Elbow injuries are one of the most common injuries in golf. They are so common, in fact, that there is even a term called “Golfer’s Elbow” referring to an injury of the medial or inside part of the elbow. The only problem with that nomenclature is that “Tennis Elbow,” an injury to the lateral or outside part of the elbow, is also a common injury in golf. Though the terminology can be misleading, we can make some general assumptions as to why you have your pain depending on where it is.
- Golfer’s elbow or medial epicondilitis: This is an injury of the flexor tendons of your elbow, which connect your elbow to the muscles that flex your wrist (make your hand go down when your arm is extended in front of you with the palm facing down). Most amateur golfers get this injury in their trail arm (right elbow for a right handed golfer) because at impact their wrist tends to flex, or bend forward, as we see in the classic “Chicken Wing” “Casting” and “Scooping” swing patterns.
Low handicappers, on the other hand, tend to do the opposite since their lead wrist is flexed at impact (a more “proper” impact position). So by knowing where your discomfort is and on which arm, we can already guess what type of swing patterns we may see, and we can start to think about how to correct it.
- Tennis elbow, on the other hand, is the opposite of golfers elbow and involves the lateral aspect of your elbow. Amateurs tend to get it in their lead elbow as they extend their wrist, or bend the back of your hand toward the target, through impact. Low handicappers extend their trail wrist at impact, thus potentially causing pain in the lateral aspect of the right arm for right-handed golfers.
Here comes the twist. For most amateur golfers, your pain is in your elbow, but the elbow is almost never the inciting problem! Instead, the causative mechanism frequently starts in your hips and pelvis. That’s right. Your lower body causes your elbow injury. If your hips are not leading the downswing, or you are not rotating enough with your lower body, or you don’t have a proper weight shift in your lower body, or if you come over the top by starting your down-swing with your arms; all of these tendencies will force your upper body to compensate by “Chicken winging” “Scooping” or “Casting.” This leads to excessive extension of the lead wrist and flexion of the trail wrist, putting you at much greater risk for elbow injuries.
Since the elbow pain is the result of a mechanical compensation, a qualified professional should never focus only on your area of pain. Instead, they need to perform a thorough evaluation of how your body moves from top to bottom and how that impacts your golf swing mechanics. Only then can they indentify the true cause of your elbow pain and correct it. “Put an elbow brace on and go hit more balls” is never the best answer. It may feel better for a while, but it is a matter of time until the injury returns if you haven’t addressed the underlying mechanism. Likewise, directed therapy at your elbow is important to help speed recovery, but will not address the underlying cause.
A couple more tips:
- It is OK to bend your lead arm. We are frequently told to “keep you elbow straight!” But that can increase the pressure on our lead arm. Bending it a few degrees will frequently help the problem without hurting your swing.
- Pay attention to your work ergonomics. Your sitting position at your desk and computer can prevent an elbow injury from healing or possibly even make it worse.
- Keep you arm down when you sleep. This can be a tough one, but if you can sleep with your hand below your chest with your elbow bent at less than 90 degrees, you can provide valuable healing time for your elbow as you sleep.
- Watch your grip pressure. Holding the club too tightly increased the work and pressure placed on your elbows
- Try to avoid “fat” contact as this increases the impact forces through your elbow. Hitting it “thin” is a better miss for those with chronic elbow problems.
Hopefully this gives you a solid basic understanding about elbow injury mechanisms and potential corrections. By knowing where the injury is and on which arm, we can already guess what may be the cause. However, we can only know the cause for sure with a full body and swing evaluation. We usually find that the elbow is the innocent bystander making compensations for improper lower body motion and sequencing. We also have to make sure other parts of your life (i.e. work, sleep etc.) aren’t making it worse or preventing it from healing. Although directed elbow therapy and an elbow brace may be helpful in the short term, a long-term fix requires a more thorough evaluation by a trained professional.
To learn more about how we can help you with injury prevention and overall golf performance, contact us today at firstname.lastname@example.org
Fitness. Health. Life
Bret Scher, MD FACC
President, Boundless Health