Tennis and golf season is upon us which means those sleeping injuries re-awaken after a winter of rest. One of the most pervasive and lingering aches is tennis elbow or golfers’ elbow. These are felt in the outer (in the case of tennis elbow) or inner (in the case of golfers’ elbow) elbow joint and affect just about everything you do that requires gripping. The medical terms are lateral epicondylitis (tennis elbow) or medial epicondylitis (golfers’ elbow) which basically mean that something is irritated on the outer or inner elbow. These terms don’t actually explain what is irritated or why. There are many approaches to dealing with these injuries including forearm cuffs, painful trigger point release, or even surgery. However fixing the underlying roots of the problem resolves pain quickly and permanently.

Know Your Anatomy

The first place to start is the shoulder. Problems here affect how tennis elbow or golfers’ elbow develop. The most common issue is that the shoulder blades sit too low on the trunk and too far out to the side (I’ve mentioned this in previous posts). This sets up a domino effect whereby the upper arm bone to rotates inward which then causes the forearm to rotate as well. This is when tennis elbow or golfers’ elbow emerges.

This commonly happens in people who spend a lot of time at a computer. But, frankly, I see it in athletes or blue-collar workers as well. The muscles of the shoulder and forearm then adapt to this posture causing deep forearm rotator muscles to become lengthened or weakened while others become shortened (Figure 1.).

Figure 1. Deep Forearm Rotators (Copyright Boone Publishing. 2010)

Treatment is usually delivered to the muscles lying on top of these deep rotators. Mostly because it is in these muscles most people feel pain. These superficial muscles are merely reacting to deeper problems in the muscles lying against the elbow bones (pictured). Treatment of the superficial muscles requires multiple visits for painful therapy which delivers marginal results at best. The real problem is that the shoulder blade is not resting or moving correctly which sets up the elbow joint for problems which then leads to tennis elbow or golfers’ elbow.

The Fix

The solution? There’s good and bad news: The good news is that fixing tennis elbow or golfers’ elbow can happen quickly. The bad news is it’s not simple. You must first correct the shoulder blade issue which is feeding the recurring elbow pain. Then address the deep forearm rotators that have altered to accommodate the shoulder and arm position as well. Doing one without other can’t correct the problem for the reasons mentioned above.

However, I’ve made it as simple as possible in my new book, Fixing You: Shoulder & Elbow Pain. In it I present the problem and solution so anyone can understand the roots of their pain and fix them. So, if you’re tired of wearing that forearm strap, endless visits to a therapist for treatment, or icing your elbows after work or a game of tennis or golf, then do yourself a favor and get to the root of the problem. It’s time to fix your elbow pain!

Rick Olderman is a sports and orthopedic physical therapist, personal trainer, Pilates instructor and speaker. He is the author of Fixing You: Back Pain, available at www.FixingYou.net. Email Rick at Rick@FixingYou.net or call 303-477-4212.

I’ve recently stumbled on, what I believe, to be a successful treatment for the elimination of tennis elbow or golfer’s elbow. I was working with a golfer with a history of severe elbow pain. It was so bad that 2 years prior, he had one of his forearm muscles severed by a surgeon to reduce his pain. This worked to some extent but he could still not swing a club or exercise with weights.

Typically my treatment involved painful digging into the forearm muscles to release deep trigger points and gain temporary relief. But the pain from tennis elbow always returned. I would’ve done the same with my golfer but the surgeon severed the very muscle I usually targeted! Obviously the pain was coming from somewhere else.

I was working with his shoulder, fixing problems there when I noticed a subtle change in his club head angle. After evaluating his forearm I found his forearm rotators were not working correctly. I developed a treatment for them which I thought should remedy the issues I encountered and he was completely pain-free within one minute. His pain returned slightly next week so I treated him again and the pain was gone for good.

I’ve since tested this treatment out on a few others with similar results. I’m writing a series of books and one is about elbow pain, in which I will include this new simple treatment. I’m very excited and hope others have similar results.