QA Top Ten - Week 10


Q&A Top Ten!
Welcome to the final week of our Q & A top ten. Many of you email me weekly with questions regarding your fitness routine and how it relates to your golf game. Ive narrowed those questions down to a top ten! You can find all of the training aids used to demonstrate the exercises in the golf fitness Pro Shop. If you are just joining us, review Weeks 1-9 to see if your question has been answered!
Question: Kelly ' Im experiencing pain in my elbow (similar to tennis elbow). Can you help?
Kara S '
Myrtle Beach, SC
Answer: Kara - The term, golf elbow isnt as openly used in todays vernacular as the term tennis elbow, but the two afflictions are very similar. Tennis elbow, medically known as laeral epicondylitis occurs in the racquet arm of tennis players, and results from hitting backhand shots where the racket arm is extended during an across-the-chest swing. The pronation and supination (turning the palm downward or upward) that go with this shot sometimes lead to small tears or strains in the exterior tendons of the elbow. As a result, small motions become so painful that daily life becomes difficult. A tennis elbow sufferer may not be able to open a jar or lift a book off the floor because of the pain. The only way to treat this injury is to rest and immobilize the elbow until the body can heal itself.
These symptoms affect golfers in slightly different spots within the elbow, but for almost exactly the same reasons. With golf elbow, which is technically called medial ephicondylitis, the lead arm is normally affected. An overwhelming number of cases (more than 90 percent) report pain in the lead arm, which is the left arm for those who play right-handed, and just as is the case in tennis elbow, the tendons in the joint are prone to strain, inflammation, and minor tears. The only difference is that in golf elbow the inner tendons are affected. The reason that golf elbow is isolated to the inner part of the joint is that all the flexor muscles the muscles that pull the palm of the hand toward the arm connect with the inner part of the elbow called the medial epicondyle. Inflammation and tenderness occur in the medial epicondyle region from the repeated pronation and supination of arms during the golf swing. Minor traumas, like hitting shots fat, are also a common cause of golf elbow.


Understanding what golf elbow is doesnt explain why amateurs are five times more likely to get it than pros. In fact, because golf elbow is a repetition injury, logic would dictate that pros are more likely to suffer its effects than are amateurs. After all, pros hit more balls, but most instances of golf elbow occur in amateurs 35 or older who play more than three rounds a week.
Older amateurs are more likely to suffer from golf elbow than pros who play and practice six days a week for the following reasons:
*Weaker forearm muscles and tighter tendons. The flexor muscles of the hand and forearm arent normally high on anyones stretch list, so as those muscles and tendons become stiffer with age the likelihood of suffering from golf elbow increases dramatically.
*Increased grip pressure. Strain on the tendons in the elbow is directly linked to the amount of pressure being applied on those tendons. The tighter you grip the golf club, the more stress you place on the medial epicondyle. Pros dont choke their clubs in a death grip; many amateurs do. Thats the major difference between the percentages of pros with golf elbow and amateurs who suffer from this injury.
*Higher frequency of common swing mistakes. Overcocking the wrists and lifting the club with your hands strains the flexor muscles and puts undue pressure on the tendons of your elbow.

Recognizing and treating golf elbow

Sometimes the pain from golf elbow is mild, a small annoyance that goes away after you rest your arm for a day or so, but inevitably returns the next time you play. As the injury progresses a dull pain may become more constant. Shaking hands with someone becomes a painful encounter, and lifting slightly heavy objects, such as a packed suitcase shocks your system. The pain is isolated in the inner elbow, making that area tender to the touch at all times, but the pain shoots through your entire body when you put stress on your elbow joint.
If untreated, golf elbow can become so painful that you wont be able to grip a club. Fortunately, it doesnt have to come to that. In fact, treating golf elbow is easy, and if you catch it early enough the injury shouldnt disrupt your normal routine. Easy remedies include the following that you can do yourself at home:
*Rest: Like in tennis elbow, the inflamed tendons that cause golf elbow simply need time to heal. A couple of days of complete rest with no lifting and little bending of the injured elbow can allow your bodys natural healing agents time to work their magic on these sore tendons.
*Ice: For 10 to 15 minutes at a time several times a day for the first three to four days of your injury, icing your elbow can reduce swelling and ease the pain.
*Heat: If pain continues after the three-day ice treatment, add wet heat to the mix, soaking your elbow in a bowl of warm water for 10 to 15 minutes at a time several times a day for several days. If the pain persists beyond a couple of weeks, see your doctor.
*Anti-inflammatory, non-steroid drugs: Taken as directed, aspirin and ibuprofen help reduce swelling and pain caused by tendon strain. When used with other treatments, an aspirin a day can go a long way toward curing your sore elbow joints.

You can also do the things on the following list with a doctors supervision or recommendation:
*Ultrasound therapy: Your doctor may prescribe ultrasound treatments for persistent pain from golf elbow. These treatments are painless and effective, but they require regular office visits to your physician.
*Steroid injections: In severe and persistent cases your doctor may recommend injecting a small dose of steroids, such as cortisone into the injured area. This is a radical step, but one that usually works. No matter how serious your condition, rarely do you need more than two or three injections.
*Forearm braces: You can purchase braces specifically designed to reduce pressure on the elbow tendons at most sporting goods stores or through your doctor. These braces arent always effective at treating golf elbow, but they do help reduce the pain so that you can enjoy yourself on the course.

