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Golf Fingers 高爾夫手指

(2009-07-15 17:34:48) 下一個

by MichaelC


I seriously took up golf game about five months ago in May 2006. I learned a little on how to play 14 years ago but never played on a golf course until 2003. Since 2003, I played scramble games about once or twice per year for various fund-raising tournaments. One can imagine I was very bad. At age 44, I finally took the plunge and got hooked.

I "discovered" a golf course in our backyard. The club house and the driving range are within walking distance. I started practicing there twice a day - once in the morning and once in the evening. I easily hit 80 to 100 balls in one hour. My game started to improve quickly. I broke 120, 110, and 100 in a matter of months. I also lost some weight from the daily exercise.

Then something strange happened to my fingers - stiff fingers in the morning. After some research, I believe it is a common problem that is often misdiagnosed. I call it "golf fingers." I am writing my story about my learning process about this illness to share with other golf lovers and those who may suffer from this problem for other reasons.

Symptoms

When I wake up in the morning or the middle of the night, all of my fingers feel stiff. They feel fine in straight positions, but when I try to bend them into a fist shape, I feel pressure on all the joints and knuckles. The fingers feel like "rusted." After moving, rubbing, and stretching them for a few times, the feeling would go away. I don't have such problems during the day.

The onset timing of the symptoms clearly corresponds to the start of my serious golf practice.

It's not that painful but it just feels strange and problematic. I am concerned that the problem may get worse over time if not properly diagnosed and treated. I started the process of searching for an answer.

Diagnosis

First I went to see my family doctor about two months ago. The first thing he mentioned was carpal tunnel syndrome (CTS). He suggested me to buy a splint to wear to sleep. He also suggested taking supplements for joints. He gave me some sample Celebrex, a muscle anti-inflammation drug. He did not seem to think the problem was caused by golf.

He suggested me to start using a dietary supplement called glucosamine and chondroitin that has long-term benefits to joints.

His nurse, while checking on my blood pressure and temperature, suggested that I may have been holding the golf clubs too tight. Perhaps she knew something about golf.

I looked up carpal tunnel syndrome on the web. I have heard about this problem before but never knew what it was about. I found some discrepancies between a typical carpal tunnel syndrome and the syptoms on my fingers. First, I don't have the tinkling feelings on the tips of my fingers. I just feel pressure on the finger joints. Second, I feel the pressure on all of my fingers including my thumb. Most carpal tunnel syndrome happens to the index and middle fingers.

I bought a set of splints from Walgreen's. They seem to help a little in the beginning; but not significantly enough (Note: later it turns out that the splints were very helpful). The pain medicine and glucosamine did not seem to help much either.

Incidentally I played a round of golf with a chiropractic doctor. I told him of my finger problems in the morning. He suggested it could be a nerve problem caused by my neck spine because of the effects on the pinky and small fingers. Again since I feel only pressure instead of nerve tinkling, I discounted that association. I didn't go to see him at his office as he suggested for further examination.

Armed with the new information, I went to see my family-practice doctor the second time. After I explained to him that I feel pressure more than tinkling or numbness, he agreed that the problem is not carpal tunnel syndrome. He took a blood sample to test for rheumatoid arthritis (RA). Two days later, the result came negative (rheumatoid factor <20 IU/ML; the normal range is <30). He recommended me to see a specialist.

I made an appointment to see the rheumatologist. His diagnosis was early signs of osteoarthritis. It's a degenerative desease, which means I am getting old. He said there is no cure for it. He suggested me to use Tylenol Arthritis for the pain. Since the problem is minor and spread to all of my finger joints, cortisone injection would be difficult to apply. The blood test for rheumatoid arthritis (RA) is a positive identifier but not a negative one. He thinks these symptoms may not have anything to do with my golfing and I should be able to continue to play golf.

I asked him why the problem occurs only in the morning and after sleep. He said that the chemistry in the joints change when one is in sleep and the fingers are inactive. If you sleep during the day, you would have the same problem. Once you move around and have the joints fully "lubricated", the problem would temporarily go away.

