And yes, golf and tennis are contact sports. Or so I like to joke with my patients, but there is truth to it because repeatedly striking a ball forcefully can hurt the elbow.
Tennis Elbow
Of course, tennis elbow does not just happen to tennis players. It occurs among players of other racket sports and is also common among plumbers, electricians, carpenters, and anyone who spends a lot of time on a computer keyboard. Tennis elbow, or “lateral epicondylitis,” is 10 times more common than golfer’s elbow, or “medial epicondylitis,” and occurs from activities that require repetitive contraction of muscles that extend the wrist. The wrist extensors attach on the lateral aspect of the elbow, called the lateral epicondyle, and when the tendinous attachment of the muscles is damaged, the elbow becomes tender and painful.
The good news is that in most cases, acupuncture is highly effective at relieving pain and restoring normal function for this condition.
There are specific acupuncture techniques for treating tennis elbow, and in addition, I have found that a knowledge of trigger point therapy is helpful because trigger points in the triceps or the supinator muscle can refer pain to the lateral elbow, and if this is occurring and they are not addressed, the treatment will not be as successful. I mention this because it is important for patients to know that simply treating acupuncture points traditionally prescribed for tennis elbow is sometimes not enough and that your acupuncturist should have knowledge of trigger point referral patterns. Care must also be taken in diagnosis because a strain in the anconeus muscle or nerve entrapment by the supinator muscle can resemble lateral epicondylitis but must be addressed differently. Tendinopathy of the triceps muscle can also cause pain at the lateral elbow.
At the end of the acupuncture treatment, I have found soft tissue manipulation to be helpful in releasing tension in the wrist extension muscles. In very chronic cases that have reoccurred over time, there will often be more degeneration and scar tissue deposition in the tendons, and it is extremely helpful to use another technique called multi-directional friction eccentric contraction therapy to break down dysfunctional scar tissue and promote the growth of functional tissue fibers.
Golfer’s Elbow
OK, if you read the article above, I think you can guess that this problem, called “medial epicondylitis”, does not just happen to golfers. Any sport or profession that requires repetitive flexing of the wrist can cause a golfer’s elbow. Notice I said “flexing,” because it is “extending” that causes tennis elbow. Among baseball players, it is called “thrower’s elbow.” It can also be caused by swimming and the frequent use of power tools. And for my fellow gym rats, from my own experience, I have discovered that doing too many chinups or barbell curls with a straight bar can cause it. The wrist flexors attach on the medial side of the elbow, and when the tendinous attachments are stressed from repetitive movement, pain and tenderness occur. As in the case of tennis elbow, acupuncture can be quite effective at treating most cases of golfer’s elbow. There are specific acupuncture techniques for treating this condition, and I like to combine these with soft-tissue manipulation to the wrist flexors. I also like to use multi-directional friction eccentric contraction therapy in chronic cases that have recurred over time. I discussed this technique above under tennis elbow. The acupuncturist also needs to check for cubital tunnel syndrome, also called “ulnar nerve entrapment,” as this occurs in 60% of cases of golfer’s elbow and also responds well to treatment.