- If you are experiencing pain on the inside of your elbow,
then that could be something called golfer's elbow.
Now, you don't have to be playing golf
to get golfer's elbow.
So if you do have pain here and you don't play golf,
then you can keep watching this video.
So in today's video, we're talking about golfer's elbow.
So we're gonna start off by talking a bit
about the anatomy of the elbow and the arm,
just so that you understand where the muscles are,
where they attach, and how that relates to your pain.
Then we're gonna go into some stretches,
and then we're gonna go into some exercises, as well.
So the first thing that we need to really understand
is what is golfer's elbow?
Golfer's elbow is a problem
that affects the insight of your elbow here.
So if you can feel there's a bony part of your elbow.
If you press into that,
the chances are it's gonna be very painful.
The muscles of your forearm come down here
and attach onto this bone or just above it.
And as those tendons, so the tenders attaching to the bone,
as they become irritated or inflamed,
then you end up with pain,
and that is what causes golfer's elbow.
Now another term for golfer's elbow is medial epicondylitis.
All that really means is in your upper arm, your humerus,
down here there's two bumpy bits that you can feel.
There's the medial one, which is the inside,
and there's the lateral one, which is on the outside.
So medial epicondylitis is the medial epicondyle,
and then the -itis basically means inflammation.
So it's inflammation of the tendons
that are attaching onto this part of your bone here.
Now, just to help you understand that,
we'll look at a bit of the anatomy, as well.
So, here is a right arm.
So as you're looking at me from here,
this is how the arm would be if the skin was taken away.
So as we come into the inside of the arm,
so we're looking at the medial epicondyle,
so on my elbow it's here,
that would be this bony bit just here.
Now, there's generally quite a few muscles that attach here,
and they all come down the arm
into the hand, fingers, or wrist.
This one here is something called a pronator.
So this basically just turns your hand this way.
So if I just take that away for a second,
then what you can see is these red marks just here.
These red marks basically mean that there's tendons
or muscles that are attached to this,
and also just underneath here, as well.
So, this whole area becomes quite painful to touch.
So these muscles that are here,
they come down in the forearm,
so this part here of your forearm.
They attach onto the wrist, the fingers, or the hand,
and how it comes about is from repetitive movement.
So it could be something like throwing a ball repetitively.
So, if you're a sports person
and you're constantly throwing.
If you are maybe a manual worker, so you're a plumber,
and you're constantly using a wrench,
so you're using your forearm and your elbow,
that can be quite repetitive and irritate the tendons.
Or it could be something like maybe you go to the gym
and you've done a lot of bicep curls,
then that can irritate it.
So anything repetitive, or if you have used a weight
that's particularly heavy,
too heavy for what your tendons can handle,
then that would cause a slight tearing
in the tendons, as well.
So any kind of physical activity that irritates the tendons
will start to lead to inflammation.
So golfer's elbow will follow three phases.
The first phase is when there's a lot of inflammation,
a lot of pain.
This is the worst stage of them all.
So things will be very painful.
It will be very tender to touch.
You won't be able to pick much up.
You won't be able to touch it.
You won't be able to do much because of the pain,
but over time that that inflammation dies down
because the body is patching up those tendons,
it's trying to repair it,
and you end up with sort of a lower level of pain,
but it's more constant.
So this becomes more chronic.
Now, as it repairs it, rather than the tendons
being aligned in a nice straight formation,
imagine there's a tear like this
and the body's trying to patch it up,
so it kind of glues it together
but it ends up being a bit knotted.
So then what happens is the tendon
becomes a bit more fibrous, a bit more like scar tissue,
so that's when it becomes painful to press
but not quite so painful to move.
So, the point of phase two is then to start to stretch.
And once you stretch, you're starting to lengthen
those tendons and lengthen those muscles
and get that movement back through the elbow.
Then once you've done that for a period of time,
then we go into phase three, which is to strengthen the arm.
And what that does is that forces the tendons
or it pulls the tendons, which forces it to remodel
back to this sort of nice, straight formation
that it should've been.
So hopefully now you understand a little bit
about the anatomy and the phases that we go through.
So what we're gonna do now is go through
a really simple stretch and also show you
how to use a massage ball to help break down
some of those muscle fibers.
Okay, so the first stretch we're gonna do
is to stretch the forearm here.
So all you're gonna do is put your hand flat on a surface,
so a desk or a table,
something that you can quite happily lean over.
So, palm facing down, put your fingers on the surface
and then try and push your heel of your hand
down as much as you can.
Now, depending on where you're standing over your hand,
you may or may not feel it.
If you want to increase that stress,
then push the heel of the hand down
and try and lean forward over your wrist.
If that's still too easy,
then turn your fingers more out to the side.
So we start like this with the heel of the hand
off the surface, and push that heel down
onto whatever it is that you're pushing on.
