Tendons are tough cords of connective tissue called collagen. They originate in muscles and attach the muscles to bones. When muscles are contracted, tendons pull on bones, causing movement. Damage to these tendons as a result of overuse causes the painful symptoms associated with golfer’s elbow.

Causes:
Golfer’s elbow is caused by excessive repetitive stress to the muscles and tendons of the forearm. The stress causes small tears in the tendon fibers. Continued use without allowing time for healing will make the condition worse. Many recreational activities, occupations, and sports require the particular wrist and hand movements that can be responsible for causing the condition. Apart from golfers, racket sport players, pitchers, weight trainers, painters, typists, and others are all susceptible to developing symptoms associated with golfer’s elbow.

Cases of golfer’s elbow are common at the beginning of the sporting season when players return to their sport after a period of non-participation. Suddenly increasing the duration or intensity of play can also lead to the condition.

Symptoms:

• Pain, normally localized on the inner side of the elbow, but sometimes extending down the inner side of the forearm
• Pain may appear suddenly or may gradually increase with use
• Pain, possibly shooting down the forearm, made worse when gripping, squeezing, rotating or bending the wrist
• Stiffness in the elbow joint
• Possible weakness of the wrist and hand
• Possible numbness or tingling extending into the fingers, usually the ring and little finger

Diagnosis:
Your doctor will ask you about your medical history, including any previous injuries to your elbow or forearm. Your general lifestyle, activities, and participation in sport will be discussed. You will be asked about the circumstances of your current injury and the onset, duration, and severity of your symptoms.

Diagnosis of golfer’s elbow is usually made through the description of your symptoms and a physical examination of your elbow. Your doctor will manipulate and touch your elbow, wrist, and hand in specific ways to assess the degree of pain and stiffness.

X-rays may be taken if your doctor thinks that there may be a reason other than golfer’s elbow that is causing your pain, for example a fracture or arthritis. Very occasionally an MRI (magnetic resonance imaging) scan may be needed to get a clear view of the soft tissues in the elbow.

Treatment:
Golfer’s elbow usually responds with time and conservative (non-surgical) treatment. Surgery is rarely necessary and is usually only performed if you have failed to respond to non-surgical treatment.

Conservative treatment of tennis elbow may include:

Rest:
Avoid any activities that make your symptoms worse, but continue to use your arm to prevent stiffness developing. Keep your wrist rigid whenever you have to lift something.
Ice:
Applying ice, crushed in a bag and wrapped in a towel, to the sore area for as long as is comfortable, several times a day, will help to reduce swelling and inflammation.
NSAIDs:
Non-steroidal anti-inflammatory drugs such as ibuprofen (Advil), naproxen (Aleve), aspirin or acetaminophen (Tylenol) can be taken to relieve pain and inflammation.
Cortisone injection:
Your doctor may administer a corticosteroid injection directly into the elbow joint. This can provide rapid relief from pain and inflammation.
Compression:
Your doctor may recommend that you put a supportive bandage on your elbow or wear a forearm strap to reduce stress to the damaged tendon.
Physical therapy:
Physical therapy can include massage, ultrasound, and electrical stimulation, all of which are designed to encourage the flow of blood to the damaged area.

After the acute stage of the injury you can begin a program of exercises to restore flexibility and improve strength in your elbow forearm, and wrist. You should review your techniques (method of swinging the club, if you are a golfer) to make sure that you use proper posture and grip.

If your case of golfer’s elbow is severe, it may take several months for the pain to completely disappear. It is extremely important to be patient and not to return to normal activities before your elbow is healed. Rushing your recovery can result in further injury.

Exercises:
Only perform these exercises if doing them causes no pain. Start gently and build up gradually.
Triceps stretch:
Sitting in a chair, slowly raise your elbow over your head as high as you can so that your palm is facing the back of your shoulder. Bring the elbow back down. Repeat 10 times for 1 set.
Biceps stretch:
Sitting in a chair with your arm down by your side and your palm facing forward, bring your arm behind you as far as you can. Repeat 10 times for 1 set.
Flex, extend, and side-to-side:
Simply bend the wrist forwards and hold the stretch for 5 seconds. Then bend the wrist backwards and hold the stretch for 5 seconds. Move the wrist from side to side (as in a handshake) and hold at the furthest point at each side for 5 seconds.
Ball grip:
Hold a foam or rubber ball in your hand. Gently squeeze it 25 times for 1 set.
Can exercises:
1. Hold a can in your hand with your palm down. Keeping your forearm on the table, slowly bend the wrist backwards towards you. Hold for 5 seconds.
2. Hold a can in your hand with your palm up. Keeping your forearm on the table, slowly bend the wrist towards you. Hold for 5 seconds.
3. Hold the can upright with your thumb pointing up and slowly move your wrist up and down.
4. Hold the can upright with your thumb pointing up. Slowly curl your wrist towards you as far as you can without forcing, hold for 5 seconds then slowly curl the wrist away from you as far as you can and hold for 5 seconds.
Elastic band:
Interweave a thick elastic band around your fingers. Keeping your elbow straight, try to spread your fingers out as far as possible. Hold for 5 seconds.