Medial Epicondylitis (Golfer’s Elbow)

Golfer's elbow

What is it?

Medial epicondylitis (golfer’s elbow) is a condition in which the bony bump at the inside of the elbow is painful and tender. The elbow joint is made up of the humerus bone in the upper arm and the ulna in the lower arm. The bony bumps at the bottom of the humerus are called epicondyles. Overuse of the muscles and tendons of the forearm and elbow are the most common reason people develop medial epicondylitis. Repeating some types of activities over and over again can put too much strain on the elbow tendons. Shoveling, hammering and gardening can all cause golfer’s elbow. In some cases, the symptoms of medial epicondylitis are due to inflammation.

The main symptoms of medial epicondylitis are tenderness and pain at the medial epicondyle of the elbow. Pain usually starts at the medial epicondyle and may spread down the forearm. Bending your wrist, twisting your forearm down or grasping objects can make the pain worse. You may feel less strength when grasping items or squeezing your hand into a fist.

Your doctor will perform a physical examination and may order x-rays in order to properly diagnose medial epicondylitis.

What are the treatment options?

Your doctor will most likely recommend that you go to see a physical or occupational therapist who will give you tips on how to rest your elbow and how to do activities without putting extra strain on the elbow. You may also be recommended to wear a strap that wraps around the upper forearm in a way that relieves the pressure on the tendon attachment. Ice may be used to ease the pain and improve healing.

Therapy sessions may include iontophoresis, which uses a mild electrical current to push anti-inflammatory medicine into the sore area. Exercises will be used to gradually stretch and strengthen the forearm muscles.

Rehabilitation Plan - Exercises

The goal of rehabilitation is to return you to your sport or activity as soon as it is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate so return to your sport or activity will be determined by how soon our elbow recovers and not by how many days or weeks it has been. The following rehabilitation plan will be used.

Phase 1- Managing Pain and Promoting Healing

• Wear elbow strap at all times 
• Manual massage to the surrounding area two times a day. The massage will help enhance circulation, promote healing and dampen the pain. 
• Moist heat to the elbow for 10 minutes two times a day. The moist heat will promote soft tissue healing and increase the flexibility of the muscles surrounding your elbow.

Phase 2- Restoring Flexibility: Active Stretching Exercises

Exercises performed in specific positions are recommended to gradually stretch or elongate the muscle-tendon fibers surrounding the elbow that may have lost some flexibility. This will help reduce the discomfort you are experiencing and restore flexibility to the muscles

• Before beginning apply moist heat to the elbow for 10 minutes to promote soft tissue healing and increase the flexibility of the muscles surrounding the elbow. 
• Perform the following active stretching exercises two times a day for 10 repetitions. 
      o Actively position the wrist in extension to a count of 15 before resting and repeat. Do not progress to the next exercise until the exercise can be completed without pain. 
      o With your elbow bent, bend your wrist away from your body 
      o With your elbow bent and palm down, bend your wrist toward the ceiling 
      o With the elbow straight, forearm neutral, bend your wrist away from your body 
      o With your elbow straight and palm down, bend your wrist toward the ceiling

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