Medial Epicondylitis, commonly known as Golfer’s elbow, is a condition that causes pain over the bony bump on the inner side of your elbow, due to the inflammation of the attached tendons.
Medial epicondyle – the bone on the inner side of the elbow
Tendon – soft but tough fibrous connective tissue which attaches the muscle to the bone
Forearm flexor muscles – the muscles which allow you to grip, flex your wrist, rotate your arm
Golfer’s elbow is caused by overusing the flexor muscles of the forearm, causing a pull or a tear to the tendons attached to the medial epicondyle. Here are some risk factors:
Playing golf, tennis, bowling, baseball
improper playing techniques
too much wrist action, unsteady strokes, poor technique of hitting the ball
unsuited models of golf clubs or tennis rackets
Work that involves repetitive or forceful gripping or clenching of the fingers, especially when the hand is bent up or down, or twisted at the wrist
Weak muscles and/or muscle imbalances
Advancing age (more common in people older than 35)
Pain or tenderness on the inner side of the elbow
Pain sometimes extending along the inner side of the forearm
Pain increases with movement or applying pressure to the area, such as in flexing the wrist or shaking hands
Tightness of forearm muscles
Weakness, stiffness or difficulty in moving the elbow or hand
Numbness or tingling sensation, radiating to the fingers, usually to the ring and little fingers
After discussing on your symptoms, physical activities, history of trauma or injury, your doctor will examine you for:
Pain on the inner side of the elbow when doing certain arm motions
Pressing on the medial epicondyle, and evaluating pain
Stiffness of elbow and pain with wrist movement
Tests and Diagnosis
X-rays are not usually necessary; unless the doctor suspects other problems. This may be used to rule out any bone involvement.
Ultrasound or MRI scan may be used to have better assessment of the condition but is rarely used for diagnosis.
Rest – Time off is very much needed to promote healing.
Do not do activities that cause pain.
Temporarily stop playing your sports, especially golf and tennis, until the pain is gone.
You may need to alter how you do even your daily activities such as opening doors, and picking up objects, to minimize tension on your tendons
Cold – Application of ice for around 20 minutes helps to decrease pain and swelling
Medication – The following drugs can help to reduce inflammation and pain:
Non-steroidal anti-inflammatory drugs (NSAIDs)
Braces – wear a counter-force brace on your forearm, if recommended by your healthcare professional, to give compression on the forearm muscles
Stretching – When the pain is minimal, gentle and proper stretching will help prevent stiffness by making the muscles more flexible and by breaking down any scar tissue that may result from the inflammation.
Physical Therapy – as the inflammation in the tendon subsides, your Physical Therapist, as recommended by your Physician, can teach you strengthening exercises for the forearm muscles, to help protect the inflamed tendon and prevent the injury from recurring.
Cortisone Injection – given by your doctor to reduce pain and swelling, if over-the-counter medications and physiotherapy do not provide relief.
Percutaneous Electrolysis Therapy – the choice of most people, especially athletes, suffering from long term Golfer’s elbow. Click here to know more about this treatment.
Surgery – rarely required, but is sometimes recommended in chronic and recurring cases that do not respond to conservative management.
You do not have to be off the course of your game after having golfer’s elbow. With rest, appropriate treatment, and proper training, you’d have a gradual but better come-back to your Sport or usual activities.
For a thorough discussion on golfer’s elbow, contact us at Orthosports Medical Center for an appointment with our Specialists. We’ll be glad to get you swinging back to your game in no time!