Medial Epicondylitis (Golfer's Elbow)

Table of Contents

Diagnosis and treatment

Rehabilitation Exercises (Golfer's Elbow)

Diagnosis and treatment

References/Source

Written by Pierre Rouzier, M.D., for McKesson Provider Technologies. Published by McKesson Provider Technologies. Last modified: 2006-04-10 Last reviewed: 2004-02-03 This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Sports Medicine Advisor 2006.2 Index Sports Medicine Advisor 2006.2 Credits Copyright © 2006 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.

What is medial epicondylitis (golfer's elbow)? Medial epicondylitis (golfer's elbow) is a painful inflammation of the bony bump on the inner side of the elbow. The elbow joint is made up of the bone in the upper arm (humerus) and one of the bones in the lower arm (ulna). The bony bumps at the bottom of the humerus are called the epicondyles. The bump on the side closest to the body is called the medial epicondyle, and the bump on the outer side of the elbow is called the lateral epicondyle. The tendons of the muscles that work to bend your wrist attach at the medial epicondyle. Medial epicondylitis is also referred to as wrist flexor tendonitis. How does it occur? Golfer's elbow occurs from overuse of the muscles that enable you to bend your fingers and wrist. When these muscles are overused, the tendons are repeatedly tugged at their point of attachment (the medial epicondyle). As a result, the tendons become inflamed (tendonitis), and repeated, tiny tears in the tendon tissue cause pain. This commonly happens in sports such as golf, in throwing sports, and in racquet sports. It also may happen in work activities like carpentry or typing. What are the symptoms? Golfer's elbow causes pain in the elbow at the side closest to the body. You may also have pain along the entire inner side of the forearm when the wrist is bent. You may have pain when you make a fist. How is it diagnosed? Your health care provider will examine your elbow and find tenderness at the medial epicondyle. How is it treated? You should apply ice packs to your elbow for 20 to 30 minutes every 3 to 4 hours for 2 or 3 days or until the pain goes away. If your elbow is swollen, you should elevate it by placing a pillow underneath it when you are lying down and by elevating it on the back of a chair or couch while sitting. You may be given an elastic bandage to wrap around your elbow to keep it from swelling. While you are recovering from your injury, you will need to change your sport or activity to one that does not make your condition worse. For example, instead of playing golf you should walk, or write things out by hand instead of typing. Your health care provider may prescribe a tennis elbow strap for you to wear just below the tender spot on your elbow. This will allow the forearm muscles to pull against the strap instead of against the painful epicondyle. Your provider may prescribe an anti-inflammatory medicine. He or she may give you an shot of a corticosteroid medicine around the medial epicondyle to reduce the inflammation. You will be given elbow exercises. In severe cases of medial epicondylitis you may need surgery. How long will the effects last? The length of recovery depends on many factors such as your age, health, and if you have had a previous injury. Recovery time also depends on the severity of the injury. A mild injury may recover within a few weeks, whereas a severe injury may take 6 weeks or longer to recover. This problem can sometimes be long-lasting and can even come back once you are better. You need to stop doing the activities that cause pain until the elbow has healed. If you continue doing activities that cause pain, your symptoms will return and it will take longer to recover. When can I return to my normal activities? Everyone recovers from an injury at a different rate. Return to your activities will be determined by how soon your elbow recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal of rehabilitation is to return you to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury. You may return when you are able to forcefully grip a bat or golf club, or do activities such as working at a keyboard without pain in your elbow. It is important that there is no swelling around your injured elbow and that it has regained its normal strength compared to the uninjured elbow. You must have full range of motion of your elbow. How can it be prevented? Since medial epicondylitis occurs because of overuse to the muscles that bend your wrist, it is important that you do not allow this overactivity to occur. At the earliest signs of pain on the inner side of your elbow, you should slow your activity down and seek treatment. Wearing a tennis elbow strap and doing elbow stretching exercises will help prevent medial epicondylitis.

Rehabilitation Exercises (Golfer's Elbow)

References/Source

Written by Tammy White, M.S., P.T., for McKesson Provider Technologies. Published by McKesson Provider Technologies. Last modified: 2006-05-01 Last reviewed: 2004-02-03 This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Sports Medicine Advisor 2006.2 Index Sports Medicine Advisor 2006.2 Credits Copyright © 2006 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.

You may do the stretching exercises right away. You may do the strengthening exercises when stretching is nearly painless. Stretching exercises Wrist range of motion: Bend your wrist forward and backward as far as you can. Do 3 sets of 10. Wrist stretch: With your uninjured hand, help to bend the injured wrist down by pressing the back of your hand and holding it down for 15 to 30 seconds. Next, stretch the hand back by pressing the fingers in a backward direction and holding it for 15 to 30 seconds. Keep your elbow straight during this exercise. Do 3 sets. Pronation and supination of the forearm: With your elbow bent 90°, turn your palm upward and hold for 5 seconds. Slowly turn your palm downward and hold for 5 seconds. Make sure you keep your elbow at your side and bent 90° throughout this exercise. Do 3 sets of 10. Strengthening exercises Wrist flexion exercise: Hold a can or hammer handle in your hand with your palm facing up. Bend your wrist upward. Slowly lower the weight and return to the starting position. Do 3 sets of 10. Gradually increase the weight of the can or weight you are holding. Wrist extension exercise: Hold a soup can or hammer handle in your hand with your palm facing down. Slowly bend your wrist upward. Slowly lower the weight down into the starting position. Do 3 sets of 10. Gradually increase the weight of the object you are holding. Grip strengthening: Squeeze a rubber ball and hold for 5 seconds. Do 3 sets of 10. Forearm pronation and supination strengthening: Hold a soup can or hammer handle in your hand and bend your elbow 90°. Slowly rotate your hand with your palm upward and then palm down. Do 3 sets of 10. Elbow flexion and extension: Hold a can of soup with your palm face up. Slowly bend your elbow so that your hand is approaching your shoulder. Then lower it slowly so your elbow is completely straight. Do 3 sets of 10. Slowly increase the weight you are using.