Maybe it shouldn’t have come as a surprise that I suffered from golfer’s elbow after playing 63 holes of golf in one day. I think I was lucky, because it was never too painful and it only took me a couple of weeks to get over the worst of the pain. Golfer’s elbow is a result of overusing the muscles in the forearm that allow you to grip, rotate your arm, and flex the wrist. This causes tiny tears in the tendon that can lead to severe pain in the forearm.
Also called medial epicondylitis, golfer’s elbow is mostly fixed by the worst treatment of all, as far as I’m concerned: rest. I did stop playing for two whole days, played a round at Littlehampton Golf Club, which made it worse. I took another two days off, played at Crowborough Beacon Golf Club and THEN finally took a whole week off. So I didn’t really rest as much as I should have, but I did play less.
My vice-captain Kim, who is a sports therapist, advised me to perform the following stretch at regular intervals: fully straighten the elbow with my hand facing upwards. Using your other hand, pull your hand down as far as you comfortably can. You should feel a stretch on the inside of your elbow and forearm; this should not be painful. Then, keeping the arm in the same position, pull the hand up. She also advised to massage the painful area. It hurt. I also wore a support strap while playing golf, which did bring some relief.
It’s pretty much gone now, but what can I do to prevent it happening again? I found some relevant advice on the NHS site:
Stop doing the activity that is causing pain, or find an alternative way of doing it that does not place stress on your tendons.
Before playing a sport that involves repetitive arm movements, warm up properly and gently stretch your arm muscles to help avoid injury.
Wear a golfer’s elbow splint when you are using your arm, and take it off while you are resting or sleeping to help prevent further damage to your tendons. Ask your GP or physiotherapist for advice about the best type of brace or splint to use.
Increasing the strength of your forearm muscles can help prevent tennis elbow. A physiotherapist can advise you about exercises to build up your forearm muscles.
Strengthening the forearm muscles
I like this video on how to strengthen your hand, wrist and forearm. Dr Levi Harrison has such a soothing voice that you’ll heal just by listening to him.
On the left: Two hours of golf. SO MUCH fun. On the right: 50 minutes of football. SO MUCH fun.
Football is great for your health
The health benefits of vigorous exercise, like football, are well known:
Increased cardiovascular health: In a 2010 study in Denmark, women who played 14 weeks of soccer improved their cardio fitness by 15 percent. The type of running in intervals in a soccer match are actually better for heart health and weightless than just jogging.
Increased muscle mass: In a 16 week study of twice weekly 1 hour sessions, the average leg muscle mass increase was 11% in women. The number of capillaries per muscle fibre was increased by 18% and the activity of glucose and fat metabolizing enzymes were elevated by 11 and 9%, respectively.
Increased bone density: On average, after the age of 40, women lose bone mass at a rate of .5 to 1% annually. In controlled studies, soccer increased a woman’s bone mineral density by an average of 2 to 3 percent; these gains from soccer translate to reversing bone ageing three to six years.
Lower body fat: Women who play soccer lose more body fat than runners because soccer engages both slow-twitch and fast-twitch muscle fibers. The perpetual switching between the two during a match cause increased fat burning.
Improved coordination: Due to shifts between walking, running and sprinting, coordination is developed in soccer. Body coordination is improved through the complex movements like dribbling, turning and passing, which are performed at varying rates of speed and direction. Hand-eye coordination is improved when players either kick the ball or receive a pass from someone.
Increased cognitive brain function: Soccer helps increase skills in concentration, persistence and self-discipline because it is a fast-paced game that requires quick decisions on the field.
Increased social interaction and support: Most women cite time constraints as the main reason for not working out. However, being on a team brings women together in a supportive manner and makes them set aside time for physical exercise. Joining a team leads to more commitment and actually following through with fitness and health goals.
