By: Dr. Richard DeFalco, DPT, OCS, CSCS, CWcHP, Cert. DN
When I talk to family and friends about living in Myrtle Beach, most, if not all immediately associate it with golfing...and rightfully so. They assume that I spend a good amount of my free time playing the sport that Mark Twain has been quoted as saying "golf is a good walk spoiled!" It really is amazing that it is a game that can frustrate you to no end, but at the same time keep you coming back for more. It is the "coming back for more" part that I will focus on in this article and how physical therapy can help.
The repetitive nature of a golf swing can have a wear and tear nature on the body, starting at the foot and ending at the head. It is a total body movement, and as such, can really affect anywhere. Having treated patients in the Carolinas for the past seven years I have treated an abundance of golf related injuries, mostly due to repetitive strain on the body. The common areas of complaint are the shoulder, elbow, back, and neck and occasionally the hip, and knee. There sometimes is a misconception that if you had pain for any considerable length of time, and have tried medications and/or injections, that nothing can help. I would strongly disagree. Many of these chronic issues can be treated by way of physical therapy. We will touch upon the elbow and shoulder, though the same philosophies can be applied to other areas of the body.
Excessive forces or overuse can disrupt the balance between mobility and stability, resulting in tendon and ligament injuries, as well as joint degenerative changes known as osteoarthritis. When you perform an activity repeatedly, breakdown of tissue occurs faster than the tissue can heal or repair itself, resulting in injury/tissue damage. Initial injuries that are diagnosed as inflammatory conditions such as a tendonitis can progress overtime to degenerative conditions of the tendon, otherwise known as a tendinosis. The problem is that at this point, the condition no longer responds as well to anti-inflammatory medications and/or injections. This is because the inflammatory process has passed and now degeneration of the tissue starts to begin. The tissues that typically breakdown have inherently inferior healing abilities and subsequently do not heal well on their own. Often times people may start wearing braces to buffer the force and continue to play, though ultimately nothing is being done to fix the problem.
Medial epicondylitis, otherwise known as Golfer's Elbow, is an inflammatory condition of the inner side of the elbow where the tendons of the forearm muscles attach to the bone, and it is characterized by tenderness to palpation, pain with gripping, and pain with activity (usually swinging of the golf club). Some golfers' may also present with lateral epicondylitis which has the same characteristic features of medial epicondylitis, though it occurs on the outside aspect of the elbow. This is also known as tennis elbow, because it is commonly seen in tennis players. These conditions can be present in any individuals, not just those playing sports.
The shoulder can become another symptomatic area with golfing. With limited range of motion in the glenohumeral joint (shoulder) the humeral head can impinge against the bony structures above it and ultimately wear down the soft tissues that lie between. What initially may be just wear and tear can eventually progress to a complete tear/rupture that will require surgical intervention. Most of the shoulder patients (both surgical and non-surgical) that present to physical therapy report that they have had symptoms for quite a long time, thinking that it would eventually get better with time, when in fact just the opposite occurs...increased pain, decreased motion, decreased strength...all leading to decreased use and possibly having to give up the sport. Common diagnoses include, but are not limited to, rotator cuff tendonitis, bursitis, shoulder instability, and biceps tendonitis. If addressed early enough, you can easily rehabilitate your shoulder and arm yourself with appropriate techniques/exercises to allow pain free use of the shoulder and allow you to enjoy the game that drives so many of us crazy!
Physical therapy interventions such as targeted manual therapy, modalities, combined with specific exercise techniques can be, and usually are, very effective at addressing these problems. By strengthening the affected muscles through specific exercises you can ultimately heal yourself of the problem for good and maintain that state with regular performance of appropriate exercise. The effect of exercise on tendons has been well studied and it has been shown that long-term exercise results in increased cross-sectional area and tensile strength. These positive findings make your body more capable of withstanding repetitive forces, such that exist with golfing.
At Professional Rehabilitation Services, we treat a wide variety of neuromusculoskeletal conditions using the latest in evidence based therapies provided by highly credentialed physical therapists. In addition to being licensed physical therapists, our providers have additional specialty certifications and training in orthopedics, manual therapy, sports, strength and conditioning, vestibular treatment, and dry needling. For further information on this or other related topics you can contact Brian P. Kinmartin PT, DPT, MTC, OCS, STC, CWcHP, Cert. DN, (Pawleys Island) (843) 235-0200, Richard A. Owens, PT, MS, OCS, Cert. SHT, CWcHP, Cert DN (Surfside) (843) 831-0163 at Professional Rehabilitation Services, Richard DeFalco, DPT, OCS, CSCS, CWcHP, Cert. DN (Myrtle Beach) (843) 839-1300, or visit our website at www.prsrehabservices.com where you can learn more about the company and even download a referral form for you physician to fill out. You can also call and schedule a free 15 minute consultation!