Medial Epicondylitis (Golfer's Elbow)

What is Medial Epicondylitis?

Despite its common name, this condition does not just affect golfers. You may be susceptible to developing “golfer’s elbow” if you play sports that require gripping, swinging and throwing motions such as golf, tennis, bowling and baseball. Golfer’s elbow is a form of elbow tendinopathy commonly caused by repeated overuse of the muscles in the forearm that allow you to flex your wrist, rotate your arm and grip objects. These repetitive hand and wrist motions can cause pulls or tiny tears in the tendons that connect the forearm muscles to the elbow bone. This inflames the tendons and causes pain in the forearm muscles as well as the bony bump on the inside of the elbow, the medial epicondyle.

Symptoms

For most people, the symptoms of medial epicondylitis gradually increase over time, especially if the condition is left untreated. Common symptoms include:

• Pain and tenderness around the bony protrusion on the inside of the elbow, as this is the site where the injured tendons connect to the bone.

• Radiating pain or tingling/numbness from the elbow into the forearm and upper arm

• Pain when squeezing or gripping objects with your hands or moving your wrist with force 

• Swelling at the elbow

Treatment

The most important aspects of recovery for medial epicondylitis are managing the irritation and inflammation of the tendon, reducing the stress being inflicted on the injured elbow, as well as stretching and strengthening the muscles and tendons around the injured elbow. Icing the injured elbow for 20-30 minutes every three to four hours can help to reduce pain. You can also take a non-steroidal anti-inflammatory (NSAIDs) medication to help with the pain and swelling. Commonly, a therapist may use different strengthening and stretching exercises, manual therapy techniques, perform a grip/carry mechanics analysis, and possibly recommend the use of an elbow strap to decrease stresses placed on the injured area.

Physical Therapy Exercises 

The following are examples of exercises you may be prescribed in a physical therapy clinic. Please remember these do not apply to everyone and depend on your specific condition.

• Wrist Flexor Stretch: Extend your injured arm straight out in front of you, palm down and parallel to the floor. Using your non-injured arm hand, gently bend your injured wrist so the fingers point upward. 

• Eccentric Pronation: Hold the end of a 1# dumbbell, with palm facing midline. In a slow/controlled manner, let your forearm rotate so palm is facing up. Use your unaffected hand to rotate your forearm back to starting position. 

• Isometric Wrist Flexion: Place your injured arm on a table such that your wrist is resting on the edge. The table should support your forearm and your hand should hang over the edge with your palm facing downward to the floor. Attempt to bend the wrist downward as if trying to point your fingers to the floor, but use your other hand to resist this motion. Hold contraction for 5 seconds before returning to the starting position. 

Prevention

The key to preventing a repetitive strain injury like tennis elbow is to avoid overuse. 

• Gradually build up endurance

• Vary your type of physical activity

• Use appropriately fitted equipment and resistance for your current level of fitness

Think you might be dealing with Medial Epicondylitis? Interested in preventive care?  Contact MTS for an hour long 1-on-1 evaluation with a PT to get started!