Golfers elbow got you stuck in the sand? The right medial epicondylitis exercises can help get back on the greens – and stronger than ever.
The Golfers Plague
Golfers elbow (also known as throwers elbow) is a common repetitive strain injury that can affect the function of your arm and majorly interrupt your favorite activities.
The injury can cause pain and tenderness on the inside of your elbow, plus discomfort down your forearm. If you’re dealing with golfers elbow, you might also feel weakness when trying to grip things or discomfort when stretching your forearm .
This injury is centered around your medial epicondyle – a small bony bump on your humerus that can be felt on the inside of your elbow. Hence the scientific name medial epicondylitis.
At the medial epicondyle, your wrist and forearm flexor muscles connect to your upper arm bone. Your pronator teres originates here too, a muscle that also helps pronate your forearm – the motion you make with an outstretched forearm to rotate your palm down toward the floor that’s also used to snap the wrist on the follow through in a golf swing or when throwing a fastball .
Image by www.mayoclinic.org
We’ll get into the details of why the motions required in golf can aggravate the area in a sec.
But the big picture is that REPETITIVE FORCE in the area where all these forearm muscles connect – the medial epicondyle – causes damage to your tissues and pain in your elbow.
If you aren’t certain whether you’ve got golfers elbow or not, there’s a quick medial epicondylitis test that can point you in the right direction.
Place your affected elbow bent by your side with your forearm reaching out in front of you and your palm facing up. Using your other hand, gently extend the fingers and the wrist on the affected side – pulling your fingers down toward the ground.
With your hands in this position, extend your elbow to reach your arm fully out in front of you. If you feel pain along that inside region of the elbow, that’s a positive golfers elbow test. You’re definitely going to want to read on and check out the 3 medial epicondylitis exercises at the end of this article.
A Swing and A Miss
The underlying reason why this injury happens is because of the movement patterns used repeatedly in activities like golf and baseball. The motions required when swinging a golf club or throwing a baseball create strong forces through the forearm and the elbow.
How? Let’s break it down a little bit…
Imagine you’re gripping on to a golf club. You bring the club up to the rear to swing, and as you do so, you’ve got to cock your wrists a little bit.
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Next, you swing down and hit the ball, causing a big impact that between the ball and the club. This contact generates a TON of force.
At this impact point of the swing, you’re flexing your wrist. To complete the motion, you bring your wrist and arms up and around to the front, finishing the swing.
There are several important points to note about this cycle of a swing.
One, you’ve got a lot flexion happening in the wrist and elbow.
Two, you’ve got a good deal of pronation in the forearm. This repetitive flexion and pronation can quickly add up and cause the muscles behind these movements – pretty much all of which meet at the medial epicondyle – to become overused.
What’s more, if your grip isn’t strong and powerful (thanks again to those flexors), the club is probably doing a lot of rattling around in your hand as it makes impact with the ball. These shockwaves can travel up your arm, into the tendons and joints of your arm – especially in and around the elbow.
If your muscles aren’t strong enough to deal with these forces bombarding them, they will start to take on damage, and you guessed it, elbow pain at the medial epicondyle.
A lot of times this can unfortunately show up on trips when you planned to just unwind and hit the greens. Let’s say you take a golf vacation where you’re suddenly golfing every day for a week…
In these cases, your forearm muscles are suddenly overworked without building up strength slowly, AND you’re not giving them a chance to recover. These trips can easily lead to chronic golfers elbow pain.
Taking the “Itis” With a Grain of Salt
If you’ve decided you’re dealing with golfers elbow, it’s also important to consider the differences between chronic and acute medial epicondylitis.
The name of this condition means inflammation of the medial epicondyle, but that can be misleading if you’ve got a chronic form.
When the injury is acute, say within the first couple weeks or maybe the first month of symptoms, there IS inflammation in the region  and that inflammation is probably causing your pain. So at this point, that -ITIS suffix that indicates inflammation is probably accurate.
However, after that, the name becomes less appropriate.
If you’ve got chronic golfer’s elbow that’s been lingering for well over a month, it’s NOT inflammation that is causing your pain.
Inflammation is no longer present in the area at this point. What’s actually happening is a degeneration of the tendons that connect to your medial epicondyle. That force and overuse has started to add up and the area is no longer just inflamed, but degenerated.
Steps to Rehab
What does this all mean in terms of treatment?
If you’ve got acute pain, you’ll really want to focus on taking it easy.
