Hi, I’m Dr Eric Cobb of Z-Health Performance and today we’re continuing our discussion on solving golfers elbow issues by focusing on other areas of the kinetic chain.
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Alright, so this is our third video on golfer’s elbow and when you get into the research, what you’ll find is that there’s not much research. There’s been tons of information developed about tennis elbow or lateral epicondylitis but it’s much more difficult to find too much information about what’s called golfer’s elbow or medial epicondylitis. As we’ve already discussed, a lot of times what we’ll see is that golfer’s elbow does not just happen when you play golf. It can be from anything that requires rapid flexion of the wrist as well as pronation, so that can be in tennis, using a hammer, being a plumber, being a rock climber. They’ll see it in a lot of different areas; typically, we’re talking about pain here, here medial epicondylitis.
In our first video, we talked about working on the spine because a lack of spinal mobility is one of the kinetic chain problems that we’ll see with golfer’s elbow. In our second video, we then talked about working on the opposite hip to improve internal rotation as that can play a huge role. As well, today, we’re going to now look at some additional ideas from research looking at shoulder capacity, shoulder strength, shoulder endurance, and shoulder motor control. Generally, what you see with people that develop golfer’s elbow are problems in three different shoulder motions.
Alright, motion number one is external rotation. Alright, so we’re focusing here. We will see weakness in external rotation, we will see weakness in abduction; so moving the arm away from the body and we will also see weakness in shoulder extension. So if you are dealing with golfer’s elbow, the next link in the chain is to begin working on shoulder motor control and strength. And like many things I like to do using isometrics, so I’m just going to show you some quick ideas.
This is one of our cool little tools from Bull Worker. Really cool company that makes stuff for isometrics. You know that I love isometric exercises so often what I will do when people have golfer’s elbow, and we’re working on the shoulder, is we’ll begin with long hold isometrics. Now, long hold is going to be somewhere around 30 to 45 seconds in each position. We’re not going to use maximal strength, we’re going to be 50 percent. 40 to 50 percent of your maximum in the beginning just to develop some endurance capacity. The big problem that you will run into in any kind of strengthening work for golfer’s elbow is a desire to grip things. Gripping is already part of the problem so I like to use tools that allow me to do the strengthening work without having to tax the grip.
So this first little exercises for shoulder external rotation, I’m going to take this device, and again you can do this with bands or ropes or whatever, but instead of holding it here I’m going to slip my hands inside. Now all I have to do is tuck my elbows into the side of my body and I can begin doing an external rotation for the shoulder isometric. So as I do this again I’m trying to hit 40-50 intensity and I’m focusing on externally rotating. As you build up the time and intensity you will definitely start to feel more and more fatigued. And that’s what we’re going for. So normally I’ll ask people to do four sets of 30 second holds in this external rotation position.
Now, from here we then want to switch to a different device. I showed in one of the other videos the forearm forklifts, which is another cool little isometric thing and you can use that tool as well for the next couple of exercises. We’ve done our isometrics for external rotation, now we want to work on abduction. So for this same idea, I’m going to stand on the The Loop and I’m going to insert my hands inside the handles. Again, I don’t want to be gripping. So now I’m going to begin abducting. So I’m lifting my hands up toward the ceiling. The nice thing here is that I can also begin working on some additional external rotation if you see what I’m doing with my hands and wrists so I’m getting abduction and external rotation again. I’m going to do 40-50 intensity hold for 30 seconds. Rest, repeat that three more times.
Our final exercise then, is going to be for shoulder extension. Now for this one, the band’s going to have to go back behind me. Alright, so from here, what I’m going to do is once again insert my hands into the loops. Make sure I have a relatively even tension here and I’m going to begin working on extension. So now again, I’m lifting my palms toward the ceiling. What I like to do in this position is 30 seconds with my palms facing, then switch it. So, it’s now kind of the knife edge, if you will, of my hand. Just have to get my hand rotated. So now I’m here and then finally the back of my hand. So, I’ll do three different positions working on shoulder extension. Each one of those I’m doing 30 seconds and then whichever one was probably the most difficult. I’ll do for the fourth set. So once you’ve begun doing these, adding them in four to five times a week. You want to continually check on, “How is the palpation tenderness around the medial epicondyle?” What you may find is that shoulder edge thermal rotation takes the pain from a five to a one. You then go to shoulder abduction and it goes from a five to a six. You then go to shoulder extension and it goes to a three. You’re basically going to need to test your pain levels both with gripping and with palpation after each one of these exercises to help you figure out which one is most important for you in relationship to pain relief. Alright, so uh so far you’re working on your thoracic mobility, you’re working on your hip mobility, now we’re working on your shoulder external rotation abduction and extension. You’re getting now a nice little package of things that you can be testing to see what gives you the greatest result!
When we come back for our next episode, we’re going to talk about some additional considerations in dealing with golfers’ elbows.
