Steemit Learning Challenge-S22W5; Golfer's Elbow"
Another interesting week of learning. Thank you @ashkhan for the teachings.
Golfers elbow is a condition that occurs when the tendons around the joints of the elbow becomes inflamed. Theses tendons could be the ones on the epicondyle or the ones found on the medial side of the elbows. And it’s also known as medial epicondylitis.
Considering the seriousness of the damage done to the tissue, it’s categorized into three namely the rupture of the tendons, tendonsis or tendinitis. Tendinitis meaning the inflammation of the tendons which usually happens to those who plays golf as a result of hyper flexion of their elbow joints or wrist.
Golfers elbow can be caused by:
- Repetitive strain or over using: Golfers always swing the elbow and when this is not done professionally, it can lead to putting strain on the tendons
- Poor alignment or positioning of the posture during the sports
- Poor sport technique or flaws in the swing techniques like bending or twisting
- Tear and wear of the tendons that’s related with age
- when golfers do not perform adequate warm up exercises, tendons can become vulnerable to more injuries
- Preexisting conditions or injuries like arthritis or tendinitis.
Symptoms of golfers elbow includes
The symptoms of golfers elbow includes;
- Feeling of sharp pain on the medial region of the elbow
- feeling of fatigue or weakness in the wrist or the forearm when trying to perform twisting or gripping activities
- painful sensations when bending the forearm or wrist or when trying to twist or grip
- feeling tingling sensations or numbness around the fingers
- there may be reduced range of motion of the elbow especially after rest or sleep (stiffness of the elbow)
- Elbow may be swollen or mild tenderness.
Types of golfers elbow
Mild golfers elbow which involves irritation or inflammation with mild stiffness and pain around the region of the elbow and joints and also affects the daily living activities.
Moderate golfers elbow affects the daily living activities also but the stiffness and pains felt in the medial elbow region is moderate.
The severe golfers elbow comes with severe stiffness and pain in the medial elbow regions thereby making it very difficult for daily tasks to be performed.
Stages of golfers elbow
- Acute stage: inflammation and pain sets in suddenly
- Subacute stage: This doesn’t last up to one month when the symptoms sets in.
- Chronic stage: from the time the symptoms like stiffness and pains sets in, this stage lasts from about one month to a period of about six weeks
Some diagnosis for golfers elbow includes:
- Physical examination where the therapist would have to visually look at the affected elbow to check for range of motion, tenderness, redness or swellings and also checkout the patients forearms and grip strength.
- Tests such as X-rays, MRI, ultrasounds are also performed to access the conditions of the muscles and tendons for arthritis, tendons rupture or damages to the muscles of the elbow.
- The doctor would have to look out for patients medical history, surgical and family and professional history to check if there has been some medical conditions in the past such as tennis elbow, arthritis etc
- NCS and EMG tests are also carried out to ascertain the strength of the elbow muscles and if there are damages to the nerves.
Assessments tests includes
Medial epicondyle test
MET is used to diagnose medial epicondylitis golfers elbow. With the patients arm relaxed on the side either sitting or standing, the therapist will flex the elbow of the patient to 90 degrees while the wrist faces upwards and resistance is applied to the wrists of the patient. The patient would have to resist the applied force while maintaining the flexion of the wrist. It’s positive if the patient feels pain on the medial elbow or weakness and finds it difficult to resist the force of the therapist.
Valgus Stress Test
This test is also used to diagnose medial epicondylities and check for the state of the MCL of the elbow. The therapist flexes the elbow of the patient to twenty - thirty degrees while the patient is sitting or standing with the arm relaxed on the sides. Valgus force is applied pushing the elbow inwards. It’s positive of the patient feels pain in the medial elbow or if the MCL or elbow feels loose
Cozen's Test
Cozens test for diagonising golfer elbow is performed with the patients elbow flexed to 90 degree while sitting in a relaxed position with arms by the side. while the palm is faced down, the wrist is extended with resistance placed on it and the patient tries to resist the force by the therapist. If tenderness or pain is felt at the medial elbow or resisting difficulty, the test is positive.
Functional tests
Functional test is carried out where a goniometer is used to perform the ROM test, a dynamometer is used to check for the grip strength of the patient while the functional ability test is performed by asking the patient to perform activities like lifting, twisting or gripping.
The three exercises I practiced includes:
- Wrist Flexors Stretch
Here with the arm extended and wrist pointing upwards, I pulled back my fingers with the other arms while resisting the pressure on the fingers ensuring limited movement. This is done for about 5-10 seconds and repeated. It helps to improve the flexibility and movement of the wrist and also improve the length of the muscles that are shortened and reduces pain.
- Wrist Isometric Exercises
Put the affected palm faced down and press on the fingers regions with the other fingers while pushing upwards to resist the pressure on the wrist and finger region. I do this both both wrists and also with the arm outstretched in the two videos. The pressure is held for about 5-10 seconds and repeated. This helps in each direction as in the video to strengthen the muscles of the arms and the wrist.
- Forearm Supination & Pronation
This is done using a weighty object such as a hammer. Holding the hammer on the affected elbow, relaxe the arms by the side and rotate the hammer from side to side ensuring limited movement. This helps to improve ROM and strengthen the muscles of the elbow.
Ensure to apply heat pad on the affected area for about 5-10 minutes after the exercise to reduce pressure on the muscles.
On trying out these excercises, I felt pressure on my wrist and the muscles of the elbow and with sustained pressure sines the lingered pain but they didn’t last. It’s makes for ease in the areas excercised.
Thank you as I ask @pandora 2010, @anailuj1992, @shiftitamanna for join the learning challenge.
Thank you for understanding the lesson and sharing your assignment; I hope that you will enjoy this week's lesson and try to implement it in your life if you see any such case.
Observations
Task 1 (3/3)
You have shared a great knowledge about golfer's elbow, its symptoms, causes, types and it's stages. I appreciate your effort.
Task 2 (3/3)
In the second question, you tell us about how you have to assess a patient by doing physical examination, history taking, and investigations. That's good you add special tests and also explanation of special tests. Excellent.
Task 3 (3.9/4)
You try the wrist isometric, forearm supination & pronation, and wrist flexors stretch. You did the wrist isometric, forearm supination & pronation and wrist flexors stretch correctly. But it would be better to keep the elbow start while applying resistance force for effective results. Always remember to apply heat pack in chronic condition and ice pack in acute condition before performing exercises to relax the muscles and reduce stiffness. I appreciate your efforts.
Overall you made a great attempt to answer all the questions. I appreciate your efforts. But next time try to avoid the above written suggestions. Keep learning and try to implement your knowledge to the people suffering from golfer's elbow or any type of elbow issue. Thank you.
Noted. Thank you for the review 🙏