Rest and ice your elbow and try to resist the urge to swing your club for a little while. As long as you’re not coming back too early or coming back too fast, you should recover pretty easily. Check out this article for the details on rehabbing golfers elbow from beginning to end.
When golfers elbow becomes a chronic issue, you’ve got to take a more active, comprehensive approach.
You’ll want to use medial epicondylitis exercises to restore proper function of the wrist and to promote muscular balance in the area.
Muscular imbalances in the wrist and forearm can occur VERY easily. Most of us spend a lot of time gripping and flexing the wrist, but very little time working our wrist and forearm extensors.
This imbalance can lead to a loss of extension mobility and strength. To protect yourself from future injuries and reduce pain, you need to restore balance.
And we not only need to work on the partner muscles for a well-balanced forearm, we also need to work the affected muscles themselves.
Exercising the wrist flexors will encourage much-needed blood flow to the area. Through proper and patient work on these muscles, the brain and nervous system starts to devote more attention to the tissues.
This blood flow will help stimulate the muscles to strengthen and to repair, and is the only way to really address the degeneration and damage of chronic medial epicondylitis.
With all that being said, let’s get into the moves that will help you battle chronic golfers elbow.
3 Medial Epicondylitis Exercises
Remember that these exercises are meant for CHRONIC golfers elbow – not for acute, but they are also great if you don’t have any pain as a preventative measure.
Remember, “An ounce of prevention is worth a pound of cure.”
These movements might provoke a little pain around your medial epicondyle and maybe into the muscle bellies along the forearm. If the injury is chronic, this is perfectly fine and actually desired.
But if your pain is acute, remember to back off, rest, and ice the area.
Active Wrist Extension Mobilization
This active wrist mobilization is a great technique, because it not only improves MOBILITY, but also improves STRENGTH – two factors that we’ve learned are key to treating this injury.
- Come into a quadruped position and sit back a little bit, leaning some weight into your feet
- As you do this, extend one wrist and extend the fingers, bringing the hand and fingers up toward your wrist while keeping the elbow straight
- Rock your weight forward slowly, maintaining extension in your wrist and fingers, until your hand comes all the way down back onto the floor, with some pressure into the hand and generating passive mobilization
- Start to move back, lifting your fingers and the hand off the ground as quickly as possible, still maintaining that extension and that straight elbow
- Repeat for 4-6 reps, keeping your extensors active throughout, then switch sides
Eccentric DB Wrist Curls
Next up, we will start working your flexor muscles to generate blood flow, restore strength, and encourage muscle and tendon healing.
For this move, you’ll need a dumbbell, likely starting with 2 to 5 pounds. Your starting weight will depend on your strength and the amount of pain you’re in.
- Kneel in front of a bench so that you can rest your working elbow on the bench
- Using your other hand, help yourself lift the dumbbell into full range of motion, with your wrist flexing up toward your forearm.
- Hold your wrist in full flexion for a second, then slowly and with CONTROL, uncurl your wrist into full extension over the edge of the bench – this motion should take about 4-5 seconds
- Complete 3 sets of 12 reps, focusing on the eccentric motion
As you do this, focus on maintaining a strong grip on the dumbbell the entire time – even at the starting point of full wrist flexion.
Extended Elbow Wrist Flexion/Extension
This drill will help create a new movement pattern that allows your wrist to move independent of your elbow. It will encourage blood flow to the area while training the FULL range of motion – from full flexion to full extension, all while building strength in the grip.
- With a straight elbow, make a strong fist
- Flex your wrist, bringing the fist closer to your forearm, but keep your elbow locked and straight and your grip strong
- Hold this flexed position for about 5 seconds
- Move into an extended flare – fully extend both your wrist and your fingers
- Hold this position for 5 seconds before returning to the flexed fist
- Complete anywhere from 3-6 cycles on each side and make sure not to let your elbow bend at any point in the movement
These 3 techniques are some of the most effective exercises for golfers elbow. You might find that doing them regularly for just 2 to 4 weeks could solve the problem.
However, these are just 3 techniques, and I’ve got many more that will restore FULL function of the entire upper limb.
Golfer’s elbow now may be a symptom of a greater problem or imbalance that if isn’t addressed, can lead to further dysfunction and injury. And problems might show up elsewhere, most commonly in the shoulder.
So if you’ve got golfers elbow now, this could mean something else is not working right and other problems are on the horizon if you don’t effectively address all of your dysfunctions.
But the most important aspect to consider is having a process to address the right things in the right order. To learn more, check out the presentation I’ve made for you that outlines the 3 Step process to restore proper function to eliminate pain and improve mobility and strength.