As physios who work extensively with elbow and forearm injuries, we see some misunderstanding between ‘tennis elbow’ and ‘golfer's elbow’. Some people believe they are the same condition, but with the difference being the sport being played when the injury was sustained. Others come in to see us presuming that this can’t be the cause of their elbow pain, given they do not play either sport, and have even greatly reduced their physical activity levels since the start of our pandemic restrictions.
The truth is, just like how you don’t need to be an athlete to contract Athlete’s foot fungal infection, or how you don’t need to be a runner to develop runner’s knee pain, the majority of our clients who we treat for tennis and golfer’s elbow have never tried either sport. In fact, your pain can come from activities as simple as emptying the dishwasher and lifting the dishes to put them away - or just typing on your computer.
Here’s a look into what tennis and golfers’ elbows really are, how you can tell if they’re causing your elbow pain, and what you can do to treat them.
What Is Tennis Elbow?
Medically known as lateral epicondylalgia or lateral epicondylitis, tennis elbow describes the disruption to the extensor tendons on the outside of the elbow that travel down the forearm to the wrist and hand. The disruption occurs when the tendons are overused and/or overloaded, which can occur during tennis or other racket sports, or can occur from daily occupations ranging from carpentry or plumbing, to landscaping or even a desk job using a keyboard and computer.
As the area on the outside of the elbow becomes irritated and possibly inflamed, symptoms develop including:
- Pain at the outside of the elbow that may radiate to the forearm Pain that is exacerbated by gripping or lifting objects or general wrist movements
- Pain may ease when resting your arm, and return when you start using your arm again
- Your grip may feel weaker than normal
We often see tennis elbow in those aged between 30-50 years, as well as in workers who use heavy tools or do lots of lifting on a daily basis. When we do see this condition in a tennis player, it is usually associated with a poor swing technique, wielding a heavy racket, incorrect grip, or high string tension.
What Is Golfer’s Elbow?
Where tennis elbow describes pain and injury on the outside of the elbow, golfer’s elbow describes an injury to the tendons on the inside of the elbow, which is medically called medial epicondylagia or epicondylitis. Like tennis elbow, golfer’s elbow also occurs when the tendons are overused, and in this case, it’s the flexor tendons that are responsible for helping flex your wrist and close your fingers into a fist.
The activities that can overuse the flexor tendons and lead to golfer’s elbow include painting, shovelling, lifting (while your palms are facing down) and other tasks involving gripping. This includes golf - as well as tennis. The symptoms of a golfer’s elbow may include:
- Pain and inflammation on the inside of the elbow
- Pain is exacerbated when gripping, lifting or bending the wrist forwards. There may also be difficulty and/or pain twisting or opening jars/doors
- Pain in the ‘funny bone’
- Pain when clenching your fist
- Weakness, numbness or tingling in your hand or wrist
We often see golfer's elbow in both men and women aged between 30-60 years, and most often affecting their dominant arm. Tennis players are also at risk of this injury if they have a late ball strike when the racket head sits behind the elbow at ball contact, or they have poor forehand stroke mechanics.
Can You Have Both A Tennis And A Golfer’s Elbow At The Same Time?
Yes - we do see this from time to time, as both conditions include overusing the tendons that attach at the elbow and travel down the forearm. Although they are located on opposite sides of the forearm and elbow, many activities place high demand on both sets of tendons, particularly in sports and workplaces that require heavy lifting and gripping while rotating the arms or wrists, such as in construction workers and rock climbers.
To confirm whether one or both areas have been affected, your physiotherapist will palpate and apply resistance testing to both sets of tendons, which will identify whether the extensors, flexors or both are involved.
Treating Elbow Pain
Regardless of whether you have tennis or golfer’s elbow, as both conditions can worsen if left untreated, prompt treatment is very important to help both reduce your painful symptoms, and help you get the best outcomes for the long-term. When you’re at home and suffering from elbow pain, you can start with avoiding the movements that cause you pain, using ice, or taking non-steroidal anti-inflammatories (NSAIDs) to reduce your immediate symptoms.
When we see a client with elbow pain, we’ll always start with a comprehensive assessment that examines exactly which structures have been affected and whether there are any other issues alongside the tendon injury, such as bursitis. We’ll look at your history and the demands of daily life on your hands, wrists and elbows, and conduct muscle and range of motion testing to give us the complete picture of what’s going on.
- Based on the results of your assessment, we’ll put together a completely customised treatment plan that may involve:
- A tailored exercise program targeted at the wrist, elbow and arm. This often starts with isometric or eccentric exercises depending on the severity, wrist extension and flexion, grip strengthening, and more
- Hands-on therapy around the elbow, as well as the upper back or even neck depending on the results of your assessment
- Working on correcting techniques and posture
- Soft tissue massage and fascial release
- Dry needling
- Strapping or bracing as needed
It’s important that your treatment and care with us is sustainable and works in with your life - and that includes continuing to work for our clients that have hands-on roles. We always try our best to accommodate your lifestyle and preferences while helping you get the best results.
Across our clinics, PhysioCentral has a range of experienced, knowledgeable and renowned physiotherapists who go above and beyond to support our clients through their immediate pain relief and recovery - and through the long-term, too.
We have three locations available in Hong Kong Central and Wong Chuk Hang, together with our own Pilates studio. Book your appointment online or call us on +852 2801.4801