Hand & Wrist Specialists of the Palm Beaches
Laura Kolshak, M.D.
Board Certified Orthopaedic Hand Surgeon, Fellowship-Trained
Palm Beach County, FL
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Call (561) 508-7066
Fax (561) 508-5738
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Most Common Golfing Injuries
In Southwest Florida, golf is abundant! Unfortunately, so are the injuries that can accompany it. When it comes to golfing injuries, the most common injury is the back. However, the second and third most common are injuries of the elbow and the hand and/or wrist. The wrist is actually injured three times more frequently than the hand.
A wrist injury can be very detrimental since, as any decent golfer knows, the wrist is very important in the game of golf. The proper wrist movement is needed for a good “snap” in the shot in long shots, and the precision “feel” in short game.
Who's at Risk?
If a golfer lacks sufficient strength in the forearm, they are more prone to wrist and hand injuries. Also, your leading wrist/hand is most at risk. Injuries can occur either gradually from overuse or from a traumatic blow, such as hitting a fat shot off hardpan or hitting a root or a rock, resulting in sprains ( ligament injuries) or fractures (broken bones).
Tendonitis is the most common wrist/hand complaint among golfers. It is an inflammation of any of the tendons that cross the wrist. Treatment for this condition usually consists of:
medicines that are non-steroidal and anti-inflammatory
If these initial treatments fail to help, your doctor may also suggest cortisone injections.
Fracutre of the Hook of the Hamate
Another distinctive golf injury, involving one of the small bones of the wrist, is a fracture of the hook of the hamate. The hook is the part of the bone that protrudes toward your palm. This makes it very vulnerable to injury from the club if there is a hard hit to the ground as the handle crosses over the bony hook when gripping the club. Hook of the hamate fractures may cause pain in the heel of the little finger, on the side of the palm.
If the adjacent ulnar nerve is irritated, this fracture may cause numbness and tingling in the ring and little fingers. Also adjacent to the hook, are the tendons that bend the ring and little fingers. When these fingers are moved and rubbed on the fractured bone, it can be painful and give a “catching” or “clicking” sensation. Left untreated, the tendons can even gradually fray and rupture. Your doctor may obtain x-rays in addition to a physical examination to diagnose this. However, a fracture is often difficult to see on plain x-rays, due to the overlap of the other small bones that are in the wrist. A CT scan is often used to see the area of the hamate hook in greater detail when a fracture is suspected.
Treatment of Fracture
Treatment of a fracture may consist of splinting or casting if the fracture is seen very early after injury. If it is seen late and there is constant pain, numbness and tingling, or tendon irritation, surgery is usually performed to remove the broken bone fragment.
In the sport of golfing, the elbow may also be affected with “golfer's elbow.” This is a painful tendonitis on the inner part of the elbow at the origin of the “flexor/pronator” muscles. They originate off the “medial epicondyle” (also called “medial epicondylitis”) which is a bony prominence of the humerus (arm bone). This condition can be caused by repeated stress to the elbow from swinging, as well as other non-golfing activities, such as heavy lifting and hammering. Lateral epicondylitis, which is on the outer side of the elbow, is commonly seen in golfers from repeated strain to the lead arm. It is similar to hitting backhands in tennis. Golfing injuries to the elbow may also be referred to as "Tennis Elbow". Visit our Tennis Elbow page to learn more about this condition, as well as treatment options.
Treatment of Golfer's Elbow
Both conditions of golfer's elbow are usually treated with rest, a physical therapy program involving muscle stretching and strengthening, and non-steroidal anti-inflammatory medicines. If these initial treatments fail, cortisone injections may be recommended by your doctor. Though it is only in a small percentage of patients, sometimes non-operative treatments are unsuccessful and your doctor may suggest a surgical procedure. This usually entails removal of the degenerated part of the tendon and possible tendon repair.
Shoulder Pain / Injury
If you’re an avid golfer, there is a good chance that you may experience shoulder pain at some point, if you haven’t already. The motion you use during driving puts a lot of rotational forces to the shoulder, which has the largest range of motion of all the joints in your body. Your shoulder has many tendinous attachments and supportive structures. Because of this, the chances of injury are increased.
Rotator cuff injuries are one of the most common causes of shoulder pain in golfers. The rotator cuff consists of the tendinous attachments to the humeral head that work together to move the shoulder in multiple planes. A rotator cuff injury occurs when tendons and/or muscles tear and cause pain. Activities such as a powerful golf swing, swimming, or falling hard on an outstretched arm are examples of movements that can cause your rotator cuff to tear.
Treatment of Rotator Cuff Injury
Visit our Rotator Cuff Dysfunction page to learn more about Rotator Cuff injury, as well as treatment options.
Other Golfing Injuries
Other potential causes of injuries during golf occur with the unsafe use of golf carts. Golfers falling out of golf carts or tip-overs may cause very serious injuries, such as fractures to the wrist, forearm, elbow, arm, shoulder, tibia (shin bone), and ankle, among others. It is important that proper care and caution be exercised when driving golf carts. Other non-upper extremity injuries worthy of mention include sprains and strains of the back, especially the lower back called the lumbar spine. In order to decrease the chances of injury, proper warm-up and stretching exercises are important. Gradually increasing the length and intensity of play should be exercised as the season progresses.
For more information about simple, safe, and effective treatments for golfing injuries, or any other conditions of the hands or upper extremities, schedule an appointment with Dr. Sagini by calling 239-337-2003.