By CEO Robert Forster, PT
Golfers Elbow (or medial epicondylitis as it’s known in medical jargon) is a painful condition of the inner elbow. It does not just happen to golfers and it is not to be confused with tennis elbow; which presents with pain at the lateral, or outside aspect of the elbow, which also does not just happen to tennis players.
Both of these injuries are tendon injuries caused by either a sudden, specific trauma or the result of repetitive strain over time from everyday activities.
These tendon injuries of the elbow are the most recalcitrant injuries we treat at Forster Physical Therapy. Once damaged, the elbow can be incredibly resistant to healing because the muscle tendons that attach at these spots work the wrist and finger joints which we use all day, everyday. Pain and irritation occurs when typing, writing, cooking, turning knobs, and lifting even the lightest objects. Patients who suffer from these elbow injuries can suffer for months on end, because these injuries rarely heal themselves.
How can that be? Most people will ignore the pain hoping it will resolve itself. Others will take ani-inflammatory painkillers, while some will ice and others might stretch more and wait in vain for the elbow to heal.
At Forster Physical Therapy we understand it takes a comprehensive approach to cure these aliments. Using therapy to first stretch and then strengthen the associated muscles and other PT tools to reduce inflammation while we teach you protect the injured site will ultimately heal the tendons quickly and completely.
PHASE ONE: As with any injury, TREAT THE PAIN FIRST
• Symptom Control is the first objective, and it may take a few treatments to achieve. There are specific mobility exercises that reduce pain, muscle spasms, and tension that can be performed without causing more damage.
Icing multiple times per day is mandatory to reduce pain, swelling, inflammation, and to encourage tendon healing. Ultrasound, electrical stimulation and other Physical Therapy modalities are utilized to reduce pain and help jumpstart the healing process.
• Manual Therapy techniques including specific cross fiber friction massage to the injured tendons breaks down excessive scarring and returns the tendon to its normal function.
• Evaluating ergonomic stress on the joint and modifying daily activity to promote healing is critical as well.
The “Band-It” Elbow Strap, is essential to healing by applying pressure on the tendon below the injury sight and unloading the tendon attachment during daily use of the elbow and wrist. This device works with the human anatomy to aid in the relief of pain without cutting off circulation, hampering movement or causing uncomfortable swelling.
PHASE II: Establishing Strength and Flexibility
This PHASE is where great health habits are formed!
• A strength and flexibility exercise program will address the deficiency in the range of motion and strength of the elbow and wrist musculature and return normal function.
• Studying your patterns of movement including sport technique or physical mechanics analysis are essential to the ergonomic corrections needed to prevent future re-injury.
PHASE III: Getting Back to Full Function Pain Free
• Just because you feel no pain in daily activities does not mean your injury is completely healed. It can not be over-stated: you still have a vulnerable tendon that needs to be strengthened before returning to repetitive activities or sport.
• Reducing the vulnerability of the joint requires habitual self care. In PHASE III rehabilitation you will learn a program of stretching and strengthening routines to correct the joint mechanics not only at the wrist and elbow, but the shoulder too, these exercises work to correct the strength imbalances that caused the injury in the first place.
PHASE IV: Safely returning to previous activity levels for work, sport, fitness, and health.
A safe and healthy return to your daily activities and sport can only be accomplished once joint mechanics are corrected. Full strength and flexibility will be achieved with a state of the science approach to your workouts; but if your bio-mechanics are not corrected, these injuries will re-occur. In this last and often neglected phase IV stage of rehab we will work with you to correct movement patterns and prevent re-injury.
• More than any other time in our history, people of all ages and abilities are turning to exercise to enhance their quality of life and overall health. We now know the best medicine to avoid and correct the lifestyle diseases that plague modern humans is exercise. Elbow pain can hamper your workouts and disrupt your health plan.
In PHASE IV of your rehabilitation, we introduce our PHASE IV Center.
With so much news about how to approach exercise, weight loss, and fitness the inevitable confusion about doing it right emerges.
• At PHASE IV we address your health and fitness goals with an individualized scientific approach to structural and metabolic health. Starting with a head to toe structural exam and VO2 and RMR metabolic testing, as well as a nutrition analysis, we will develop easy to follow exercise and nutrition program tailored to achieve your personal sustainable health and fitness goals.
• PHASE IV programs focus on results driven science. With guidance, support, and communication, our highly experienced and educated staff of Physical Therapists and Exercise Physiologists, work as a team under one roof to ensure injury prevention, and a personalized rational sequence of exercise and nutrition to achieve your health and fitness goals. If exercise is difficult for you, please give Forster Physical Therapy a call to schedule a structural exam. You do not need a referral from your doctor.