Golfer’s Elbow

Mark: Hi, it's Mark from Top Local. We're here with Wil Seto of Insync Physio. He's the owner. He's the boss. He's the man. He's one of the top rated physiotherapists in Vancouver. One of the top three. How are you doing today, Wil?

Wil: Yeah, I'm doing great. Thanks. Yeah. Thank you. 

Mark: Golfer's elbow is what we're going to talk about. So this is similar to tennis elbow, isn't it? 

Wil: Yeah, very similar, except just on the other side. A really good way to describe and explain what it is exactly is, we had a client that came in earlier this week, who was presenting with some pain on the inside of his elbow.

So he was a 27 year old, a rock climber, doesn't even play golf, slash computer programmer. So he's on the keyboard, like pretty much nine to five, five days a week kind of thing. Right. It's a lot of repetitive strain, and then, you add him being an avid rock climber to the mix of that. 

So he was complaining about the pain that he was getting and it started just as he started doing more climbing again and training and training was involving like three to four days a week. He's a pretty avid climber.

As we looked at it, he was getting some overuse and issues going on in his medial aspect of his tendons. It's an overuse syndrome involving the tendons, where it becomes weaker and there's different degrees of severity that you can get with golfer's elbow from mild, moderate to severe, where, when you get really bad swelling it's a pretty severe tendinopathies developing into there.

That's essentially what it is, is an overuse syndrome. And you can get a lot of overdeveloped strength in the forearm muscles that basically ended up causing a lot of pulling onto those tendons. When you have sort of this imbalance where the muscles are stronger, it can actually pull on those tendons a little bit more.

So what happens with his situation? Because he's also a computer programmer, he's not actually resting his arms, he's always using them, he's overusing them. And one of the other components of this that came out in his history and what he was telling me was that he wasn't stretching enough, he wasn't actually recovering. That's actually really important, too, because part of that recovery allows those muscles to relax. So when those muscles in the forearms, if your muscles are really super tight, then what happens is that things shorten and then it ends up causing a lot of stress and strain into the tendons.

If you start to do things really quickly, too fast, and you get strong too quickly, too fast, then your weakest points is usually when you get these kinds of injuries, are your tendons. Because your muscles will get strong, faster than your tendons, and then you ended up injuring them and then they become strained. So that's basically what it is. 

So the other interesting thing, is that if you have a preexisting injury in that arm and he had an issue with his finger before, cause he's an avid climber, so he was already prone to having that. That's the other thing to look out for. 

So if you've had stuff happen in your arm before and you are an avid golfer or a climber or a racket player, then you gotta be really careful in doing those recovery things for it. Right. That's good to keep up with. 

Mark: What was the treatment protocol?

Wil: When we actually looked at what was going on, the other interesting thing, was he didn't have any neck issues, but he had some neck stiffness too. That wasn't the main issue, it was just causing things to creep up in the neck. So we had to treat a little bit of that as well. 

We looked at three main things. Loosening up that area of the muscle in the forearm.  I'll spare the details there, the names and the terminology, but in the forearm muscles, we needed to actually relax them. They were always like this, so we needed to find a way to help them to be able have them in a state of relaxation. He was always like this with his forearms, always, even when he was relaxed. So that was the first thing. 

The second thing was helping settle down that actual irritation.  Referring him to the doctor, cause it was actually quite inflamed and getting something to settle down the inflammation or icing it. Having some kind of a brace... He really wanted to keep climbing, that was the problem. I'm not gonna say no, you know, I did say that it's a good idea not to, so we gotta give him more brace to absorb the excess forces and the tension that he's going to actually be using on his arms. 

The third thing too, is like, so how I was saying, that he has all this stuff going on higher up. His nervous system was all triggered, all tight, and tense.

So we needed to start to mobilize all of that, and we needed to make sure that the mobility component was really big. Really looking at increasing the mobility and that whole, not just the arm, but the neck area and the nervous system, and just really making sure that everything is moving well and the muscles, and then also the strength component, making sure that now we have other aspects of the antagonizing strength or the opposite muscles that he never uses get stronger.

Finally, the main thing here too, is educating him again. You know your job, this is what you do. You gotta work on stretching and you gotta work on doing certain things to recover in that forearm, not just after you climb, but after you work or even after you do something simple as gardening, and you're doing stuff with that arm.

So some simple stuff to really help them look at keeping that arm in a good state, because he likes to push himself. 

Mark: Right. And so it's really indicative when you get a strain in one area of your body, it will magnify across other places as you try and compensate, basically.

Wil: Yeah, you can. For sure. The other interesting thing is that we got, as we get him the rehab and doing a lot of home exercises to reinforce other mobility and especially strength on this right side. You need to do it on the opposite side. And then also working on sort of this, like, you're saying this core strength for the upper extremity.

Mark: There you go. If you want expert help, if you've got pain in your elbows and you don't know what's going on, and you want somebody who can really diagnose it and get you going well, Insync Physio are the guys to get, having a look at what's going on with your body and get you feeling right again. You can check out the website at insyncphysio.com. You can book online. They have two offices, one in North Burnaby, and one on Cambie street in Vancouver. Or you can call them and just book. 

In Vancouver, (604) 566-9716 to book your appointment or in North Burnaby, (604) 298-4878. They'll look after you and you will be feeling better really quickly.

Wil: Thanks, thanks Mark. I hope that helps.