I came across a traditional Chinese medicine specialist. She said pretty much the same thing. According to her, this problem is quite well known and there is no cure for it.

Online Information

I did some intensive Internet search and reading on this topic. Many people have the same problem ¨C stiff fingers in the morning. It's much more common than I thought. It seems most of them do not know the cause and there is no good cure. Doctors seem to give vague answers like my doctors did. Arthritis Association website promotes golf for arthritis patients.

Here are two links to forums where ¡°stiff fingers¡± were discussed. One even mentioned about symptoms after playing golf. However, there seems to be no literature online making the definite connection between golf and stiff fingers.

http://ehealthforum.com/health/topic31598.html

http://www.power-surge.com/php/forums/index.php?showtopic=6510

Trigger fingers, morning stiffness, and Fibromyalgia are well documented online and in the medicine community. However, these problems do not exactly match what I have and there seems no easy way to identify the direct root cause or effective cure. Playing golf was not listed as one of the root causes.

http://www.fibromyalgia-symptoms.org/fibromyalgia_morning_stiffness.html

On websites that detail various golf-related injuries, "golf elbows" and "tendon injuries" are quite common but no one mentions golf fingers. I asked my coaches and other people who play golf often; they do not seem to have heard such problems.

http://www.sportsinjurybulletin.com/archive/golf-injury.html

Here is an online description of tendon injuries: De Quervain's Disease is a tenosynovitis of the abductor pollicis longus and extensor pollicis brevis (deep muscles of the forearm). This overuse injury is caused by a tight grip of the club and repeated ulnar deviation during the golf swing. Clinical findings include swelling and tenderness at the radial styloid and a positive Finkelstein test (ulnar deviation of the wrist with the thumb fully adducted causes marked pain). Splints, taping and NSAIDs will relieve mild symptoms. Severe cases usually need corticosteroid injection. Where inflammation has resulted in thickening and stenosis of the fibro-osseous tunnel, surgery is indicated.

I asked a pharmacist at Walgreen's and searched products there. At first she asked me if I eat too salty food, which may cause the accumulation of water in the joints. But I don't have serious swelling on my fingers, but just feel tight pressure. Then I told her that I play golf every day. She then said, "Modulation! Everything you do needs to have modulation. Do not overdo it."

Then I found a friend of mine who is about my age and has exactly the same problem. He started the game three years ago and has had the stiff finger symptoms ever since. I started to see the connection between my golf habit and stiff fingers.

Golf Fingers

I tried almost everything to cure the problem. I slept with splint, socks, and gloves to keep my fingers in straight or fist shapes. It seems to help a little but the problem did not go away. I also tried massage, cold treatment, and hot treatment. I tried to grib the clubs not as tight. None of them seem worked. I took Advil, Tylenol, vitamins, and other medicine. The problem persists. I even noticed that the problem stayed with me when I took a 10-day vacation in August.

In early October, I pulled my back muscle while playing golf. As a result, I had to rest to recover. I didn't use the golf range or play a game for weeks. Finally I felt significant improvement in my fingers. The symptoms almost went away. But they resumed when I started playing again. This is the first direct prove that my finger problems were indeed caused by golfing. This was a good timing to study the cause-and-effects by testing various elements that may triggle the symptoms.

There are three movements of my fingers during a normal golf swing that may have be the root cause. One is the gripping - simply squeezing the fingers against the grip may pressure the muscle, fluids, and joints. Second one is the actual swinging, which gives the fluids a centrifuge force. The third one is the impact from hitting the ball.

I tested the impact of each of these movements to my stiff finger symptoms. I did each movement at different nights before going to bed and determined its impact on my fingers in the morning.

I found that simply swinging with my hands open does not worsen the stiff fingers. Simply squeezing my hands against the grip without hitting the ball only made the stiff fingers slightly worse. The difference became much more noticeable if my fingers are feeling pressure and stiff the day after a game. A combination of squeezing and hitting the ball clearly made the stiff fingers worse.