And then to increase it, you can shift over the fingers.
Now, if again, that's still too easy,
then you can turn your hand with fingers pointing behind you
and the same thing, fingers first,
and then pushing the heel of the hand down like so.
And if you wanna increase the stretch,
then you lean backwards in this case.
So the more you rotate your hand,
the more that's gonna put strain through here.
So when you start this phase is when the pain
has come down from a seven, eight, nine,
and down to a more like a five out of 10 for pain,
four or five out of 10.
So find what stretch works for you,
what angle works for you.
Don't push it into too much pain.
So you want to be able to hold this for a period of time
rather than intense pain for a short period.
So, for example, you'd want to be able
to hold this for up to a minute.
If you can't because the pain is too much,
then you're going to hard.
So, up to a minute, so you start with 20 seconds
if you're quite new to this, and then over time
build that up to one minute, all in one go.
I would do this probably every other day,
because as you're stretching you might find
that you're making yourself quite sore.
So if you do it all the time,
then potentially you're gonna feel even more sore.
So, say you do it on a Monday, do that once in a day,
then Wednesday, once in a day, Friday.
Over time, as you get used to doing that
and you've built up the amount of time,
then go into Monday, maybe twice a day,
Wednesday, twice a day, Friday, twice a day, and so on.
Eventually you might be able to do every day
once your body is used to it,
but just don't rush trying to do it too much.
Little is better than too much.
The next thing you can do is use a lacrosse ball.
Now, I like these because they're rubbery
and they grip well.
So find a surface, and you wanna come quite low.
So you're either kneeling down or sitting down.
Get the ball on top of your surface
and then put the affected arm on top of the ball.
Put the other hand on top of your forearm
and just gently press down.
Now, from here, move from the middle towards that bone.
So I'm gonna start here,
and what I'm doing is I'm looking for where it's tender,
where it's painful or tight.
So as I move this way, I can then feel a tender point,
so I'm gonna stop and just let everything relax.
So gentle pressure, not too much,
no more than a five out of 10 for pain.
So press on that and hold.
You may see some people doing this,
where they're rolling up and down along tendons.
All that's gonna do is inflame the tendons.
If you do that, you're just gonna make your pain worse.
So what happens is when you're rolling on the ball,
you're feeling pain.
So those nerves are sending signals up to the brain,
which tells your brain there's pain.
Those signals then come down to the muscles
and telling the muscles to tighten
as a way of trying to protect them.
So, if you're constantly doing this,
then you're constantly stimulating the pain signals,
the pain nerves.
But if you are pressing on and you relax,
then over time those pain signals start to die down
and your body can then relax the muscles.
So hold this for up to a minute,
and then move it closer to the elbow,
again, looking for tender points.
Hold that for a minute when you find the tender point,
and then move that again a bit further up.
Find another tender point, hold that,
and you just keep repeating
until you get right up to that bone,
and you'll feel it 'cause it kind of stops,
stops the ball going any further.
So work around that for a period of time,
and just do that, again, every other day.
If you're doing this too much,
then that's gonna also make you quite sore.
So you could do something like a bit of stretching
and a bit of massage ball all on a Monday,
and then Wednesday, Friday.
If you do stretching, ball, stretching, ball,
say Monday, Tuesday, Wednesday, and so on,
then you don't quite get enough time for those tissues
to then calm down and start to heal.
So all you're doing through this phase
is stimulating the body to break down those tight fibers
and start to remodel to how they should be.
So experiment with where you put the ball.
You can come all the way down towards the wrist.
You can come onto the inside more.
You can come more towards the bone.
If you wanna do the outside, that's absolutely fine.
You can do that,
but that's not really working golfer's elbow.
That's more tennis elbow.
So every other day,
no more than two, three minutes per session.
So this phase, the phase two,
where you're working the flexibility,
you could expect to be doing that for at least four weeks,
but realistically, you're looking at six weeks,
eight weeks, something like that.
When you feel like the muscles have become less painful
and you feel like there's greater movement through the wrist
or through the elbow, then you can start
to introduce strength training,
so then we start to move into phase three.
You wanna make sure that pain is at least a four or lower
before you move into the strength training,
because if pain is still five or six,
then by strength training,
you're gonna start to irritate things again,
so you could potentially start to bring that pain back.
So don't rush this phase.
Take your time, and when you are ready,
then go into phase three, which we'll discuss right now.
Now, when it comes to the rehab of your golfer's elbow,
quite often you'll see these exercises prescribed,
where you're repetitively doing, like,
wrist curls with some sort of weight.
This is okay, but because of the nature of the repetition,
it can put quite a lot of strain on those muscles
in those tendons, so you could potentially quite easily
irritate your tendon and your golfer's elbow again.
