Issue link: https://www.massageandbodyworkdigital.com/i/68012
GOLFER'S ELBOW The term golfer's elbow is misleading, because golfers are only a small segment of the population that suffer from this injury. The muscle-tendon unit involved in this injury is the flexor carpi radialis, the structure used to flex the wrist. Bikers, construction workers, painters, pianists, tennis players, violinists, and individuals who work out using weights all get golfer's elbow fairly frequently. It is also common in those who spend many hours a day at their computer, and is frequently a part of the complex picture referred to as repetitive stress injuries (RSI). When the injury does stem from golfing, the affected elbow is the one associated with the low grip on the golf club; the flexor carpi radialis undergoes intense resisted flexion stress as the club meets the ball. To locate the structures affected in golfer's elbow, press one of your elbows into the side of your body, squeezing it against your ribs as hard as you can. The bony protrusion pressing into your ribs is the medial epicondyle. Golfer's elbow usually occurs right at the medial epicondyle—specifically, at the tenoperiosteal junction of the flexor carpi radialis tendon (the portion of the tendon that is attached to the periosteum, or bone covering, of the medial epicondyle). This is the area of the muscle-tendon unit where the most stress and tension are exerted. If the structure is not rested or treated after an initial strain, the injury may spread to affect the body of the tendon, the muscle belly, or the distal attachment on the anterior side of the base of the second and third metacarpal bones of the hand. HOW AND WHY THIS INJURY OCCURS It's often hard for clients to remember what they did that brought on golfer's elbow. It can be caused by almost any activity that uses a repeated forearm flexor motion—for example, intensive writing or typing, hammering, lifting, painting, or overdoing wrist curls at the gym—and the pain often starts up to several days after the strain occurs. Frequently, no pain is felt if the person is warmed up and involved in an athletic activity like golf or tennis. Golfer's elbow can last a week, a month, or a year or two, depending on how well or poorly the strained fibers heal. If the person keeps repeating the activity that caused the strain, adhesive scar tissue may form and prolong the healing time. If the client cannot or does not stop the pain-causing activities, the treatment will take much longer. Referred pain is minimal in the elbow, but if the injury worsens, the person may experience the pain as radiating from the elbow toward the wrist. In that case, what's actually happening is that the injury is spreading throughout the muscle-tendon unit. Once the tenoperiosteal junction is injured, the whole structure is weakened and more vulnerable to injury. If it is repeatedly put under stress, more and more fibers become strained. As a result, an injury that started at the tendon attachment soon spreads to the tendon body and then the muscle as it tries in vain to do its work. Increasingly in our society, people are working longer hours, exercising less, and spending more time on their computers for fun after work is over. This causes great strain on the flexor carpi radialis muscle-tendon unit. Whenever people don't exercise to gain and maintain flexibility and strength beyond what they need for their normal daily activities, things can break down quickly. I began recently treating a woman with golfer's elbow who spends most of her day working at a computer and who hasn't exercised for four years because she is so busy. Her good arm could lift a 2-pound weight just 20 visit massageandbodywork.com to access your digital magazine 107