I now believe that my stiff fingers were caused by excessive hitting the golf balls in the driving range. The problem may have nothing to do with carpal tunnel syndrome although I learned more about it. Most likely it has nothing to do with arthritis either.

When playing a round of golf, we may hit 70-100 times in 4-5 hour period. On a driving range, we can easily hit 100 times in a matter of 30-60 minutes. Such intensive hitting cause an impact on the fingers.

The Cure

I made a few adjustments to my golf techniques:

(1) I re-gripped all of my clubs to make the grips soft and easy on the fingers. The soft grips can absorb much pressure from the clubs.

(2) I wore gloves on both of my hands as an extra protection. To fellow golfers, I may look funny with gloves on both of my hands; but they protect my fingers. Some of the golf training books do suggest using gloves on both hands for some people who are sensitive to the grip motion. Recently I saw a doctor playing with two gloves for the same reason.

(3) I switched to ten-finger grip from locked-finger grip. The locked-finger grip made my little finger and pinky finger very painful. Changing to ten-finger grip immediately solved this problem.

My finger problem started to get much better once I started changing my practice habit:

(4) I no longer go to range to practice long-distance hitting with irons or woods in late afternoon or at home during the evenings. I now do it only in the morning since that would leave more time for my fingers to recover before sleep. In the late afternoons I practice only putting and short shots, which is great for my game.

(5) When practicing long-distance and full swings, I now would take breaks to check my alignment and posture between hits to give some time between swings. I don't hit as many balls as before during each practice but I increased my accuracy and get into a good habit of maintaining a pre-swing routine. I now do the long-distance, hard hitting only once or twice per week.

I also played the game less. I now play only once or twice per week instead of 3-4 times.

I still take glucosamine/chondroitin/MSM supplement, but I don't think that has anything to do with the immediate improvement. It may help the long-term health of my joints. I bought two bottles from Walgreen's since they had a buy-one-get-one-for-free sale. I put one bottle at home and the other in the office.

I do think sleeping with a splint does help the situation. It helps keeping the fingers in a slightly curved/fist position during sleep. I suggested the kind made by
Mueller. These are interchangeable between left and right hands, making it much easier to put them on in dark.

The Conclusion

I believe my stiff-finger-in-the-morning syndrome was a result of excessive hitting of golf balls in the driving range. It's a problem caused by the physical impact of golfing to the joints. The problem can be eliminated or minimized by modulating the golf practices.

I believe other activities such as operating vibrating machine drills that have high physical impact on the fingers may cause problems similar to "golf finger,' although more research should be done.

My golf fingers did not go away completely. It comes back the next-day morning after each game but subdues after resting for a day or so. It would be very interesting and helpful to study exactly which part of the fingers that are impacted by golfing that caused the problem. Consequently, a more direct preventative measurement can be designed to prevent or minimize the problem.

I still have some questions lingering. Is it really the joints that caused the problem? How about the impact of golfing on finger muscles and blood circulation? Should I change my steel shafts for my iron clubs to graphite to make them a little more shock-absorbing and easier on my fingers?

I hope to continue the study and share the results with you here soon.

Now let's enjoy golf more by practicing less.
--------------------------------------------

Originally published in October 2006 on the following site:

http://www.directron.com/golffingers.html


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You caught the bug! 又一個被拉下水的。

Suggestions will help (I said "will" due to the facts that unless some thing is wrong, you should enjoy 100%. And won't be labeled later in your life - you don't know what you've missd.):

1. Concentrate on your swing. Learn from instructor not copy instructor. Try "natural" wing. Have you heard people talking "nice and easy", while you were trying to struck the ball? Or "don't kill the ball"? They are about the same meaning. Find out waht's natural to you. Feel the smoothness on every shot until you found your own "zone".

2. Hit the sweet spot with intense focus every time, practise or for real. You heard a lot saying "keep your eyes on the ball". It means the same. When you've done that you felt every thing is right; the sound, the trajectry, the distance and of course the hands and fingers. I won't try "fade" or "draw" shot unless you become scratch player. When it that going to take place?

I am sorry, all these are easy said than done. That's just the nature of the business.
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