Golf Hand Injuries
For most golfers, the hand and/or wrist is the third most common body region injured, after the back and elbow. The wrist is injured 3 times more frequently than the hand. In golf, the action of the wrist is important for the “snap” of the shot in long shots, and the precision “feel” in short shots. Golfers who lack strength in their forearms are more prone to wrist and hand injuries. The leading wrist/hand (left side for right-handed players, right side for lefties) is most at risk. Injuries result either gradually from overuse, or from a traumatic blow (hitting a root or a rock, or hitting a fat shot off hardpan) causing sprains (ligament injuries) or fractures (“broken bones”).
Common Golf Hand Wrist Injuries
The most common wrist/hand complaint is due to tendonitis (tendon inflammation) of any of the tendons that cross the wrist. Treatment usually consists of rest, splinting, ice, and non-steroidal anti-inflammatory medicines. If these initial treatments fail, cortisone injections may be used at the discretion of your doctor.
Hook Of The Hamate Fracture
Another distinctive golf injury is fracture of the hook of the hamate, one of the small bones of the wrist. The hook is the particular part of that bone that protrudes toward your palm, and is vulnerable to injury from the club on a hard hit to the ground as the handle crosses right over the bony hook when gripping the club (see Figure 1, 1a). Hook of the hamate fractures may cause pain in the heel of the little finger side of the palm. If it irritates the adjacent ulnar nerve, it may cause numbness and tingling in the ring and little fingers. The tendons that bend the ring and little fingers are also adjacent to the hook, and movement of these fingers may be painful and give a sensation of “catching” or “clicking” if these tendons are rubbing on the fractured bone.
Left untreated, the tendons can even gradually fray and rupture. In addition to physical examination, your doctor may obtain X-rays, but the fracture is often difficult to see on plain X-rays because of the overlap of the other small bones in the wrist. A special study called a CT scan is often used to visualize the area of the hamate hook in greater detail when a fracture is suspected (see Figure 2). Treatment may consist of splinting or casting if the fracture is seen very early after injury. If seen late and there is continued pain, numbness and tingling, or tendon irritation, surgery is usually performed to remove the broken bone fragment. This may include open reduction, internal fixation, or excision of the hook.
Golfer’s Elbow or Medial Epicondylitis
The elbow may be affected with “golfer’s elbow”, which is a painful tendonitis on the inner aspect of the elbow at the origin of the “flexor/pronator” muscles. These muscles include the pronator teres, flexor carpi radialis, Palmaris longus, the flexor carpi ulnaris, and flexor digitorum superficialis. They originate from a bony prominence of the humerus (arm bone) called the medial epicondyle, and so this condition is also called “medial epicondylitis” (see Figure 3). It can be caused by repeated swinging stress to the elbow, and may result from many other non-golfing activities, such as heavy lifting and hammering.
Lateral epicondylitis, on the outer side of the elbow, is also commonly seen in golfers from repeated strain to the lead arm, similar to hitting backhands in tennis. Both these conditions are usually first treated with rest, a physical therapy program of muscle stretching and strengthening, and non-steroidal anti-inflammatory (NSAID) medicines. If these initial treatments fail, cortisone injections may be used at the discretion of your doctor. In a small percentage of patients, non-operative treatment is unsuccessful, and your doctor may recommend a surgical procedure that entails removal of the degenerated part of the tendon and possible tendon repair.
Triangular Fibrocartilage Complex
Triangular fibrocartilage complex (TFCC) is a cartilage structure that is located on the side of the wrist opposite the thumb. This structure supports the small carpal bones in the wrist and provides stability for the forearm bones (radius and ulna) when the forearm rotates or hand grasps.
A tear or injury to the TFCC often results in chronic wrist pain. Two types of TFCC tears exist; Type 1, which refers to traumatic tears that occur from falls or excessive arm rotation, and Type 2, which refers to more chronic or degenerative conditions that take place over time. Treatment of TFCC includes non-surgical options, such as splinting or casting, use of NSAIDs, cortisone injection, and/or ultrasound therapy. More severe cases may require surgical treatment. This typically involves minimally invasive wrist surgery.
Golfers are especially susceptible to TFCC tears.
Damaged Blood Vessels
Hypothenar Hammer Syndrome, an injury to one of the main arteries in the hand, occurs when repeated striking to the palm of the hand weakens the vessel wall. It causes the vessel to enlarge and in some cases clot. Hypothenar Hammer Syndrome can result in pain in the region of the palm, as well as disrupt blood flow to the fingertips, causing fingertip pain, discoloration, and numbness. The repetitive stress of striking a golf ball increase the likelihood golfers experience this form of injury. Treatment for damaged blood vessels include non-surgical options as well as hand surgery.
Golf Cart Injuries
Another potential cause of injury when golfing is the unsafe use of golf carts. Golf cart accidents with fall-outs and tip-overs may cause very serious injury such as fractures to the wrist, forearm, elbow, arm, shoulder, tibia (shin bone), and ankle, among others Proper care and caution must be exercised when driving golf carts.
Get Relief From Your Golfing Injury
Because the sport of golfing applies repetitive stress to the hand and upper extremities, there are several common conditions that many golfers experience. While the nature and severity of these injuries vary, all call for timely medical evaluation and treatment. If you believe you have any of the conditions described previously and would like to be evaluated, contact us today. Our friendly staff will help schedule an appointment with one of our highly trained physicians, who can develop the best treatment course for you.