Increase in overall health benefits even if training starts in adulthood: Researchers in Europe recruited more than 70 women ages 20 to 47 who had no history of playing soccer as children or teenagers. Two-thirds of the women were randomly assigned to either a running group or a soccer team. The rest served as a control group. For 14 weeks, the women in the active groups exercised by running or playing soccer for an hour a day just two days a week. The women playing soccer showed improved balance, muscle strength, and bone density.
Increased confidence: Building physical strength and endurance helps build confidence in a woman both on and off the field. A confident woman more aptly handles her life and career outside of the field. In several studies, women who feel physically capable in fitness demonstrate greater levels of self-esteem.
Reduced stress levels: Focusing on a game both tactically and physically forces the mind to distract itself for daily stressors. Coupled with endorphins from the physical exertion leads to reduced stress levels in soccer players. Women players in a study said feel more clear-headed after a match.
However, although some would deny it, golf is also a form of exercise, just a bit more sedate. And moderate intensity exercise also brings many benefits:
Tiny golfers in big Scottish landscape (Colvend Golf Club)
Coronary heart disease: Your risk of developing coronary heart disease, such as angina or a heart attack, is much reduced if you are regularly physically active. Inactive people have almost double the risk of having a heart attack compared with those who are regularly physically active.
Stroke: Physically active people are less likely to have a stroke. One study found that women aged 45 and older who walk briskly (at least three miles per hour), or who walk for more than two hours a week, reduce their risk of stroke by a third compared with less active women.
Cholesterol: Regular physical activity has been shown to raise levels of high-density lipoprotein (HDL) cholesterol. This is good cholesterol because it may actually help to protect against cardiovascular disease (coronary heart disease, stroke and peripheral vascular disease).
High blood pressure: Regular physical activity can help to lower your blood pressure levels if you have high blood pressure. It can also help to prevent high blood pressure from developing. High blood pressure is one of the risk factors for heart disease and stroke.
Diabetes: If you are regularly physically active then you have a lower risk than inactive people of developing type 2 diabetes. The greater the amount of physical activity that you do, the lower your risk of developing type 2 diabetes. If you have been diagnosed with impaired glucose tolerance (pre-diabetes), regular physical activity can help to prevent this from developing into diabetes. Also, if you already have type 2 diabetes, regular physical activity can help improve the control of your diabetes.
Weight control: Physical activity helps you to burn off excess fat. Regular physical activity combined with a healthy diet is the best way of losing weight, and keeping that weight off. [The BMJ article quoted below gives an average calorie expenditure of 264–450 kcal/hour]
Bone and joint problems: Regular weight-bearing physical activity can also help to prevent ‘thinning’ of the bones (osteoporosis). The pulling and tugging on your bones by your muscles during exercise stimulates bone-making cells, which strengthens your bones.
Cancer: Regular physical activity can help to reduce your chance of developing cancer. It roughly halves your chance of developing bowel (colorectal) cancer. Breast cancer is also less common in women who are regularly physically active.
Mental health: Physical activity is thought to help ease stress, boost your energy levels and improve your general well-being and self-esteem. It can also help to reduce anger. As well as this, physical activity can make you sleep better. (But do the activity during the daytime or early evening, not near to bedtime.)
Memory loss and dementia: Regular physical activity may help to prevent some types of dementia. If you do have dementia, regular physical activity may also help to keep you mobile for longer.
the incidence of injury in amateur golfers annually to be between 15.8% and 40.9% and lifetime injury incidence between 25.2% and 67.4%.
This is mostly due to repetitive practice. I once suffered from golfer’s elbow and it was horrible. I thought my golfing career was over, especially as I was told that only a prolonged period of rest of several months could fix it. You can imagine my despair. I try not to think too much about that difficult time. Thankfully, the pain disappeared after 24 hours. I don’t know what that was about.
Golf protects from colon and breast cancer, but the same article says that
Five ultraviolet radiation dosimetry studies report exposures that place golfers at higher risk of skin cancer than non-golfers. A cross-sectional study of female professional and amateur golf players highlighted increased numbers of non-melanoma skin cancers.
