Plenty of people play tennis and golf in Singapore, and inevitably some end up suffering from tennis elbow and golfer’s elbow. Orthopaedic surgeon Dr GEN LIN FOO discusses symptoms and causes of these conditions, and golfer’s elbow and tennis elbow treatments. Here’s how you can get back on the court or fairway where you should be!
What causes tennis elbow and golfer’s elbow?
Despite their names, tennis or golf are not always the culprits. Both can occur when there is a direct injury or, more commonly, when the joint is repetitively strained over time. The main difference between the two is the location of the pain.
Tennis elbow is more common than golfer’s elbow and is usually due to injury to the common extensor tendons. These are tendons that originate from the outer (lateral) aspect of the elbow and are involved in extending (lifting up) the wrist and the fingers. Gradual injuries to the tendons lead to inflammation, which then causes pain, swelling and limitation in elbow movement. Risk factors include manual jobs involving a lot of lifting, repetitive actions such as computer work, and, as the name suggests, upper-limb sports like tennis and golf.
What are the typical symptoms of golfer’s elbow and tennis elbow?
The pain is usually made worse by certain movements of the elbow or wrist. Tennis elbow symptoms are mainly felt at the outer (lateral) aspect of the elbow. Patients with golfer’s elbow will feel their symptoms at the inner part instead. This is due to injury to the common flexor tendons that originate from the inner (medial) aspect of the elbow. The pain results in arm weakness, difficulty when exercising or performing daily actions like lifting a jug of water.
What tests can confirm a diagnosis?
If the pain persists despite resting and taking a course of analgesia/anti-inflammatories, it’s best to seek medical attention. Physical tests including testing for the location of pain and whether certain movements provoke the symptoms are usually adequate to confirm diagnosis.
However, when the pain is long-standing or severe, there is a possibility of more serious injury. An ultrasound or MRI scan is helpful to confirm the diagnosis and exclude more serious causes.
What are the most effective golfer’s and tennis elbow treatment options?
There’s unfortunately no “quick fix”. Complete resolution of symptoms might take months, or up to a year, especially if patients don’t seek care early. Bearing the pain and continuing the activity that aggravates the injury will delay healing.
Initial treatment begins with rest. This can be challenging, as many common activities use those tendons. Using topical or oral medication to alleviate pain and reduce inflammation, and putting on an elbow strap can be helpful. The strap forces the affected tendon to rest and is a reminder to avoid activities that can add to the injury.
Once there’s sufficient improvement, targeted stretching and conditioning exercises can help strengthen the tendons. A physiotherapist or hand therapist can ensure proper technique and close follow-up of your progress.
For persistent or chronic cases, treatment options include extra-corporeal shock wave therapy (ESWT) and injections. ESWT utilises high energy acoustic waves to break down diseased tendon tissue (tendinopathy) and promote healing and repair. Cortisone injections reduce the inflammation in the affected region, breaking the chain cycle which can prevent meaningful stretching and conditioning elbow exercises.
In acute injuries, platelet-rich-plasma (PRP) injection can be helpful to accelerate healing and reduce inflammation; this involves concentrating the platelets from your blood and injecting it into the injured area.
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This article first appeared in the July 2024 edition of Expat Living. You can purchase the latest issue or subscribe so you never miss a copy!
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