Golfers Elbow in Northampton & Corby
Your Local Experts in Elbow Pain
Are you struggling with Elbow PAIN and looking for effective, professional treatment? At Team Rehab UK Ltd, our dedicated clinics in Brixworth and Corby offer premium physiotherapy services to help you regain your mobility and live pain-free. With a minimum of 24 years of experience each, our highly skilled chartered physiotherapists are committed to providing personalised care tailored to your specific needs.
Understanding Golfers Elbow Pain
Introduction to Golfers Elbow
Golfer's elbow, also known as medial epicondylitis, is a painful condition that occurs due to repeated muscle contractions in the forearm causing inflammation and micro-tears in the tendons that attach to the medial epicondyle. The medial epicondyle is the bony prominence that is felt on the inside of the elbow. This condition not only affects golfers but also individuals engaged in activities that require repetitive use of the forearm.
Anatomy of the Elbow Joint
The elbow joint is a complex structure formed by the articulation of three bones:
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Humerus: The upper arm bone that connects to the shoulder at its proximal end and forms part of the elbow joint at its distal end. The lower end of the humerus features two bony protrusions, known as the medial and lateral epicondyles, which serve as attachment points for various muscles and tendons.
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Radius: The smaller of the two forearm bones, located on the thumb side. It is crucial for the rotational movements of the forearm.
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Ulna: The larger forearm bone, situated on the pinky side, which forms the hinge of the elbow joint with the humerus, allowing for bending and straightening of the arm.
What is Golfers Elbow?
Golfer's elbow is similar to tennis elbow but affects the inner part of the elbow rather than the outer part. Both conditions are types of tendonitis, meaning inflammation of the tendons. In golfer's elbow, the tendons that attach the forearm muscles to the medial epicondyle become inflamed due to overuse or injury.
Tendons:
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Tendons are tough, fibrous tissues that connect muscles to bones. In the case of golfers elbow, the tendons attaching the forearm muscles to the medial epicondyle become inflamed due to repetitive strain. This inflammation leads to pain and tenderness on the inner elbow.
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Ligaments:
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Ligaments are strong bands of tissue that connect bones to other bones, providing stability to the joint. The medial and lateral collateral ligaments are the primary stabilising ligaments of the elbow. The annular ligament encircles the head of the radius, holding it in place and allowing smooth rotation around the ulna.
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Signs and Symptoms of Golfers Elbow?
Golfer's elbow, or medial epicondylitis, manifests through a range of symptoms that can significantly affect daily activities and overall quality of life. Understanding these symptoms is crucial for early detection and effective treatment.
Elbow Pain
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Sudden or Gradual Onset: The pain associated with golfer's elbow can develop either suddenly, often after a specific activity that overstrains the forearm muscles, or gradually over time due to repetitive stress. This pain typically presents as an achy sensation.
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Location: The pain is usually localised on the inner side of the elbow, where the tendons attach to the medial epicondyle. This area is tender to touch and can be quite sensitive during activity or movement.
Stiffness
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Decreased Range of Motion: Stiffness in the elbow joint can make it difficult to fully extend or flex the arm. This reduced range of motion can impact everyday activities such as reaching for objects, lifting items, or even shaking hands.
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Morning Stiffness: Many individuals with golfer's elbow experience increased stiffness in the morning or after periods of inactivity. This can make starting the day particularly challenging and may require gentle stretching to alleviate.
Radiating Pain
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Inner Forearm Pain: The discomfort often extends from the elbow down the inner forearm. This radiating pain can affect the entire length of the forearm, making it uncomfortable to perform tasks that involve arm movement.
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Hand and Wrist Pain: In some cases, the pain can radiate further to the hand and wrist. This can complicate activities that require fine motor skills, such as writing or typing, and can contribute to overall hand weakness.
Weak Grip
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Difficulty Holding Objects: A hallmark symptom of golfer's elbow is a weakened grip. This occurs because the inflamed tendons and muscles struggle to function properly, making it hard to grasp objects firmly.
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Impact on Daily Activities: Simple tasks like holding a coffee cup, carrying groceries, or turning a doorknob can become challenging and painful. This weakness can significantly impact one's ability to perform routine activities efficiently.
Increased Pain with Movement
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Gripping Objects: Activities that involve gripping, such as holding a racquet, using hand tools, or even shaking hands, can cause a sharp increase in pain. This is due to the additional strain placed on the already inflamed tendons.
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Wrist Flexion: Pain intensifies when the wrist is flexed or bent forward toward the forearm. This motion stretches the tendons attached to the medial epicondyle, exacerbating the inflammation and pain. Activities such as typing, using a computer mouse, or lifting weights can become particularly painful.
Signs and Symptoms of Golfers Elbow?
