By Hershel Sarbin and Jim Brown
Golf After 50 Editors
Ever heard of the hamate bone? Probably not. We didn't know much about it either until a reader asked us to look into a condition called "Golfer's Wrist." The hamate is located on the outside part of the hand at the base of the little finger and ring finger. The bone has an extension -- a hook -- that can be broken by a single blow or by repetitive impact to the heel of the hand, something that happens often while playing golf.
That's why a hamate hook fracture is also called "golfer's wrist," even though it also affects tennis, baseball, and hockey players, as well as cyclists. A baseball hitter who checks his swing risks breaking the hamate with the knob of the bat. But for the rest of us, it is more likely to occur over a period of time when we grip a golf club or strike the club against a rock or other unforgiving surface.
Symptoms
Put golfer's wrist on the suspect list if you have pain or tenderness around the heel of your hand, if you have weakness when you try to grip something, or when there is no feeling in your little finger. It is not that easy to diagnose, even with an x-ray. John F. Feller, M.D., an Assistant Professor of Radiology at Stanford University, reported on a study in which 12 patients suffering from wrist pain showed no x-ray evidence of hamate fractures. But magnetic resonance imaging (MRI) revealed fractures in all 12 persons.
Dr. Feller emphasizes that early detection of a hamate stress fracture is important. Left untreated, the condition will result in chronic pain that will interfere with performance. The longer you wait, the more time it will take to heal, and you can compound the damage by continuing to play golf. If you have pain in that area of the wrist and think the hamate bone might be involved, immobilize it, apply ice, and see a doctor. It will not heal by itself.
Treatment
The treatment for a hamate fracture usually involves removing the fractured hook through relatively simple surgery. The blood supply to the area is very poor, and immobilizing the hand without surgery has been less successful in allowing the bone to heal. Assuming the injury is diagnosed within two weeks, plan on six to twelve weeks of rest and rehabilitation before you can play golf again
Preventing golfer's wrist might require a change in the way you grip your clubs. Golfers who use an overly tight grip make the hamate bone more prone to injury, so loosen your grip. It will take time, but the long-term benefit outweighs the short-term change in technique.
In the next column, we'll look into lower back pain. If you want information about other golf injuries, contact Jim at sportsmed@mindspring.com or Hershel at HershelS@aol.com. We'll do our best to find sports medicine experts to answer your questions.
©2004 Hershel Sarbin Associates
