Wrist Injuries In Golfers

Wrist Injuries In Golfers

Golf injuries of the wrist are rare, but when they occur, they can be devastating for avid golfers, competitive amateur golfers, or professional golfers, as the hand and wrist are so integral to the game. During the swing the lead side of the body is the predominant generator of this power. In Golfers injury is either due to overuse or impact related mechanisms or swing errors and occur more frequently in younger golfers with lower handicaps. In professional golf, wrist injury incidence has been reported to be up to 54%.

Clinical Symptoms

Wrist pain can generally group symptoms into 3 distinct locations: Ulnar-sided (along the little finger side), Radial-sided (along the thumb side) and Dorsal (back of the wrist) pain.

Following are the conditions which can occur at the above mentioned sites:

• Subluxation or instability of tendon

• Inflammation of tendon membrane 

• Injury to cartilage complex

• ‘Fat shot’ pain

• Intersection syndrome

• 1st Carpometacarpal (CMC) joint injury

• Bone fractures

• Carpal Tunnel syndrome (CTS)

How Do These Injuries Occur?

During the swing the lead wrist will begin to move along the little finger side (ulnar deviation) and move towards the thumb side (radial deviation) at the top of the backswing. As the swing commences the wrist rapidly moves back into ulna-deviation (along little finger) by impact. One explanation for why a lower-handicapped golfer will experience lead wrist pain more commonly is through the process of "playing through the ball”. The trail wrist follows a completely different motion, beginning in neutral and moving into maximal extension at the top of the back swing and returning to neutral at impact.

Causes of Wrist Pain

•  Hitting off hard surfaces 

• ‘Fat shot’ 

•  Hitting immovable objects such as tree roots or rocks. 

•  Poor Grip

Treatments

Root cause management and prevention from recurrence can be beneficial from physiotherapy treatment. Therapist will assess to determine the causes and extent of injuries and provide the treatment for the same.

Physiotherapy management includes:

• This type of injury will often require 'load modification' with more traumatic sudden onset injuries requiring immediate removal of load and POLICE (protection, optimal loading, ice, compression, elevation) protocol

• While in other cases, your wrist pain can be severe enough to require immobilization in a brace or cast. It is important to rest the wrist and avoid activities that may aggravate the condition in order to prevent further injury. With the right treatment, most golf wrist injuries will heal, and you'll be back to teeing off in no time

• Joint and soft tissue mobility issues with some manual treatment (soft tissues releases and joint mobilization)

• Kinesio taping (to limit unwanted movements)

• Followed by Strengthening exercise program that can improve grip and general upper limb strength

There are a number of benefits of load training in addition to the injury avoidance related to communication and relationship building with athletes, support staff, and coaches. When athletes are involved in monitoring, this can enhance their feeling of involvement in the training program, empower them, and increase their sense of ownership. 

You may consult your physiotherapist to have your customised load progression protocol in accordance to your physiological , physical and goal based activity requirement.

Written by: Ankita R. Parkhe (Physiotherapist)

A motivated and dedicated Physical Therapist with a constant urge of enhancing and broadening the spectrum of knowledge having 5 years of experience. Has been  serving the patients with the goal to help them return to their previous functional capabilities helping them perform all their activities of daily living with a 95% success rate. Has been closely involved in helping neurological patients presenting with stroke, parkinsonian disease, spinal cord injury, maximizing their available functional abilities. Emphasizes on patient education and family education about home exercise program, positioning and prognosis of the condition.

References 

Campbell D, Campbell R, O'Connor P, et al. Sports-related extensor carpi ulnaris pathology: a review of functional anatomy, sports injury and management. BJSM 2013;47:1105-1111.

Hawkes R, O'Connor P, Campbell D. The prevalence, variety and impact of wrist problems in elite professional golfers on the European Tour. BJSM 2013;47:1075-1079.O'Connor PJ, Campbell R, Bharath AK, et al.

Murray, P. M., & Cooney, W. P. (1996). Golf-induced injuries of the wrist. Clinics in sports medicine, 15(1), 85-109.

Pictorial review of wrist injuries in the elite golfer. BJSM Sep 2016, 50 (17) 1053-1063.