Medical: Golfer’s Elbow

Suzie Prevett explains why motorcyclists are prone to developing golfer’s elbow and describes how to relieve the pain.

Golfer’s elbow is a condition that can cause pain or discomfort on the inside (medial side) of your elbow, but despite the name, golfers aren’t the only people to suffer. The condition also causes pain and discomfort for motorcyclists. But what exactly is golfer’s elbow, and why can riding a bike cause it? 

The condition, also known as Medial Epicondylalgia, causes pain within the large tendon on the inner aspect of your elbow, where all of your flexor muscle tendons converge. Any sudden overloading of your large tendon, say gripping a motorcycle’s handlebars too tightly during a day on the trails, can damage your tendons and lead to pain. Riders with desk jobs are at particular risk because their muscles and tendons get a sudden overload when they start riding after being relaxed all week. 

The resulting pain from developing golfer’s elbow can occur while you undertake certain activities like motorcycling. However, for some people, there may be more of a constant pain which worsens with activity, especially if you’re picking up your bike a lot, working on your motorcycle, or holding on for dear life over rugged terrain. You may also feel like your elbow is a little stiffer than normal, or that your grip is weaker. It is important to know whether or not you definitely have this condition prior to starting exercises, so it is recommended to seek a physiotherapy assessment first or see your doctor. 

In the majority of people, golfer’s elbow will slowly improve, although recovery may take from several weeks to several months. Smoking and type 2 diabetes make you more susceptible. You can help aid your recovery by doing the following:

Activity modification 

Adjust your daily activities to reduce discomfort in your elbow. You don’t have to stop doing all your normal activities, just try to modify them and take regular breaks. If you’re experiencing increased pain for over an hour after activity, especially the next day, this is an indication that you are doing too much and you need to adjust your activity. 

Cold Therapy

Try using an ice pack on the affected area to help reduce the pain. You can use a bag of frozen peas (or similar) for approximately 10 minutes, a maximum of every two hours. Make sure you cover the bag in a damp cloth and check your skin regularly. It’s important not to use ice if you have circulation problems, damaged skin, or altered sensation in the area.

Medication 

Your doctor may prescribe medication to help you manage the pain, and pharmacists can also give good advice. Let them know if you’re on other medications. 

Elbow strap / brace 

These can help unload the tendon during activity. Normally these should be placed approximately 2cm down your forearm from your medial epicondyle, however each strap will come with specific instructions. 

Exercise 1

Static (isometric) exercise 

Start with this exercise only if you’re elbow is quite irritable and easily aggravated by activity. You can use a light dumbbell (0.5- 1kg) or other light-weighted household object to do this exercise. 

Static isometric hold start, arm extended

Hold the weight as pictured with your elbow bent and arm resting on a stable surface. Hold this position for 30-60 seconds. Repeat this 3-5 times with a two-minute rest in between each hold, once a day. 

Static isometric hold progression, arm extended

If you are managing the static exercise without any issues, you can progress by increasing the weight a little and/or by undertaking the exercise with your elbow in a less flexed (bent) position, as shown above. Gradually reduce the amount of bend you have in your elbow over several sessions rather than changing the position significantly in one session. Repeat this 3-5 times with a two-minute rest in between each hold, once a day. If you are managing well with this exercise you can add exercise two to your program. 

Exercise 2 

Flexor strengthening exercise

If your pain is low and less irritable, then you can add in this exercise to your rehabilitation immediately. Again, you can use a lightweight or any other light-weighted household object to carry out this exercise. 

Hold the lightweight. Bend the wrist up slowly, as far as comfortable, over approximately four seconds and then lower slowly over approximately four seconds. Complete 10-15 repetitions of this and then rest for two minutes. Repeat this 2-3 times, once a day. 

Flexor strengthening, flexed position, start

This exercise can be progressed by increasing the weight a little and/or by undertaking the exercise with your elbow in a less flexed (bent) position, as shown in the previous exercise. Gradually reduce the amount of bend you have in your elbow over several sessions rather than changing the position significantly in one session. 

Flexor strengthening, extended position, start

Mild discomfort during exercise is acceptable, however, if you are experiencing higher pain levels, particularly for over an hour after the exercises or activity, or worsening the following day, then you may need to reduce the exercise to a more tolerable level. 

Flexor strengthening, flexed position progression, arm extended

These exercises often need to be undertaken on a regular basis for a minimum of 3-4 months. Some people do not experience significant improvements within the first six weeks. For a full reference list, please contact Suzie on suzanna@motivatedhealth.com 

Flexor strengthening, extended position progression, arm extended.

Disclaimer: This article is intended to be for educational purposes only and does not constitute medical advice or replace professional assessment. Please seek a professional assessment before undertaking a new exercise program, especially if you have any medical conditions, any previous injuries or other health/physical concerns. If you undertake any of the exercises within this article you do so at your own risk.