G.U.R. - Golfers Under Repair

Upper Body Golf Injury Rehabilitation

Tennis Elbow – Cause Effect & Prevention

Introduction

On every golf course in the world you will see golfers with “tennis elbow” braces on their arms. Most golfers will also know a member at their club who has experienced the curse of “tennis elbow”. Contrary to popular belief most golfers incur “tennis elbow” rather than “golfer's elbow”

Thirty to forty years ago this was the opposite. “Golfer's elbow” was more prevalent and the cause purely due to changes in golf technique over the years.

In the 1950's & 60's the golf swing had a tendency to be more “armsy” with greater side movement however now the swing has evolved into a more athletic and powerful movement. (Research has shown that the club head speeds can reach 120km/hr and the forces are equal to your body weight at impact) and the trunk deep muscles are now being fired in the golf swing.

What is Tennis Elbow?

Tennis Elbow is pain on the outside of the forearm radiating down into the wrist area. It is aggravated by gripping objects e.g. golf clubs, door handles, steering wheel. The pain gradually leads to a feeling of weakness in the hand and arm and eventually an inability to play golf.

What Causes Tennis Elbow?

Constant repetition of a movement e.g. golf practice, computer work, gardening.

This article will focus on the origins of Tennis Elbow from a golf perspective and giving you a “take away” system to give to your golf coach and golf therapist. Outlined are checklists to fill in and self-screen your equipment, swing and body for tennis elbow.

Golf Equipment Check

Tennis Elbow can be caused as a result of the following (tick the boxes):
	Have not had grips checked for the right size (small hands, grips too big)
	Glove worn on the palm of the hand and fingers (compensating with hands)
	Clubs not fitted corrrectly (too heavy, long, etc)
	Slippery grips, old/dirty/grips wet with rain or sweat
	Poor training regimes e.g. spending too long on one shot causing arms to over compensate
	Practicing off mats for excessive periods of time (excessive impact on non forgiving surface)
	Weak postural and deep core stability muscles in shoulders / abdominals and gluteals causing arms to over compensate

Golf Swing Check

	Poor warm up for golf (no stretching and hitting full long shots straight away)
	Gripping too hard on the club (poor grip position, badly conditioned grips)
	Poor set up (Poor posture e.g. Droopy Flower, causing excessive arching of wrists at address – wrists too high)
	Poor set up (Poor grip – too weak in left hand causing incorrect hinging/ cocking of wrists)
	Poor sequencing (over use of hands and arms, compensating for poor sequence of body parts)
	Poor impact positions to the ball (weak wrist position from poor backswing causing excessive vibration through impact)
	Over cocking (BOWING of the wrists on the backswing)
	Loosening the grip at the top of the swing and then re-gripping (possible grip tension at address causing change of grip pressure during swing)
	Excessive repetition of a bad movement in your golf swing
	Poor swing misconceptions (keeping head still and keeping left arm straight)

Golf Physical Tests

The following tests can also be used as tennis elbow injury prevention exercise drills.

• Flexion Test

  Making sure your shoulder is down and your arm is fully extended try to flex your wrist to 90 degrees keeping your fingers and thumb in a fist position.

• Extension Test

  Making sure your shoulder is down and your arm is fully extended try to pull (using your other hand) your fingers and thumb back towards your wrist (full extension is 90degrees and beyond).

• Neck and Arm Extension Test

  Keeping your arm and small finger close to the side of your body with your shoulders down and back, slowly pull your head to the opposite shoulder by moving your ear to your shoulder. You should feel a stretch in the side of the neck within a pain free range.

• Crucifix Test

  Keeping your shoulders at 90 degrees with your arms in a hold up position try to maintain the correct curves of your neck and spine (use a wall to ensure you obtain correct postural feedback). Hold this position for 30 seconds.

Conclusion

If you have found the breakdowns are related to your tennis elbow please contact your local golf therapist and golf coach to seek appropriate consultation. Hopefully by checking yourself out and using this screening system you will prevent tennis elbow limiting your golf participation.

© International Physiotherapy Systems