If you are gonna do this, if you have been prescribed this,
then there's a couple of things you should be aware of.
First, just go really slow.
Pause, and then slowly back down.
It's better to do fewer and slow with control
than it is to do it with repetition.
So, if you've been prescribed any more than 10,
then I would probably drop that down to 10 repetitions,
and very, very slow.
Because what you wanna do
is you want to be working these muscles,
but you don't want to do too high reps
because you're just gonna irritate and inflame.
Now, what I actually prefer to do
is to get people to start from down here.
That way, there's not so much resistance,
even though you're using the same weight.
Just because of where you've positioned your arm,
it just makes it slightly easier.
So from here, you could start
with some very gentle wrist curls, just up and down.
If that is easy, then you can bring your arm
more into a flexed position, and then do the same thing.
But what I actually like to do,
or this is my preferred method,
is to go from here, flex the wrist,
and then slightly bend the elbow.
You could go all the way up.
It just depends on how much pain that puts through.
But you wanna make sure you start with a very light weight.
So from here, flex the wrist, bring it up,
and try and get your little finger to turn up higher.
So you're trying to turn your thumb outwards or downwards
and little finger upwards.
Choose a really light weight and build this up over time.
So wrist flection up
with a bit of rotation outwards, as well.
Pause, and then down really slowly.
Start with five repetitions.
If that feels okay, then the next time you come to do it,
do six or seven, and eventually build that up to doing 10.
I would do this three times a week, and not much more.
You still want to give your body that time to repair,
time to recover and strengthen.
So do this, say, on a Monday, Wednesday, Friday,
something like that, or if you still,
if you're transitioning from the stretching
to the strengthening, you could do something
like stretching on the Monday,
strengthening on the Wednesday,
stretching Friday, and then repeat.
So it would be two, strengthening the following week,
and one stretching.
As you get more into purely just the strengthening,
then stick to every other day, so Monday, Wednesday, Friday.
As I mentioned earlier, part of the muscles here
In your forearm are responsible for squeezing
or for bending your fingers and curling up your wrist.
So find yourself a stress ball,
something that you can squish
that's a bit firm, but not hard,
and something that you can get some movement
through your fingers.
And all you're gonna do is grab the stress ball and squeeze,
but with the focus on trying to do it more
from your little finger and ring finger
than you are trying to do it with your index finger.
So it doesn't matter what position your arm is in.
You could have it straight or slightly bent
in a more relaxed person or completely bent up like this.
It doesn't matter too much.
Or you could support it on a desk or table or something,
and just focus on squeezing,
pause, and then slowly releasing.
And do this about 10 times, no more.
If even 10 is too much, then just drop it down.
It doesn't matter if it's fewer than 10,
but don't push yourself into pain.
Now, this strengthening phase could last for several months.
As you're going through this phase,
you are trying to build up the resistance that you use,
so as you find that the two starts to get easy,
so this is two kilograms, by the way.
So if you're in the US, then you're looking
at about four pounds, maybe five pounds,
and then gradually build that up over time.
As you start to get stronger,
what you'll probably notice is that your pain
starts to decrease.
You might find that after strengthening,
it might feel a bit irritated, it might feel a bit inflamed.
If it does, ice it, but hopefully you should start having
more good days than bad days.
If you do find that whatever you're doing
is irritating your elbow, then reduce it.
Reduce the frequency, reduce the intensity
or the resistance.
But in terms of timeframes from start to finish,
the inflammatory stage, you're looking
at between four and eight weeks.
Then the pain should come down to about seven, six, five,
so you're starting to go into that more chronic pain phase.
That could potentially last for a couple of months, as well.
And then the flexibility phase
or the stretching and the lacrosse ball, again,
you're looking at maybe six weeks, six to 12 weeks,
and then the strengthening, again,
probably about 12 weeks, as well.
It's a long process.
Sometimes these conditions can last for years.
The more you do in terms of consistency,
then the more chance of you getting rid
of this problem yourself.
If you're trying to rush it and you're going too hard,
you're going, using too heavy weights
or the frequency is too much and you keep irritating it,
then all you're gonna do is delay your recovery.
So less is often more.
So don't overdo it.
Take your time, listen to your body, and just go with it.
So hopefully that all makes sense.
Hopefully you got a good understanding of the anatomy
and what structures are involved
and what's causing your pain,
and also the treatment plan for you to do at home
and hopefully get yourself out of pain.
Be patient with this.
Don't try and rush it.
This sort of condition can last for months,
so you just have to go at your body's own pace,
your body's own sort of healing pace.
Let me know in the comments section below
which phase you're in and what stretches or exercises
you're doing to help you.
If you have any questions,
also stick them in the comments section below.
In the meantime, have a look at these resources over here
that you might find useful,
and until the next video, take care and I'll see you soon.