Buchberger: Wrist, elbow injuries affect golfers

Mar 25, 2023

As usual in central New York, we have gone almost instantaneously from winter to summer, at least regarding the temperature. With the warmer and dryer weather many people are hitting the golf courses to knock off the winter rust. In the process of getting back to the links, it is the golfer's enthusiasm that may result in early-season injuries. Some of the most common injuries that occur in the recreational golfer are in the wrist and elbow.

The wrist and elbow are particularly susceptible to overuse conditions. Unfortunately, overuse is an area that most recreational golfers are guilty of, especially early in the season — the proverbial "too much, too soon" syndrome.

Injuries to the wrist commonly seen when playing golf include ligament injuries, tendonitis, tendon injuries and even fractures. The hamate is a bone on the small finger side of the wrist. It contains a prominence called the "hook." This hook can be fractured when the golfer hits the ball "fat" (taking a large divot) causing a rapid deceleration of the club head and pushing the club handle into the hook. While this is not the most common injury, it should be considered, with pain on the small finger side of the hand and wrist.

The triangular fibrocartilage complex is also on the small finger side of the wrist and sits at the bottom of the ulna bone of the forearm. It is made up of a fibrous disc, a ligament connecting the ulna to the wrist and another ligament connecting the ulna to the radius or forearm bone on the thumb side. Together these structures stabilize the wrist. If torn the small finger side of the wrist can be painful and make your wrist feel unstable and weak.

Patients with injuries and/or pain on the small finger side of the wrist should be assessed by a hand and wrist specialist to establish an efficient management plan that minimizes the chance of disability. X-rays are necessary to differentiate the fracture from the ligament injury. Usually, a period of immobilization followed by physical therapy is the course of post injury treatment.

Dr. Dale Buchberger

Tendonitis and tendon strain of the wrist can occur from squeezing the club handle to forcefully and/or taking a large divot as in the previously mentioned disorders. Typically, these injuries can be managed with ice applications, anti-inflammatory medications, a period of rest and physical therapy to learn a routine of stretching and strengthening exercises.

Elbow injuries related to golf include ligament injuries, tendonitis and tendon strain. Pain on the inside part of the elbow from overuse usually indicates "golfers’ elbow," or flexor tendonitis. Pain on the inside of the elbow from a rapid deceleration could indicate a sprain or tear of the ulnar collateral ligament. This is most common in a baseball pitcher, but it can happen in golf when hitting behind the ball too much taking a large divot.

Pain on the outside of the elbow commonly indicates "tennis elbow" or extensor tendonitis. This also, occurs when the golfer squeezes the club handle to tight or plays excessive rounds of golf before they are ready. Overuse conditions of the elbow can be treated in a similar fashion as the conditions of the wrist with ice applications, anti-inflammatory medications, a period of rest and physical therapy to learn a routine of stretching and strengthening exercises. The more traumatic injuries from rapid or abrupt deceleration should be evaluated by a sports medicine and/or hand/wrist specialist to ensure an efficient recovery.

Injury prevention exercises for the wrist and elbow should be performed prior to the beginning of golf season and continue them throughout the season. A simple and inexpensive tool for developing strength in the hand, wrist and elbow is a "rice bucket." Take a used 5-gallon paint bucket, wash and dry it thoroughly and then fill it three-quarters of the way full of dry rice. The primary exercise is to put your opened hand with straight fingers into the rice until your fingertips touch the bottom of the bucket. At this point begin closing your hand grabbing a hand full of rice, then open your hand. Opening the hand will be difficult because of the resistance generated from the rice. If you have never performed this exercise before, it is easy to overdo it, so start easy with three sets of five repetitions and then take two days off. Assess the degree of soreness and gradually increase the repetitions from there.

If you are unsure if you are ready to undertake an exercise program without supervision, contact your trusted sports medicine professional for guidance. We don't want the cure to create problem.

Dr. Dale Buchberger is a licensed chiropractor, physical therapist, certified strength and conditioning specialist and diplomate of the American Chiropractic Board of Sports Physicians with 35 years of clinical sports injury experience. He can be contacted at (315) 515-3117, activeptsolutions.com or shouldermadesimple.com.

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