GOLFER’S ELBOW PHYSICAL THERAPY

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GOLFERS ELBOW PHYSICAL THERAPY
http//www.virtualphysicaltherapists.com/
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Pain on the inside of the elbow is commonly
called Golfers Elbow or Medial Epicondylitis. It
is a condition that develops from repetitive use
of the hand and elbow. Activities that can
trigger this condition include repeatedly
swinging a golf club or other activities that
require repetitive gripping, twisting or
throwing. Working at a computer, performing yard
work, athletes with repetitive overhead motions,
carpenters, and plumbers are most at risk.
Golfers Elbow physical therapy consists of
target exercises to treat the specific cause of
your pain.
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History of Golfers Elbow Medial
Epicondylitis was traditionally the medical term
for Golfers Elbow, with itis indicating an
inflammatory component. Treatments were focused
on reducing inflammation, such as ice,
anti-inflammatories, and steroid injections. But
ten years ago, the research found this to be a
misconception. The inflammatory stage only lasts
a few days. Pain that continues for more than six
days could no longer be attributed to
inflammation.
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The cause of epicondylitis was then theorized to
result from the tendon not healing correctly
(where the muscle attaches to the bone). With
continued use, micro-retearing would occur due to
a weakened tendon. Tendonitis was changed to
Tendinosis instead of inflammation, the focus
was poor tendon healing. Treatments for
tendinosis consisted of stretching and eccentric
strengthening to improve the recovery of the
tendon. Some did find relief, but many also went
on to become chronic. Recent research has found
that a high percentage of those with elbow pain
have a joint derangement or mechanical disorder
that interferes with the normal function of the
medial elbow joint. It sounds daunting but is
usually easily treated!
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The Cause of Golfers Elbow Golfers elbow is a
condition that occurs due to repetitive use of
the forearm, either disrupting the cartilage
within the elbow joint or causing irritation to
the medial tendons of the forearm. Pain from
Golfers elbow is located at a bony bump on the
inside of your elbow, known as the medial
epicondyle. This is where the tendons to your
wrist/finger flexors and pronator muscles attach.
It is also where the pain is referred from a
problem within the joint or a ligamentous tear.
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1. Inflammatory Acute damage to the medial
elbow will initiate a chemical process producing
inflammation. A constant throbbing pain
characterizes the inflammatory phase.
Inflammation is critical to the healing process.
It allows chemicals to be released to clean up
the area, increase blood flow, and heal any
damaged tissues and bone. The inflammatory stage
is short-lived, only lasting a few days.
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2. A problem within the medial elbow
joint Joints have cartilage protecting the
outer layer of bone and an extra buffer between
the bones. (Examples of cushions between bones
Meniscus in the knee labrum in the hip/shoulder,
the disc in the spine.)
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Repetitive motion strains the joint, especially
if the movement is awkward or has poor mechanics.
This strain can cause microscopic tears in the
cartilage and even give rise to a tiny piece of
your cartilage breaking off. This is part of the
natural wear and tear process, but excessive
activity combined with poor mechanics will
advance this breakdown, known as a derangement
.Even though this piece is very small, it can
cause pain and loss of motion if it interferes
with the joints smooth mobility. Derangements
are characterized by intermittent pain, pain
during movement, and a loss of motion (can be
constant pain if joint is held in an abnormal
position such as a dislocation). Golfers Elbow
physical therapy will address will address
internal joint derangments by repeatitive
movments to clear the derangement.
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3. A problem within the medial muscle
tendons Tendons are soft tissue at the end of
the muscle that attache the muscle to a bone.
Repetitive forces can cause a microscopic
breakdown in the cartilage and/or cause the
tendon to become tender and irritated. When the
tendons break down, the newly repaired tissue
needs to be stretched and strengthened to imitate
its original state. When a repaired tendon does
not regain proper strength and flexibility, it is
prone to re-injury. The group of muscles affected
by Golfers elbow are those that bend the wrist,
fingers, and thumb and pronate (turn or hold) the
wrist so that the palm faces downward. Pain
secondary to a tendon dysfunction is
characterized by tissue tightness and muscular
weakness. Golfers Elbow physical therapy will
address will address damaged tendons by specific
stretching and strengthening exercises.
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• Symptoms
• Pain along the inside of the forearm with wrist,
  hand, or elbow movements, especially gripping or
  squeezing.
• Tenderness to touch and swelling along the inside
  of the forearm.
• Weakness in the hand and forearm when gripping
  objects.
• Elbow stiffness and loss of ability to fully
  straighten the elbow the last 5-10 degrees.