Preventing elbow problems before they occur

The good news about golf elbow is that with proper exercise and technique you can dramatically reduce your chances of ever having any problems. Whether you change your grip, adjust your swing, or work a few preventative exercises into your daily routine, you have plenty of simple ways to lower your odds of experiencing this injury.
Reducing your grip pressure

Many scholarly golf instructors have written endless treatises on the importance of a sound grip in golf, but no matter which method you use in your game or which principles of the grip you believe or disbelieve, two things should not be in dispute:
*No matter what method you use to hold the golf club, the purpose of the grip it to put your hands on the club so that they work as a unit to generate maximum clubhead speed and consistency at impact.
*Relaxed hands move faster through the hitting zone than tight, tense hands.
To test this golf adage, hold your arm straight in front of you and flap your hand from side to side as if you were slapping an imaginary troll. Now clinch your fist as tightly as possible and attempt to move your hand the same way. The hand moves much slower when you clinch your fist than it does when the hand is open and relaxed. The same thing is true during the golf swing. A tight death grip on the club slows the hands down through impact, while relaxed hands move quickly and efficiently through the hitting zone.
Lightening your grip pressure allows you to move your hands quickly and freely through impact, and reduces the stress on tendons in your hands, wrists, and elbows. Those facts are indisputable. But the problem with that concept is not in logic and reason; the problem lies in the fact that hitting something with relaxed hands goes against your natural instincts. Any time you prepare to hit something, your body naturally tenses. Its a rudimentary response. Whether you hit a punching bag or a ball, your bodys natural response is to brace for impact. Tension in your hands extends up your arms and into your chest and back, throwing your entire motion out of synch and leading to potential injuries throughout the body.

You can overcome these tension-related tendencies, but only by focusing on a relaxed grip pressure and diligently practicing a few key things:
*Training with molded grips: Although the rules of golf do not allow you to play with a grip that has been molded or altered in any way (like form-fitted grips that help you place your hands on the club the right way) you can and should practice with these form-fitted grips. . In addition to helping place your hands on the club correctly, these molded grips allow to you reduce the tension in your hands without fear of the club slipping or turning as you swing.
You should take one old club out of circulation and dedicate it solely to practice. Doing so allows you to add a molded grip without running afoul of the rules. You can pick up a molded grip at most golf stores, or order one through any of the thousands of catalog and Internet retailers that specialize in golf merchandise. As long as you dont carry your molded club onto the course, you can practice relaxing your grip pressure with a teaching tool that provides enormous long-term benefits to your game.
*Regularly changing the grips on your clubs: Touring professional change the grips on their clubs every four to six weeks. Amateurs sometimes go years without changing their grips. This is a critical flaw among amateurs and one that leads to all kinds of unnecessary complications. The simple fact of the matter is your grips get dirty and worn as they age. As the rubber or synthetic material wears out, it becomes slick, and you have to grip the club tighter to keep it from slipping during the swing. This tighter grip can lead to bad swings and injury.

All that you need to prevent these problems is a little diligence when it comes to caring for your equipment. For example, here are a few proactive suggestions.
*Regularly replace your grips: adding new grips at least once every two or three months depending on use.
*Clean your grips at least as often as you clean your clubheads. If you wash your clubs after every round, take the time to wash and dry your grips as well.
*Wipe your grips with a damp towel before every round. Doing so removes the dirt and oils from your hands that accumulate on the grips. You always see professional caddies wiping down players grips before, during and after a round. They know the importance of keeping this part of the club clean.

Stretching the forearms


Regular forearm stretches keep the tendons in the elbow and wrist flexible and ready for action. You can do these stretches at any time sitting in your office, relaxing at home, or during a round of golf. They should become such a natural part of your routine that you perform them reflexively whenever you have a spare moment. To do these stretches, simply extend one arm directly in front of your chest and flex the wrist as far back as possible. After youve stretched the hand back as far as it will naturally go, use your other hand to extend the stretch a little farther by applying pressure to your fingers. Hold this stretch 15 to 30 seconds and repeat to the opposite side.

After stretching both hands upward, repeat the same motion flexing the hand downward with your palm facing your chest. After the wrist has stretched the hand as far as it will naturally go, extend the stretch by applying pressure to the back of the hand. Hold that stretch for another 15 to 30 seconds and repeat to the opposite side.
This entire exercise takes under four minutes, which is less time than the normal advertisement break in your favorite sitcom. If you repeat this exercise at least once a day, you can substantially improve your form and severely diminish your likelihood of elbow injury
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    Kelly Blackburn Health & FitnessEditor's Note: Kelly Blackburn has traveled the PGA Tour and Champions Tour circuits as a fitness consultant and trainer for 13 years. Kelly welcomes your email questions and comments, contact her at Visit to learn more about health and fitness for golf.