The Impact of Tennis and Golfer’s Elbow on Shoulder External Rotators and Abductors’ Peak Torque

Abstract

Context: Upper limb activities require a repetitive movement of the shoulder external rotator and abductor muscles. The malfunction of the proximal part of the upper limb kinetic chain tends to change the mechanics of the distal part and increase the risk of injuries. Objectives: To compare the normalized eccentric peak torque (NEPT) of the shoulder external rotator and abductor muscles among healthy athletes and those with tennis elbow and golfer’s elbow. Design: An experimental cross-sectional study. Setting: Isokinetic laboratory, Faculty of Physical Therapy, Cairo University. Participants: A total of 30 male athletes participated voluntarily in this study. Intervention: Participants were distributed into 3 groups: healthy group, tennis elbow group, and golfer’s elbow group. Main Outcome Measures: NEPT of shoulder abductors and external rotators. The Biodex Isokinetic Dynamometer was used to measure the variables of interest. Results: There was a significant increase in the NEPT of shoulder abductors and external rotators in healthy control group compared with both tennis elbow and golfer’s elbow groups at an angular velocity of 60°/s (P < .05). Moreover, there was a significant increase in the NEPT of shoulder external rotators and abductors at an angular velocity of 120°/s in healthy control group compared with tennis elbow group and in golfer’s elbow group compared with tennis elbow group (P < .05). Conclusion: Tennis elbow and golfer’s elbow are associated with decreased NEPT of shoulder external rotators and abductors compared with those of healthy athletes. This tends to decrease the external stability of the shoulder joint and put high stress on the distal joints of the upper kinetic chain.

Golf and Health, More than 18 Holes—A Bibliometric Analysis

“…Of the 21 works dealing with this topic, 13 focused exclusively on golf, while the remaining 8 studied a range of sports (including golf) and analyzed the risks of outdoor sports [ 132 , 160 ] and injuries caused while engaged in sports [ 87 , 133 , 134 , 135 , 161 , 162 ]. Among the group of studies focusing exclusively on golf, there were studies on injuries among golfers [ 75 , 82 , 85 , 159 , 163 , 164 , 165 ] and the possible risks for players on the golf course [ 76 , 83 , 84 , 85 , 86 , 88 , 166 ]. In this line of research, we found nine publications in both databases [ 76 , 82 , 83 , 84 , 88 , 132 , 133 , 134 , 135 ].…”

Estimates of Golf-Related Upper Extremity Injuries in the United States: A 10-Year Epidemiology Study (2011-2020)

“…1,14 Numerous other groups have supported our findings of the shoulder being the most commonly injured UE joint among golf athletes. 1,7,11,14,19,20,25,26 While this study was limited to 10-year epidemiological trends, and did not elucidate exact tissue injury mechanisms, we believe that golf-related shoulder injuries are a product of rotator cuff disease and subacromial impingement. 2,24-26 Mallon et al 16 confirmed these findings and highlighted the role of the rotator cuff in transferring force from the torso/arms down into the golf club during the swing arc.…”

“…While our study did not explicitly stratify competition level or subanalyze specific muscle groups related to UE injury, the current investigation supports the previous literature, demonstrating that the most common golf-related injuries of the UE joints are the shoulder, forearm, and wrist. 1,4,11,14,17,[19][20][21][22][23][24][25][26] The present study has significant limitations. Most importantly, the number of injuries and rates are estimates only because of the use of the NEISS database.…”

“…While our study did not explicitly stratify competition level or subanalyze specific muscle groups related to UE injury, the current investigation supports the previous literature, demonstrating that the most common golf-related injuries of the UE joints are the shoulder, forearm, and wrist. 1,4,11,14,17,19-26…”

Etiology and Prevention of Common Injuries in Golf

“…Swing modifications with a therapist or swing coach should emphasize less reliance on the wrists/elbows and more on truncal and shoulder rotation. In a 2020 study analyzing 30 male athletes with lateral epicondylosis, medial epicondylosis, or no elbow pathology, Nabil et al (37) found those in the epicondylosis groups had significantly less shoulder function peak torques compared with the healthy group. They concluded that malfunction in the proximal aspect of the upper limb kinetic chain places increased stress through the distal forearm musculature.…”