Medial Epicondylitis (Golfer's Elbow)
Elbow Anatomy
The elbow is a joint made up of three bones: the upper arm bone, the humerus, and the two forearm bones, the radius and ulna. The lower end of the humerus has bony bumps called epicondyles that serve as sites of attachment for major tendons and muscles that help in arm movement. The bump on the inside of the elbow is called the medial epicondyle. It helps in the attachment of the tendons and muscles that help extend your fingers and wrist.
What is Golfer’s Elbow?
Golfer’s elbow, also called medial epicondylitis, is a painful condition occurring from repeated muscle contractions in the forearm that leads to inflammation and microtears in the tendons that attach to the medial epicondyle.
Golfer’s elbow and tennis elbow are similar, except that golfer’s elbow occurs on the inside of the elbow and tennis elbow occurs on the outside of the elbow. Both conditions are a type of tendonitis - inflammation of the tendons.
Causes of Golfer’s Elbow
Golfer’s elbow is usually caused by the overuse of the forearm muscles and tendons that control wrist and finger movement, but may also be caused by direct trauma such as a fall, car accident or work injury.
Golfer’s elbow is commonly seen in golfers; hence the name. It occurs especially when poor technique or unsuitable equipment is used when hitting the ball. Other common causes include any activity that requires repetitive motion of the forearm such as painting, hammering, typing, raking, pitching sports, gardening, shoveling, fencing and playing golf.
Signs and Symptoms of Golfer’s Elbow
The signs and symptoms of golfer’s elbow can include the following:
- Elbow pain that appears suddenly or gradually
- Achy pain to the inner side of the elbow during activity
- Elbow stiffness with decreased range of motion
- Pain that radiates to the inner forearm, hand or wrist
- Weakened grip
- Increased pain while gripping objects
- Increased pain in the elbow when the wrist is flexed or bent forward toward the forearm
Diagnosis of Golfer’s Elbow
Your doctor will review your medical history and perform a thorough physical examination of your elbow joint. Your physician may order an X-ray to rule out a fracture or arthritis as the cause of your pain. Occasionally, if the diagnosis is unclear, further tests such as MRI, ultrasonography and injection test may be ordered to confirm golfer’s elbow.
Treatment Options for Golfer’s Elbow
Conservative Treatment Options for Golfer’s Elbow
Your physician will recommend conservative treatment options to treat the symptoms associated with golfer’s elbow. These may include the following:
- Activity restrictions: Limit the use and rest your arm from activities that worsen symptoms.
- Orthotics: Splints or braces may be ordered to decrease stress on the injured tissues.
- Ice: Ice packs applied to the injury will help reduce swelling and pain. Ice should be applied over a towel to the affected area for 20 minutes, four times a day for a couple of days. Never place ice directly over the skin.
- Medications: Anti-inflammatory medications and/or steroid injections may be ordered to treat the pain and swelling.
- Occupational therapy: OT may be ordered for strengthening and stretching exercises once your symptoms have reduced.
- Pulsed ultrasound: This is a treatment used by therapists to break up scar tissue and increase blood flow to the injured tendons and promote healing.
- Professional instruction: Consulting a sports professional to assess and instruct in proper swing technique and appropriate equipment may be recommended to prevent recurrence.
Surgery for Golfer’s Elbow
If conservative treatment options fail to resolve the condition and symptoms persist for 6 - 12 months, your surgeon may recommend surgery to treat golfer’s elbow. The goal of surgery is to remove the diseased tissue around the inner elbow, improve blood supply to the area to promote healing and alleviate the symptoms.
