We are talking about a condition caused by an overloading of the tendons in the forearm that affects many golfers, professionals or amateurs, but it also affects people who have never touched a golf club and who have professions requiring many repetitive, manual actions, like carpenters or parcel delivery workers.
Epicondylitis, or golfer's elbow, is an injury to the tendons in the elbow caused by repetitive actions in wrist flexion and pronation, or rotation. The most common symptoms are pain on the inside of the elbow and sometimes tingling in some fingers. Depending on when the condition is detected, it may require surgical intervention, although this only occurs in 30% of cases.
“Golfer’s elbow can be disabling, pain caused by a repetitive movement due to the tendon injury can greatly limit a worker or athlete in their day-to-day life,” says Dr. Maria del Mar Villanova, orthopedic surgeon and traumatologist at Hospital Estepona. "We move our arms to do thousands of actions throughout the day and people who have epicondylitis know that very well because they feel pain in each of those movements," she adds.
Stretching, training and not smoking, the keys to preventing epicondylitis
Epicondylitis can be prevented, although you cannot do that is you do not know there is a problem. In the case of athletes, golfer's elbow can be prevented by following some guidelines like training and preparing the muscles in the area, warming up before playing and stretching afterwards, choosing light equipment and staying well hydrated, among others.
“Obviously the golfer's technical movement must be corrected, because over flexing the wrist when swinging must be avoided. In other jobs it is the same, it is very important to have correct posture”, says Dr. Villanova.
In addition, Dr. Villanova points out something that would not normally be related to the condition - smoking, which turns out to be one of the worst risk factors in the case of golfer’s elbow.
Curiously, these injuries affecting the elbow are not necessarily related to muscle weakness in the elbow area. "For example, in the specific case of golfer's elbow, it is common for patients to have a weak shoulder and that causes their technical movement to fail, because they do not have strong enough shoulder rotators and abductors," adds the doctor.
So, in prevention training the doctor recommends the patient not focus only on the elbow but also on the muscular chain, since obviously the elbow does not work alone, it works in conjunction with the shoulder.
However, these small details or tips, which may seem very simple and can prevent the lesion, but often players only find out about them when they consult a specialist, which is why it is so important to be aware of and understand the problem to avoid injuries that may end up in an operating room.
Golfer's elbow, is there anything you can do about it?
Dr. Maria del Mar Villanova recommends consulting a specialist as soon as the first symptoms appear. The earlier the problem is detected, the better prognosis it will have.
As for a cure, first you should start with the simplest step, which is to apply a prescribed pharmacological treatment to reduce pain. Normally, this is accompanied by physiotherapy treatment with dry needling, shockwave treatment or electrotherapy. It is about lowering the stress the elbow area has been subjected to, either due to sport or to repetitive actions in a professional environment.
“If the first phase did not work”, explains Dr. Villanova, “we would go on to do infiltrations, that is, inject a substance in the elbow to improve the symptoms. This can be done with glucocorticoids, a very powerful anti-inflammatory agent, or with new biological therapies like platelet-rich plasma applications, that is, injecting the patient with their platelets from their own blood”.
Cases of epicondylitis, or golfer's elbow, that require surgery account for around 30% of patients. At this point, at Hospiten Estepona, the aim is always to perform minimally invasive surgery, so the patient's recovery is faster, allowing them to get back to work and sport as soon as possible.
Dr. Maria del Mar Villanova
Specialist in Orthopedic Surgery and Traumatology
Expert in Musculoskeletal Ultrasound
Holder of a Master’s Degree in Shoulder Pathology