Like all of my articles in which I discuss pain and injury, please go see a doc if your specific context calls for it.
None of this is meant to replace medical advice, but hopefully you find some value in the content, thoughts, and discussion!
What is Golfer's Elbow?
Medial epicondylar tendinopathy is the official name.
Golfer's elbow happens when the tendon on the middle side of our elbow damages and degenerates. Most often, this damage is due to excessive and ill-prepared high velocity activities that place high jerk on the tendon.
Golfer's elbow can be debilitating, painful and frustrating.
Luckily, tendons CAN adapt.
They can heal, recover, and strengthen.
We just need to LOAD them properly.
The Building Blocks of Tendon
Tendons connect muscles to bones.
They are a transitional structure in that the muscle end of the tendon will behave more like muscle, while the bone end will behave more like bone.
They're primarily made up of collagen fibers and elastin that orient themselves parallel to the tendon.
This orientation makes tendons very strong in their resistance of pulling forces of tension.
Making up the collagen fibers are amino acids, specifically - Glycine, Proline, and Lysine.
A New Research Article
A good amount of research exists regarding nutritional supplementation to support collagen synthesis - and therefore tendon healing.
It appears IT IS possible to improve amino acid levels within the blood and improve collagen synthesis when we undertake specific nutritional protocols paired with a proper loading stimulus.
Let's break down one of these studies to see what they found...
Keith Barr completed a case study where he took one player through a protocol of isometric exercises that loaded an injured patella tendon (knee tendon) as well as a nutritional supplementation that included 15 grams of gelatin with ~225 mg of Vitamin C.
The isometric exercise was used to place the tendon in a state of stress relaxation.
Essentially, as we load a tendon through an isometric exercise, the tendon will eventually achieve a steady state of relaxation. This relaxation then causes stress shielding to decrease, placing a directional mechanical signal through the injured area of the tendon helping it remodel and restore function.
The isometric exercises used to repair/restore function in the patella tendon in this research article were three-fold:
All exercises were held at a "mid range" and progressively loaded over the 18 month program.
The exercises were completed twice per week.
The length of isometric holding started at 10 seconds, and progressed by 5 seconds, eventually capping at 30 seconds per set.
Every training session the athletes were asked to perform 1-3 sets of 2-4 repetitions.
So, for example, one training may have looked like this:
Leg extension 1x4 with a 15 second isometric hold each rep
Leg press 3x2 with a 15 second isometric hold each rep
Spanish squat 2x3 with a 15 second isometric hold each rep
One hour before patella tendon loading the athlete consumed 15 grams of gelatin with ~225 mg of vitamin C.
Basically, they mixed 15 grams of this gelatin powder into a 16 oz glass of orange juice (~225 mg vitamin C) ~ I personally prefer light pulp, but I'll leave that up to you.
This was done due to past studies on collagen synthesis indicating that a gelatin/vitamin C combo before activity can augment collagen synthesis. This is due to the combo causing an increase in circulating glycine, proline, hydroxyproline, and hydroxylysine (a bunch of amino acids, important for tissue repair and building).
After 18 months, a blinded orthopedic surgeon declared the patella tendon to be normal.
Self reported pain and tenderness within the injured tendon decreased. During the final scan, the athlete considered themselves "pain free."
This was a singular case study, with only one subject. Therefore, we need to be careful extrapolating too much from it.
However, at the same time, it was formulated and organized based on past research studies and results indicating that collagen + vitamin C, when paired with a proper loading stimulus, can enhance collagen repair.
First thing, if you are battling golfer's elbow and deem it necessary, go see a good doc or PT if needed.
I've wrote in the past about exercises you may want to consider pursuing if you're battling golfer's (or tennis) elbow...
Thirdly, you might as well include a nutritional supplementation like the one mentioned above. There's no harm in doing so (unless you are allergic, diabetic, or have some other health exception - in which case please go see your doc first)
Have an ELITE day.
Founder and Head Coach - SCRATCHGolfTraining.com
Carter is a strength and conditioning coach out of the Milwaukee area working with athletes, in-person and virtually. Having helped hundreds of athletes, ranging from the middle school to the professional level and beyond, Carter brings a breadth of experience and knowledge to every athlete he works with. He launched SCRATCHGolfTraining.com in the summer of 2021 to help empower golfers to greater performance and longevity.
Carter believes ALL golfers are athletes, and they should be training accordingly.
Become a SCRATCH Athlete today, and start training like the ATHLETE you are!