Further therapeutic measures

When treating a golfer’s elbow, there are various therapeutic measures that are presented in more detail below. These include:

Exercises to strengthen the extensor muscles
Massage techniques
Flossing
Cold and heat therapy
Acupuncture
Electrotherapy (TENS)/Shockwave therapy/Ultrasound applications
Acupressure/trigger point treatment

Since a golfer’s elbow is typically caused by overloading the flexor muscles of the forearm and hand, it is important to train the extensor muscles to compensate. You can find more exercises under: Exercises Golfers elbow, exercises for elbow pain

Exercise: For the first exercise you need a towel and a dumbbell with 0.5 kg or a small bottle of water with 0.5 l. Put the towel on a table and put your forearm on it so that the hand hangs over the edge of the table.
Form a fist and pull your hand up, hold the position briefly and let it slowly sink down again. Repeat this exercise 15-30 times in 3 sets. To increase the level of the exercise, take the barbell or the water bottle in your hand.
Exercise: For the next exercise you need an elastic gymnastic band, for example a Thera band.
Sit upright on a chair and put one foot on the middle of the Theraband. Hold both ends of the band in your hand so that the band is taut. Turn your hand so that the palm is facing the floor and make a fist.

Keep your forearm close to your body and your forearm parallel to the ground and pull your hand up. Repeat this exercise 15-30 times in 3 sets.

>A variety of massage techniques can be applied to the golfer’s elbow, which can help to relieve pain and support the healing process. Since with the gulf elbow the flexor tendons of the forearm are concerned the focus with the Massage is on the flexor side of the forearm.

The Massagetechniken can be used also in the self therapy. In addition, cross frictions can accelerate the healing process. In this technique, the muscles are massaged across the course with the index and middle finger placed one above the other.

The whole muscle should be worked on, especially the region around the most painful part. Stroking with both hands over the entire flexion side of the forearm with medium pressure can round off the treatment and contributes above all to muscle relaxation. Flossing is a treatment method in physiotherapy in which a stretchy but firm elastic band is wrapped tightly around the affected part of the body.

The wrapped joint and muscles are then moved, loaded and mobilized. The circular pressure of the flossing band is intended to regulate the tension of the muscles and fasciae and thus restore the mobility of the joint. The method is said to have a pain-relieving and mobilizing effect on the joint and to eliminate functional limitations.

In the case of the golfer’s elbow, the Flossing Band is wrapped around the forearm, over the elbow joint and around the distal upper arm in a circular overlapping fashion. The joint is then exercised to mobilize it and put it under stress. Usually several applications of flossing are necessary to achieve a lasting effect.

However, the joint should already feel loose and more freely movable immediately afterwards. Pressure points from the Flossing Band or increased reddening of the skin are normal immediately after application and disappear quickly.

For example, the elbow and wrist can be bent and the fingers clenched into a fist.
Then the arm is stretched, the forearm turned outwards and the fingers spread and stretched.
But variations of supporting exercises such as push-ups are also possible.

Both cold and heat applications can help alleviate the symptoms of a golf elbow. This depends on what the patient finds beneficial and what the stage of the disease is at the time of treatment.

In the case of acute inflammation of the tendon attachments and for short-term relief of pain, cold therapy can be used very well.
The possibilities range from ice bags, ice lollies, crushed ice or cool packs to baths in ice water. All applications of cold should only be applied for a short period of time not exceeding 20 minutes, otherwise the tissue can be damaged.
With chronic or subacute complaints heat therapy is usually felt as more pleasant. The application of fango or mud packs or warm baths has a muscle-relaxing and pain-relieving effect.
The mobility of the joint can be improved and the blood circulation is stimulated, which results in a better metabolism in the tissue.

Acupuncture can reduce the symptoms of a golfer’s elbow. Especially in case of a chronic golfer’s elbow (pain for more than 6 months) this treatment can offer an alternative therapy approach. Acupuncture originally comes from traditional Chinese medicine.

It describes specific points on the body that can be used to influence pain and other events in the body. When treating a golfer’s elbow, local trigger points on the flexion side of the elbow are usually treated, as well as more distant points, for example on the ear, cervical spine or even on the foot. Acupuncture treatment usually involves the use of longer needles, which remain stuck in the skin for between 20 and 30 minutes and are then removed.

It is also possible to use permanent needles, which are smaller and flat and remain stuck in the body until they fall off by themselves. The treatment with acupuncture for a golfer’s elbow is currently not covered by public health insurance. Usually several sessions are necessary to achieve a long-term treatment success.

TENS stands for transcutaneous electrical nerve stimulation and is carried out with the help of special electrical therapy devices, which are also available for use at home. In electrotherapy with a TENS device, two adhesive electrodes are applied, one on the forearm and one on the upper arm. Low or high-frequency voltage should cause the descending pain inhibition of the body to be activated and increased release of endogenous pain-inhibiting substances such as endorphin.
The application of TENS electrotherapy lasts about 30 minutes per session and can be repeated as often as desired.
In shock wave therapy, acoustic waves are used, which are electromagnetically induced. In the case of the golfer’s elbow, the shock waves are intended to penetrate deep into the tissue and stimulate the metabolism of the tissue, so that in the case of a chronic course the blood circulation is stimulated and the inflammation can heal better.
Ultrasound applications have a similar effect on a golfer’s elbow. The high-frequency ultrasound waves should only cause a feeling of warmth on the skin during therapy.
The waves penetrate into the tissue and can destroy smaller calcium deposits, stimulate the metabolism and blood circulation and thus support the healing process.

In acupressure as well as in trigger point treatment, blunt pressure, for example with the thumb, is applied to certain points in order to achieve a reduction in muscle tension. With both therapy approaches, pain points are pressed in the course of the flexor muscles of the forearm up to the wrist, especially in the area of the tendon attachments around the inner joint bump of the upper arm (epicondylus medialis humeri), which often represents the strongest pain point. The pressure is held for about 30 seconds to 2 minutes until the pain subsides and only a feeling of pressure remains.

The tension of the tendon should also have eased. Acupressure and trigger point treatment is based on a reflex arc that runs across the spinal cord and immediately regulates the tension of the muscles. Thus, these therapy methods can provide rapid pain relief and can also be used in self-treatment.

Acupressure, like acupuncture, belongs to traditional Chinese medicine and therefore follows a whole-body approach.
Trigger point therapy, on the other hand, is applied rather locally at the site of the pain.