Today, I (Scott) will focus on two very common injuries at the elbow, tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis). As much as tennis and golf can cause these injuries, you’re just as likely to get them from lifting at the gym or doing some DIY around the house.
Both conditions are typically caused by excessive load on the tendons that attach the muscles of the forearm (medial or lateral) to the elbow.
With gyms, golf courses and tennis courts now open, people have eagerly returned to, or are close to returning to these activities. Many people have also used the pandemic to start or finish DIY projects around the house. This sudden increase in tissue loading is a risk factor for developing a new injury or aggravating an old one. It’s easy to get excited when returning to the gym or sport and the saying ‘too much too soon’ can definitely apply here.
Similar to running, returning to the gym, golf or tennis should include a gradual build up of volume and intensity. Just because your previous injury settled down during lockdown doesn’t mean you won’t overload that tissue again after returning. If you’re thinking of heading to the driving range, think twice before grabbing your driver straight away. To warm up, start with shorter swings with one of your shortest clubs (e.g. Pitching wedge). After this, you can increase your swing length and move on to your mid irons, long irons, and finally, your woods. Make sure to take breaks and leave some balls to practice your chipping and putting. These shots will be less likely to overload your tissues and more likely to improve your score. You know the saying…
As for returning to the gym, it is important to allow tissue adaptation by starting with a reduced volume and load. If you’re like a lot of people who typically perform 3-4 sets of 6-15 repetitions for each exercise at the gym, try starting with 2 sets of 12-15 repetitions for your first week back. You can add an additional set the following week before increasing load the week after. This will allow your muscles and tendons to adapt to the load and reduce your chances of injury (or re-injury).
An important thing to know is that the upper limbs should contribute the LEAST amount of power to your golf swing or tennis stroke. During a tennis serve, your lower limbs and trunk initiate the movement and transfer energy to your upper limbs to hit the ball. Research shows that deficits in lower limb or trunk strength or poor contribution from these regions can result in overloading the elbow. Increasing tissue capacity in the forearm muscles AND strengthening the trunk and lower limbs (the kinetic chain) will improve distribution of load and reduce the risk of developing an elbow injury. Did you also know that one third of patients with tennis elbow also have neck dysfunction? Treating all necessary regions related to your condition will provide the best possible outcome.
Don’t let elbow pain get in the way of your game. An appointment with one of our physiotherapists will provide you with an accurate diagnosis and a comprehensive treatment plan. Your programme will most likely consist of some exercises to target the primary area of concern and other areas of dysfunction (e.g. neck, shoulder, trunk, lower limbs), some manual therapy to help with pain and mobility, and education regarding swing mechanics, progressing load, and warm up exercises you can do prior to lifting or playing to help minimise pain and maximise performance.