‘During the Players Championship in May 2013, we first noticed Tiger Woods, World Rankings leader was suffering from an elbow injury. Just like Tiger Woods, God of Cricket world, Sachin Tendulkar was suffering from a tennis elbow injury in the year 2004. Here, we will discuss these two elbow conditions.” – Afreen Khan Physiotherapist, Pro Physiotherapy.
Burning, stabbing elbow pain. This is the common description for two conditions, tennis elbow and golfer’s elbow.
These terms are often mixed up but are actually quite different. Welcome back, I’m Afreen Khan Physiotherapist. Today I’m gonna give you a breakdown of these two conditions discussing the differences and the similarities.
Lateral elbow pain is commonly associated with activities where we challenge the wrist extensors to a high degree such as in the backswing in tennis giving it the name tennis elbow. In contrast, medial side of the elbow pain is commonly associated with activities where we challenge the wrist flexors to a high degree such as the rear arm in golf, giving it the name golfer’s elbow.
Both of these conditions are actually associated with many more activities than just golf and tennis, for instance, lateral elbow pain is quite prevalent affecting about 1 to 3 percent of the population. It can be present during various job tasks and activities which place a higher demand on the back of the wrist. Some examples include plumbers and the use of plumbing tools, office workers or those spending a lot of time typing, and even those participating in Ultimate Frisbee.
We, also see this type of pain during the bench press when people tend to have their elbows flared as the bar lowers putting their lateral elbow under more stress. Medial elbow pain is less common than lateral elbow pain affecting about half a percent of the general population and it can present outside golffor.
We see it show up a lot during various physical activities that are very grip demanding. Similarly, we see this present a lot in individuals who worked out regularly and do a lot of activities that are highly challenging to their grip.
The tennis elbow is associated with the lateral elbow involving the extensor muscles of the forearm, these originate around the lateral epicondyle, ER region, giving the condition various names such as lateral epicondylitis. These muscles primarily function to extend the wrist but also have secondary actions such as finger extension and wrist side bending.
The Golfer’s elbow is associated with the medial elbow involving the flexor muscles of the forearm these originate around the medial epicondyle region arising the various diagnosis names is received such as medial epicondyle and the disease called medial epicondylitis, these muscles function to flex the wrist primarily while also having various other secondary actions such as finger flexion and forearm pronation.
Well, these elbow presentations are on opposite sides, affecting very different musculature. They have highly similar characteristics in pain symptoms and possibly cops commonly. These are believed to be due to repetitive stress that tears the muscle and tendon causing inflammation and swelling, which leads to pain and disuse.
However, this theory has been challenged as the research shows that there is generally a lack of or at least a minimal amount of inflammation present in these conditions. A good example is from a study by Regan et al, which identified that the change is seen in those with tennis elbow or more characteristic of degeneration than in an inflammatory process.
For the tennis elbow, we see that one of the main muscles involved the extensor carpi radialis brevis merges into the lateral collateral ligament of the elbow which connects with the annular ligament. Collectively, these cover a significant amount of region and are thought to be possibly involved as well for golfers elbow there is a similar network of muscular tissue connecting into tendons and ligaments that span the region around the medial epicondyle.
What we do know for sure is that the level of pain in these presentations is not reflective of the level of damage to the structures in the region. An interesting finding is that we see, individuals who are experiencing both of these issues will commonly present with deficits in the rest of the upper extremity, as well such as having reduced strength in the external rotators of the shoulder or the lower trapezius of the mid-back.
For both of these, if there are no red flag symptoms, such as rapid swelling, increased redness, or trauma to the area, then these can be managed conservatively, such as with physiotherapy. So experiencing symptoms around the elbow, it is valuable to be screened and evaluated in order to rule out any involvement from other areas.
The neck, back, and shoulders are all possible locations that can refer symptoms to the elbow. Once diagnosed appropriately, these can be treated well with an evidence-based physiotherapy exercise program. Usually, we’ll see golfers’ elbow that will clear up in four to twelve weeks’ time, whereas tennis elbow is a lot more variable in many cases, it will clear up in a similar timeline as a golfer’s elbow. However, it is known to persist over a year in some cases.
There are surgical options for both of these conditions, however, these are rarely needed. Instead, a guided evidence-based physical therapy exercise program has shown to improve function, as well as reduced pain.
I will be covering treatment options mainly, non-surgical, physiotherapy for both of these conditions in separate articles in the near future. So make sure you follow our website in order to stay up to date with our newest content.
I thank you guys for reading, share it with your relatives and friends. Leave any questions in the comments below and we will see you guys next time. If you are suffering from any of these conditions, feel free to contact J Mazumdar physiotherapist or Afreen Khan physiotherapist. mobile 8951022334.