With the nice weather now upon us and golfing season now in full swing, I thought I would talk about Flexor Tendonitis aka Golfer’s Elbow this month.
What is Flexor Tendonitis/Golfer’s Elbow?
Simply put this is inflammation of the forearm flexor tendon. A tendon is tissue made of collagen that connects muscle to bone. The flexor tendon, which is affected in Golfer’s elbow is located on the inside of the arm at the location of the elbow. This is where the pain occurs.
The Cause of Flexor Tendonitis/Golfer's Elbow
The cause of tendonitis is due to overuse and overloading of a tendon. As a result the tendon experiences microtearing and inflammation. The blood supply can be compromised from the trauma leading to reduced tissue repair, which prolongs healing time.
Specifically, common flexor tendonitis, “Golfer’s Elbow” is caused by repetitive activities involving wrist flexion commonly golf, hence “Golfer’s Elbow” . It can also be caused by other activities such as overhead serving in tennis, and hammering.
Contributing Factors: muscle imbalances, lack of flexibility, degenerative changes in the tendon, poor supply to the tendon, improper equipment and training errors.
There are four different grades of severity when it comes to tendonitis. These include the following:
1) Grade 1 Tendonitis: Pain after activity only.
2) Grade 2 Tendonitis: Pain at beginning of the activity, which disappears during activity, and returns after activity.
3) Grade 3 Tendonitis: Pain at beginning, during, AND after activity.
4) Grade 4 Tendonitis: Pain with activities of daily living, and pain continues to get worse.
Symptoms of Flexor Tendonitis/Golfer’s Elbow
1) Gradual onset, with tenderness local to the tendon 1-2 days after activity. This increases to pain during activity as severity increases.
2) Inflammation (heat, redness, swelling).
3) Decreased range of motion of the flexor muscle.
4) Flare-ups to the acute stage may occur with repeated overuse.
5) Sometimes a weak grip may also be experienced.
How is Flexor Tendonitis/Golfer’s Elbow Determined
A massage therapist cannot diagnose conditions, however they can use a variety of range of motion, and orthopedic tests as well as health history information to determine that tendonitis is likely the cause of your pain.
How is Flexor Tendonitis/Golfer’s Elbow Treated
Massage therapy and physiotherapy are very effective in treating this condition. When the tendonitis is in the acute stage the therapist will focus on decreasing inflammation. Therapeutic ultrasound is very effective at reducing inflammation and speeding up the healing process (for more information about ultrasound visit my website).
Once the inflammation is under control, the massage therapist will then turn the focus of the treatment to reducing tension in the affected and surrounding muscles, and decreasing adhesions, which may have formed in the injured tendon. The massage therapist may also give you some exercises to do for homecare in between treatments such as icing, stretching and strengthening. The optimal treatment frequency to resolve this type of condition is 3x/wk for 2-3 wks, followed by 2x/wk for 1 wk, then 1x/wk as needed. The outcome depends on how long the tendonitis has been present before treatments begin.