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Golf may be your weekend passion, but without proper strength and flexibility training, your body may not enjoy the sport as much as you do. While elbow, wrist and lower back injuries are common problems for all golfers, women golfers have more potential to develop elbow and wrist injuries in part because of their greater relative joint laxity and lower muscle mass in the upper body.

Sports injuries in women are a particular concern for Dr. Alison Toth, who in August will begin directing the Women's Sports Medicine program at Duke University Medical Center. She will present a discussion on golf injuries and other sports-related injuries at 4 p.m., Saturday, June 2, at the U.S. Women's Open at Southern Pines. The presentation, moderated by professional health care consultant Maggie McGlynn, will feature Toth along with information on integrative medicine, comprehensive health and wellness, heart disease and cancer.

"One of the most common golf injuries is lateral epicondylitis, sometimes known as tennis elbow," Toth said. "It comes from the great forces required to grip and swing the golf club when the body is not used to using these muscles."

Toth said it may be possible to avoid elbow and wrist injuries by doing simple hand- and wrist-strengthening exercises prior to and during the golf season. She also encourages golfing athletes to work with golf professionals and trained sports medicine professionals to correct poor grip or swing mechanics, and to learn how to prepare the muscles and joints for golf.

To this end, Toth said the Duke Sports Medicine Center is planning golf injury prevention seminars and clinics for golfers beginning next spring. Golfers of all levels will be invited to participate in a comprehensive program that will include injury evaluation, golf-specific strength and flexibility training, strength testing, instruction on safe, effective grip and swing mechanics, and evaluation of equipment choices.

"Like many sports injuries, most golf injuries are due to overuse, especially the use of muscles that are untrained for the great stresses of that sport. Typically, the golf clubs are put away for the winter, then dusted off in the spring for a round of 18 before the golfer's muscles and joints are ready," Toth said. "We want to help golfers to recognize injuries early and to prevent them."

Toth said early recognition of golf-related injury symptoms could speed rehabilitation and the return to the links.

"For example, 'tennis elbow' starts out slowly with pain on the outside of the elbow only when gripping or lifting overhand," she said. "If treated early, the golfer will likely miss only a few weeks. Without rest and subsequent strengthening of the forearm muscles, the pain progressively gets worse so that even minimal activity hurts and weakness occurs. The same is true with wrist and back injuries. Unless the athlete will rest, then learn to change the mechanics or weaknesses that caused the injuries, they won't get better."

Rest, ice and non-steroidal anti-inflammatory medications or acetaminophen will help elbow pain, but Toth stressed that the condition at the elbow is not inflammation but rather tendon micro-tearing or degeneration. However, she emphasized that rest, ice, and pain medicine will not correct what caused the tendon injury in the first place. "If you go back to repeating your bad habits, the injury will likely come back again," she said.

Toth said returning to sport successfully after elbow epicondylitis requires gradual flexibility and strength training of the forearm muscles. Occasionally, a corticosteroid injection or surgery may be required to treat the condition.

"Initially, it is useful to be evaluated by a sports medicine physician who can make the diagnosis, treat with local or oral medication if necessary and prescribe sport-specific rehabilitation with a physical therapist for a few weeks," Toth said. "The entire recovery process can take four to five months, so patience is important."

Toth's presentation is part of the Women's Health Festival, housed in a 10,000-square-foot pavilion, at the U.S. Open that will showcase the latest in technology and advancement in the field of women's health. Duke University Health System is a sponsor of the festival and will have an interactive booth and seminars that will offer everything from general health screenings to hands-on demonstrations to one-on-one interactions with women's health experts.