Accurate diagnosis of golfer's elbow, or medial epicondylitis, is crucial for effective treatment and management. An orthopaedic specialist typically conducts a comprehensive evaluation to identify the condition accurately. The diagnostic process involves several key steps:
Medical History
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Comprehensive Review: The specialist will begin by taking a detailed medical history to understand the patient’s symptoms, duration of the pain, and any activities that may have contributed to the condition. This includes:
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Previous Injuries: Inquiring about any past injuries to the elbow or forearm that might have led to or exacerbated the current condition.
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Activity Levels: Discussing the patient’s occupation and recreational activities to identify repetitive motions or overuse of the forearm muscles.
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Pain Description: Understanding the nature of the pain, whether it is sharp, dull, constant, or intermittent, and identifying any activities that worsen or alleviate the symptoms.
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Physical Examination
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Assessment of Pain and Tenderness: The specialist will palpate (examine by touch) the inner side of the elbow to identify areas of tenderness and inflammation. This helps in pinpointing the exact location of the pain.
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Range of Motion Tests: The patient will be asked to perform specific movements to assess the range of motion in the elbow joint. These tests help determine the extent of stiffness and functional impairment:
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Flexion and Extension: Bending and straightening the elbow to see if these movements trigger pain.
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Supination and Pronation: Rotating the forearm to evaluate pain during these movements.
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Strength Tests: The specialist may check the strength of the forearm muscles by asking the patient to grip objects or resist force applied by the specialist. This helps in assessing the grip strength and identifying any weakness.
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Provocative Tests: Specific tests are performed to reproduce the symptoms of golfer's elbow. These may include:
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Resisted Wrist Flexion: The patient is asked to flex the wrist against resistance, which can trigger pain in cases of medial epicondylitis.
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Resisted Pronation: The patient resists an attempt to turn the palm up, which may also elicit pain.
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Imagery Investigations for Golfers Elbow?
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X-rays: While X-rays do not show soft tissue damage, they are useful in ruling out other conditions that might cause similar symptoms, such as fractures, bone spurs, or arthritis. The specialist will look for any abnormalities in the bone structure of the elbow.
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MRI (Magnetic Resonance Imaging): If the diagnosis remains unclear, an MRI may be ordered. MRI scans provide detailed images of the soft tissues, including tendons and muscles, allowing the specialist to see any inflammation, tears, or degeneration in the tendons attaching to the medial epicondyle.
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Ultrasonography: This imaging test uses sound waves to create images of the soft tissues. It can help in visualising tendon abnormalities and confirming the presence of medial epicondylitis. Ultrasonography is a useful tool for real-time assessment of the tendons during movement.
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Other Diagnostic Tests: In some cases, additional tests such as nerve conduction studies may be performed if there is suspicion of nerve involvement or to rule out other conditions like cubital tunnel syndrome.
Imagery Investigations for Golfers Elbow?
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X-rays: While X-rays do not show soft tissue damage, they are useful in ruling out other conditions that might cause similar symptoms, such as fractures, bone spurs, or arthritis. The specialist will look for any abnormalities in the bone structure of the elbow.
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MRI (Magnetic Resonance Imaging): If the diagnosis remains unclear, an MRI may be ordered. MRI scans provide detailed images of the soft tissues, including tendons and muscles, allowing the specialist to see any inflammation, tears, or degeneration in the tendons attaching to the medial epicondyle.
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Ultrasonography: This imaging test uses sound waves to create images of the soft tissues. It can help in visualising tendon abnormalities and confirming the presence of medial epicondylitis. Ultrasonography is a useful tool for real-time assessment of the tendons during movement.
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Other Diagnostic Tests: In some cases, additional tests such as nerve conduction studies may be performed if there is suspicion of nerve involvement or to rule out other conditions like cubital tunnel syndrome.
Ensuring Optimal Treatment Outcomes
At Team Rehab UK, we emphasise that treatments which are not effective should not continue beyond accepted clinical timescales without further in-depth investigations. We prefer these additional assessments to be conducted by consultant specialists outside our company’s financial interests. This approach ensures we receive an unbiased second opinion, guaranteeing that the care you receive is the most clinically appropriate.
Treatment Options for Golfers Elbow
Golfer's elbow, or medial epicondylitis, can significantly impact daily activities and overall quality of life. Treatment for this condition typically starts with conservative approaches and may progress to surgical interventions if necessary. Here is an expanded look at the treatment options available:
Conservative Treatments
Activity Restrictions
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Limiting Activities: The first step in treating golfer's elbow is to avoid activities that exacerbate the pain. This involves modifying or completely stopping movements that strain the affected tendons, such as repetitive wrist and forearm motions.
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Ergonomic Adjustments: Making adjustments to your workstation or using ergonomic tools can help reduce strain on the forearm.
Rest
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Complete Rest: Allowing the elbow to rest by avoiding any aggravating activities is crucial for reducing inflammation and promoting healing. This period of rest can vary from a few weeks to several months, depending on the severity of the condition.
Splints or Braces
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Supportive Devices: Wearing splints or braces helps to minimize stress on the damaged tendons by keeping the elbow in a neutral position. These devices provide support during daily activities and help prevent further injury.
