will help to minimize the inflammatory response. Stretching of the forearms is appropriate to maintain flexibility and decrease the soft tissue restrictions that become present from your body's production of scar tissue at the injury site. Scar tissue is the body's mechanism for patching up injuries; the problem lies in that when it is laid down your body does so in a very haphazard manner. This leads to the fibers of the tissue being very chaotic, and thus a decreased tensile strength of that tendon and a high likelihood of re-injury. If you have had no success at palliative care independently, it is time to visit your physical therapist for more aggressive treatments and a comprehensive rehabilitative program that will address strength, flexibility and improve tissue integrity via ASTYM that will have you back on your way to qualifying for the next U.S. Open.

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