Ultrasound Imaging To Assess Medial Elbow Joint Space In Female Collegiate Division I Golfers

Abstract

Medial elbow complex injuries have been reported in competitive and recreational golfers. Ultrasound imaging (USI) is a common method for assessing medial joint stability in baseball and other overhead athletes, however there is a paucity of literature in golfers. During the golf swing, there are increased valgus forces on the trailing arm elbow versus the leading elbow, potentially leading to increased medial joint laxity of the trailing arm. PURPOSE: The purpose of this pilot study was to examine differences in medial elbow joint space (MJS) measured by USI between the trailing and lead arm of asymptomatic female collegiate golfers. METHODS: Seven asymptomatic NCAA Division I collegiate female golfers (age 19.4 ± 1.4 yrs) participated. Ultrasound images of the medial joint space of both arms were obtained using a GE LOGIQ E ultrasound unit. Participants were placed supine with elbow position at 30 degrees, with a wedge placed underneath the humerus creating a gravity induced valgus force on the MJS. Measurements of the MJS were performed, and differences between the trailing and leading arm were analyzed with a paired t-test. RESULTS: Mean elbow MJS opening on the trailing arm was .32cm (SD.079cm), and .28cm (SD .096cm) on the leading arm. There was a statistically significant difference (t= 3.495, p= .01) between MJS opening measurements of the trailing and leading arms. CONCLUSIONS: The results of this investigation indicate that there is increased elbow MJS opening of the trailing arm compared to the leading arm. While this study does not allow for cause and effect conclusions, this is consistent with the increased load placed on the trailing arm MJS during the golf swing. Further research is needed using larger sample sizes, more heterogeneous study populations, and examination of injury rates and MJS measurements.