Ice Therapy
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Cold Application: Applying ice packs to the affected area can help reduce pain and swelling. It is recommended to use ice packs for 15-20 minutes several times a day, especially after engaging in activities that might worsen the pain.
Medications
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NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can be used to manage pain and inflammation. These medications can be taken orally or applied topically as gels or creams.
Physiotherapy
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Strengthening Exercises: Physiotherapists at team Rehab uk can guide patients through exercises that strengthen the forearm muscles and improve their function. These exercises focus on gradually building muscle strength without overstraining the tendons.
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Techniques for Daily Activities: Learning techniques to perform daily activities in a way that minimises strain on the elbow can help prevent further injury.
Surgical Treatment
When conservative treatments fail to resolve the condition and symptoms persist for 6-12 months, surgery may be recommended. The goal of surgery is to remove the diseased tissue, improve blood supply to the area, and alleviate symptoms. Surgical options include:
Debridement
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Scar Tissue Removal: During debridement, the surgeon removes scar tissue and, if present, bone spurs from the medial epicondyle. This helps reduce pain and improve tendon function.
Tendon Reattachment
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Reattaching Tendons: The surgeon reattaches the damaged tendon to the bone using special sutures. This procedure stabilises the tendon and promotes proper healing.
Post-operative Care
Post-surgery care is crucial for successful recovery and includes the following steps:
Immobilisation
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Using Supports: Patients are typically placed in a sling, cast, or splint to immobilise the elbow. This helps protect the surgical site and allows the tendons to heal properly.
Elevation
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Reducing Swelling: Keeping the elbow elevated on pillows above heart level helps reduce swelling and pain. This position aids in improving circulation and reducing fluid build up.
Hand Exercises
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Flexing and Opening: Performing gentle hand exercises, such as flexing and opening the hand, helps reduce swelling and maintains circulation in the arm.
Ice Packs
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Cold Therapy: Applying ice packs to the surgical area helps reduce swelling and pain. This should be done in intervals, typically 15-20 minutes several times a day.
Incision Care
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Keeping the Area Clean: Ensuring that the incision area remains clean and dry is essential to prevent infection. Patients should follow their surgeon's instructions for cleaning and protecting the incision.
Rehabilitation
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Exercise Plan: Following a prescribed rehabilitation program is critical for restoring motion and strength in the elbow. This plan may include physical therapy sessions and specific exercises to enhance recovery.
Medication
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Pain Management: Taking prescribed pain medications as directed by the surgeon helps manage post-operative pain and discomfort, making the recovery process more comfortable.
Healthy Lifestyle
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Diet and Habits: Maintaining a healthy diet and quitting smoking can significantly promote healing. Proper nutrition supports tissue repair, while avoiding smoking improves circulation and reduces the risk of complications.
Risks and Complications
While most patients experience no complications following surgery for golfer's elbow, potential risks exist, including:
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Excessive Elbow Stiffness: Post-operative stiffness can occur, affecting the range of motion.
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Infection: As with any surgical procedure, there is a risk of infection at the incision site.
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Nerve Damage: There is a potential for nerve damage during surgery, which can affect sensation and function.
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Hematoma: Accumulation of blood outside of blood vessels can occur, leading to swelling and pain.
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Incision Breakdown: The surgical incision may not heal properly, leading to complications.
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Recurrence of Symptoms: In some cases, symptoms may return after surgery.
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Compartment Syndrome: Excessive swelling at the operative site can lead to compartment syndrome, a serious condition that requires immediate attention.
We have included this video animation to help you visualise the anatomy that we, as professionals, often take for granted. At Team Rehab UK, we are dedicated to helping our patients understand the causes of their symptoms, empowering them to effectively manage their condition both during and after their treatment.
Please note that some of our videos may be of American origin and might contain slightly different professional terms or approaches compared to those used in the UK. However, the content remains highly informative and beneficial. You should seek advice form your UK based specialist before trying any advice contained, or inferred, in the video you ensure it complies with UK best practice standards.
Summary
Intra-articular shoulder injections are a safe and effective technique for treating various shoulder conditions, such as arthritis, tendinitis, and bursitis, particularly when conservative treatments have failed. These injections can provide significant pain relief and improve shoulder function, helping you return to your normal activities.
If you are experiencing persistent shoulder pain, consult with a physiotherapist in Northampton for a comprehensive evaluation and personalised treatment plan. At our clinic, we offer extensive physiotherapy in Northampton, including sports massage in Northampton, to support your recovery. We are recognised providers for Bupa Northampton and Axa Northampton, ensuring high-quality care for our patients. Don't let shoulder pain hinder your daily activities—reach out to our shoulder specialists in Northampton for expert care and support.
Book your appointment at Team Rehab uk in Northampton (Brixworth) or Corby, and take the first step towards a pain-free life. Share this information with friends or family who might benefit from our services, and let's help everyone get back to their best selves.
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