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Importance of a Proper Diagnosis? Golfers Elbow
is a generalized term for any localized injury to
your medial elbow. Golfers Elbow physical
therapy must start with a thorough evaluation to
decipher the true cause of your elbow pain. Other
conditions first need to be ruled out, including
referred pain from your neck, inflammatory
arthritis, gout, fracture, ligament
tear/instability, dislocation, and infection.
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• Observe for any abnormalities (edema, redness,
  irregularities in bones, ligaments, muscles, etc)
• Rule out your spine as the source of pain
• Test your strength
• Assess your range of motion in your wrist,
  forearm, and elbow.
• Assess for ligamentous laxity
• Perform repeated movements and assess their
  effect on your baselines

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Physical Therapy Treatment for Golfers
Elbow Proper treatment must begin with an
accurate diagnosis. Unfortunately, elbow pain is
often misdiagnosed as tendonitis or an
inflammatory condition. Chemical or inflammatory
pain is constant and short-lived. Examples of
pain from inflammation are a toothache or hitting
your thumb with a hammer a continuous,
throbbing pain. When tissue damage is from an
injury or infection, the body releases chemicals
to initiate the healing process to clean the area
and increase blood flow to repair tissues.
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Elbow pain brought on with activity such as
turning a doorknob, brushing your hair, gripping,
but not painful at rest cannot be from
inflammation. Intermittent pain is from a
mechanical source or disruption within the
joint. Most often, medial elbow pain is
intermittent and brought on only with activity. A
mechanical exam is required to determine the root
cause of your pain. An MRI will show
abnormalities but does not differentiate painful
from non-painful tissues. We can only ascertain
what is working and what is painful by using and
moving the joint and soft tissues.
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Most pain from Golfers Elbow is the result of a
problem within the joint, known as a derangement.
Pain from a derangement is usually easily
corrected. This mechanical problem needs to be
cleared. (If you have a pebble in your shoe,
walking is painful. If you shake your foot, so
the pebble moves into your toe box, you can now
walk without pain. The stone is still there. You
just moved it out of the way.) Similarly, if you
can move the small particle out of the joints
arc of motion, you will no longer have pain. The
body will break down the particle when it is out
of the joint space.
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The derangement can be anywhere within the joint.
Often there is a loss of the ability to
straighten the elbow fully and pain when
attempted. This particle must be cleared or
removed out of the joint space. A way to test is
to find a baseline or activity that causes pain.
It could be squeezing something or resisting as
you extend your fingers. Perform that painful
activity and assess your pain. Next, straighten
your elbow and then relax by bending it slightly.
Perform this ten times, each time trying to go a
bit further into extension or straightening your
elbow. Retest your baseline activity. Do you have
more, less, or the same amount of pain performing?
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If you have lessGreatyou found your
self-treatment! If there is no change, then it
could still be a derangement. It would help if
you had further guidance to find the right
direction to clear the derangement. Or you may
have poor tissue healing Tendinosis. A
clinician specializing in Mechanical Assessment
and Treatment will advise you on what you need to
abolish the pain.
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How Can Virtual Physical Therapists Help? There
is no reason for you to suffer in pain when you
can get relief now with Golfers Elbow physical
therapy! It is also essential to get treatment
for Golfers elbow as soon as it occurs because
the tendons are affected and do not have a good
blood supply. An inflamed tendon that goes
untreated can begin to tear, and a more severe
condition can result. If you have a derangement,
it can easily be treated, and you can get relief
right away!
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• Can Golfers Elbow Be Prevented?
• Golfers Elbow physical therapy will help you
  understand the risk of injury and awareness of
  your daily movements to help prevent elbow pain.
• Use proper form and technique when repetitive
  tasks or sports movements, like golf swings.
• Maintain shoulder, forearm, and wrist muscle
  strength.

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• Perform gentle forearm muscle stretches before
  and after performing tasks.
• When lifting heavy objects, use proper posture
  and body mechanics to reduce joint strain.
• Listen to your body when you have pain. Active
  rest periods are critical for full healing after
  exercise.

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Golfers Elbow physical therapy is now
conveniently available by online physical
therapists. Each of our virtual physical therapy
provider(s) has also received an additional
specialty in Mechanical Diagnosis (Cert. MDT) to
assure you receive the highest quality online
physical therapist. Tennis/Golfers Elbow 5
Mistakes to Avoid
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Virtual physical therapists

• info.virtualphysicaltherapists_at_gmail.com

• http//www.virtualphysicaltherapists.com/