Golfer’s and Tennis Elbow
Wrist and elbow injuries often occur when the body does not have the capacity to effectively compensate for restrictions that form at the shoulder, spine, or hips. For example, in the game of Golf, the wrists are often over-used to drive, as well as decelerate, the golf club.
By working to correct soft-tissue imbalances throughout the body, we are often able to prevent injuries such as Golfer’s Elbow from occurring. By removing these restrictions, we are able to restore full mobility and strength, and help the golfer perform better at his or her game.
Golfer’s Elbow refers to the pain and inflammation that occurs at the inside point of the elbow (medial epicondylitis). Golfer’s Elbow can be caused by any activity (not just Golf) that requires forceful and repeated bending of the wrist and fingers. When the Golfer swings his club, the flexor muscles and tendons of the arm tighten just before contact with the ball.
The repetition of this action stresses the muscles, causing micro-tearing of the flexor tendon, and inflammation of the surrounding soft-tissues.
The Kinetic Chain and Golfer’s Elbow
The game of golf only emphasizes one side of the body; either you are a right-handed golfer or a left-handed golfer. This unilateral focus is the cause of numerous injuries. Because the game of golf emphasizes just one side of the body most golfers develop muscle imbalances and a wide array of myofascial restrictions.
Golf, in the ideal form, is all about efficiently storing and releasing energy from your core to your extremities. It involves your entire kinetic chain: from your feet forming a solid stance, up through your hips, your core and the release of energy through your shoulders, and arms right into the club head; much like a coiled spring, storing energy then suddenly releasing it.
Unfortunately, for most golfers, the spring is either broken or minimally functioning. To these golfers, the game of golf is more about learning to compensate for muscle imbalances, poor posture, and a multitude of myofascial restrictions.
Consider these common examination findings on a patient who comes in for a golfer’s elbow problem. Examination findings:
- Rounded shoulders (anterior posture).
- Neck and low back restrictions (hypertonic muscle, trigger points).
- Tight restricted hips (hypertonic muscles, restricted motion).
- Poor Balance
A tight muscle on one side of your body will always create a muscle imbalance. Muscle imbalances always create a cascade of events. Physically these imbalances create friction, this friction creates micro tears in your muscles, and then micro tears create inflammation and the formation of scar tissue. This scar tissue inhibits motion which causes numerous compensations throughout the body and an ongoing cycle of dysfunction. Each restriction that forms also creates abnormal motor patterns in the body, altering the orders in which energy is transfers from your core to your extremities. This is often referred to as the Kinematic Sequence.
In the case of a golfer, a hip restriction often causes the golfer to over-compensate with their shoulders, which in time creates restrictions in that shoulder and a corresponding alteration of their posture.
From this anterior shoulder position you are setting yourself up for wrist and elbow injuries. It does not matter what sport we are talking about; you will have a decrease in performance. Whatever power you are trying to release from your core will be lost in this position.
So here is the key point: what appears on the surface to be just an elbow injury could be a symptom of a much larger problem. Even if you are not aware of imbalances or restrictions, they are affecting you. A strong, balanced, mobile core which also involves unrestricted hips and mobile shoulders in the right postural position is essential. Not only will you prevent injuries from occurring but you will have a much better chance of permanently resolving them. Best of all, you will excel at your golf game.
Tennis Elbow is a painful condition at the outside point of the elbow. The condition typically involves inflammation and irritation of the extensor tendon where it attaches to the lateral epicondyle.
- The extensors attach to the lateral epicondyle on the outside of the elbow.
- The common extensor tendon also attaches to the lateral epicondyle.
- Both these structures are susceptible to micro-tears when they are exposed to repetitive actions.
As with Golfer’s Elbow, the so-called Tennis Elbow can be caused by a variety of activities. Any activity that involves supination (turning the hand, palm side up), or lifting objects with your elbow in full extension (elbow straight) can cause this condition.
The repetitive motions of these activities result in micro-tears, inflammation, scar tissue formation, and physical dysfunctions that then become Tennis Elbow. Several layers of soft-tissues are involved in the injury, including:
- The deep annular ligament.
- The supinator and anconeus muscles.
- The superficial structures of the extensor muscles.
In most cases, Active Release Techniques, Graston Techniques, or specific soft tissue procedures could prevent or greatly reduce this type of injury.
At our clinic, we use specific soft tissue procedures to treat each layer of the injury. These procedures release the restrictive adhesions that bind these soft-tissue layers together, and allow the tissues to once again move smoothly over each other. Our practitioners are careful to work through the entire kinetic chain (not just the area of pain) and address all the structures that are affected or restricted by the Tennis Elbow.
Through touch and practice, the practitioner can literally feel when this has been achieved. In most cases, the patient experiences an immediate decrease in pain, and an increase in range of motion and strength.
It is important to treat the entire kinetic chain for an elbow injury. Not just the point of pain!
For the majority of cases, I consider elbow injuries to be very easy to treat when using Active Release Techniques. In fact, for many years, I had not realized how ineffective other methods were for treating this type of injury. We often hear about how a patient has suffered for years, trying numerous types of therapies, with little or no success.
At our clinic, we are able to resolve most elbow injuries within 6 to 8 visits. Many medical professionals and patients cannot believe that we can achieve results so quickly, especially when the patient has already been through extended therapy prior to visiting us.
In order to effectively balance your muscles and remove joint restrictions we conduct a biomechanical analysis to identify your unique pattern of muscle imbalances. By utilizing a series of muscle balance and motion analysis tests, we can identify the exact type, extent, and location of soft-tissue restrictions.
We then use soft-tissue treatments and follow-up exercises to release and resolve these restrictions, and then strengthen the muscles to prevent re-injury.
With this type of treatment perspective, we look beyond just the symptomatic areas, and also consider the effect that other soft-tissue structures within the elbow’s kinetic chain have upon the injury. These areas can include restrictions in structures ranging from the neck to the wrist.
We are able to achieve a very high level of success in treating these conditions simply because we identify and remove all the multiple levels of restrictions that inhibit the translation and movement of soft-tissues in these areas.