I must remember to slap on the factor 50.
Although still infrequent, golf is reported to be the sport with the highest incidence of lightning strike in the USA
Also, I’m somewhat doubtful about the claim that “[golf] can also help to reduce anger”. The BMJ article says that in the area of mental health,
a small experimental study enrolling nine persons with severe and enduring mental illness tentatively reported a number of mental and social benefits for participants. There is conflicting evidence relating to the effect of golf and other sports on mood and anxiety, with positive and negative mood changes noted. Improvement in stress and anxiety was reported by two studies, highlighting stress-busting qualities, verbalised as a ‘sense of cool control’ and a ‘release of aggression’. Conversely, studies describe anxieties relating to performance on the golf course.
Conclusion: football and golf both rock, but golf lasts longer
I’m sure I’m not the only golfer who’s experienced murderous rage in a bunker. But whatever the risks, they’re vastly outweighed by all the good stuff golf can mean for your health. In fact, golf seems to me a miracle cure against ageing. I regularly have conversations like the following: “So, Brenda, what do you do for a living?”. “Céline, I’m 82, I haven’t worked in 20 years.” Seriously. Golfers look so young. And I know they tend to belong to wealthier, well-fed, well-looked after sections of society, but a regular four hour walk has to be a big contributing factor.
Me, my bag and my current favourite golfing outfit
Jan is worried about my back
“Your back may be fine now, but wait until you’re older. You really should get a trolley”, Jan said.
I was pretty sure that carrying my bag wasn’t a problem, however, Jan isn’t always wrong and I do intend to play golf as long as possible, so I thought I’d investigate. I sent a GP, a sports therapist and a physiotherapist the following email:
Could you tell me if you think carrying a bag of clubs while playing golf (mine is around 11 kg) is good or bad, and explain why? I’m getting conflicting views on it. Some say it makes your back stronger, others that it speeds up wear and tear and squishes my discs. I’m worried that I’ll end up with big problems in a few years.
What the health professionals think
Physio: “Looking at the way you carry your bag, I don’t see a problem at all. You always use the straps over both shoulders. There is an 85 year old at Haywards Heath golf club who has always carried and never suffered any pain. Those who are predisposed to spinal problems will suffer and could damage themselves. To carry you must have excellent straps and don’t overload.”
GP: “I don’t think 11 kg is that big a weight to carry on your back, but it depends how you carry it. If it’s slung over one shoulder, you risk shoulder problems and muscular back pain from an uneven load. The general recommendation for people in good health is that they should be able to carry 20% of their body weight.”
Sports therapist: “I agree with Anna (GP) that 11 kg is no weight at all IF carried evenly. Use shoulder straps and do not carry over one shoulder only. The main thing to be aware of is maintaining good posture: upper back extended, leading from the chest, not hunched over. The weight of the bag must be distributed evenly, so be aware of how you pack your bag too.”
A study on the impact of carrying weight on spinal loads
I also did a search on the Internet and found a study on carrying and spine loading. It’s very academic and complex, but its conclusion is straightforward (one of the weights tested happened to be 11 kg):
Carrying weights increases spinal loads. The loads on a telemeterised VBR were measured in five patients carrying weights in different ways. Holding a weight in front of the body strongly increased the force, while carrying it in a backpack led to only a minor load increase.
Conclusion: carrying my bag is ok for now
It looks easy, but that ball is very heavy
So there you have it. I’m sure carrying a golf bag isn’t ideal for some people, but I’ve been doing it for five years with no apparent problems, so it’s probably ok for me. Also, I do a lot of exercise that strengthens my back. I play football, I recently ran a half-marathon and I go soldiering three times a week with my British Military Fitness crew. We do all sorts of strengthening exercises for the whole body, including the back. A decent level of fitness, good posture and an even load on the back should keep me going. I will just have to put up with Jan tutting at me.
About This Site
The diary of an amateur golfer who is no longer Lady Captain of Brighton & Hove Golf Club.