Golfer's Elbow (Medial Epicondylitis)

Medial Epicondylitis, also referred to as 'golfer's elbow,' is similar to tennis elbow and is considered a cumulative trauma injury. It is thought that over time, repeated use of the muscles of the arm and forearm may lead to small tears in the tendons. The muscles that are used to pull the hand down (wrist flexors) are located on the palm side of the forearm. These muscles attach to the common flexor tendon, which attaches to the medial epicondyle (on the inside of the elbow). When the wrist flexors are overused, the common flexor tendon becomes inflammation and painful.

Pain on the inside of the elbow, usually during or after intense use, usually indicates medial epicondylitis. Because this occurs often in golfers it has become known as 'golfer's elbow'.

Causes of Medial Epicondylitis
It is thought that overuse of the wrist extensors creates cumulative stress, and small tears in the tendon. This causes inflammation and pain. As the tendon repairs, scar tissue may form. Some physicians believe that a lack of blood flow to the aging tendons makes them weak and prone to injury.

Symptoms
Pain at the medial epicondyle (inside of elbow) is a classic symptom of medial epicondylitits. The pain may increases when flexing the wrist, and may radiate down the forearm. Activities that use the flexor muscles in a bending motion or grasping with the hand can increase the symptoms.

Treatment
Discontinuing activities that cause the pain is the first step to proper treatment of medial epicondylitis. Icing the elbow for 10-15 minutes at a time will decrease the inflammation and swelling and relieve pain. Wrapping the forearm near the elbow may help protect the injured muscles as they are healing. In some cases, a wrist splint may be recommended for the same purpose. Using the R.I.C.E. method (rest, ice, compression and elevation) of acute injury treatment is extremely helpful to reduce pain and swelling. Icing the elbow for 10-15 minutes at a time will decrease the inflammation and swelling and relieve pain. Wrapping the forearm near the elbow may help protect the injured muscles as they are healing.

A physical therapist may use ultrasound or other modalities to help heal the damage of an injury. Additionally, they may precsribe flexibility and strengthening exercises to allow you to return to the activity. In some cases, a wrist splint or brace may be recommended.

Anti-inflammatory medication may help reduce inflammation and pain. In chronic or intense cases, a cortisone injection may relieve the discomfort.

Because recurrence of this condition is common, return to activity should not occur too quickly, and preventive exercises that stretch and strengthen the muscles should be done consistently.

If nonsurgical forms of treatment do not eliminate the pain of this condition, surgery may be recommended. A hand specialist can offer advise regarding potential treatments and the possible outcomes. Lateral epicondylitis is often a nagging or chronic condition sometimes requiring many months for healing to occur.

Also see: Treating Golfer's Elbow

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