Healthy hands
You need them to play this game well
olfers are prone to hand disorders
for a couple of simple reasons. It’s
the hands, of course, which connect play-
ers to their equipment, and a painless,
firm grip is required to confidently swing a
golf club. Conditions such as carpal tunnel
syndrome and thumb joint arthritis can
keep players from enjoying the game.
Carpal tunnel syndrome (CTS) is a condition caused by the compression of the
median nerve as it passes through a tunnel at the base of the palm. It affects adult
males and females of all occupations. Its
symptoms include some or all of the following: numbness and tingling in the
thumb, index and long fingers; pain in the
hand or forearm; weakened grip strength,
awakening at nighttime with numb hands;
and numbness while driving. The symptoms can be intermittent or constant and
can vary in severity and intensity. The diagnosis is confirmed with an EMG-nerve
conduction study.
Initial treatment focuses on modification
of activities that can exacerbate the condition. Ergonomic modifications to computer work stations, limiting use of
vibratory tools and reducing repetitive
G
hand activities can help to reduce symptoms. NSAIDS and other anti-inflamma-tory medicines are rarely effective in
relieving CTS symptoms, but corticosteroid injections directly into the carpal
tunnel can provide short-term, temporary
relief. Bracing can frequently help reduce
symptoms at night and allow for better
sleep.
Non-operative treatment of carpal tunnel syndrome frequently is unsuccessful in
permanently relieving the condition. The
underlying problem is a mechanical compression of the median nerve analogous
to a packaging problem with too much
material stuffed into too small a space.
Operative treatment involves releasing the
tight band overlying the nerve through an
incision in the base of the palm. Most
people can return to activities like golf in
four to six weeks. Success rates for carpal
tunnel release are very high, and complications are rare.
Arthritis can occur in any of the three
joints of the thumb. The joint at the base
of the thumb, where the thumb attaches
near the wrist, is the most commonly affected. Symptoms of basal thumb joint
arthritis include pain with grasping, weak
grip strength and decreased thumb mobility. Often a “grinding” sensation is noted
with power grasping. The diagnosis is
confirmed on examination and with the
use of a plain X-ray.
Initial treatment is use of a splint that extends from the tip of the thumb onto the
mid-forearm, restricting the motion of the
thumb. While bracing is effective in relieving the pain from the arthritis, it is not well
tolerated because it severely limits the use
of the hand. Activity modification by limiting power grasping can reduce the pain.
Golfers can place over-sized grips on
their clubs to reduce the force required to
hold the club. A corticosteroid injection
into the joint is usually effective in reliev-
ing the pain for periods of up to six to
nine months.
