Medial epicondylitis, also known as golfers elbow typically presents itself as pain and tenderness that is sensitive to the touch on the medial side of the elbow which can go down to the inner forearm. Numbness or tingling into the ring and pinky fingers may also be present.
This condition is caused by a breakdown or tendinosis of the muscles and tendons that control the wrist and fingers due to excessive stress on these structures. This type of stress can occur from repetitive activity such as golf, racquet sports, overhead throwing sports, weight lifting. However, 90% of cases are not sport related may be caused by activities such as painting, plumbing, carpentry, data entry and nursing a baby.
You may be more at risk of developing golfer’s elbow if you are over age 40, performing the same types of repetitive activity for at least 2 hours a day, obese, smoking, in addition to other health risk factors.
Typical symptoms include pain and tenderness that is sensitive to the touch on the medial side of the elbow which can go down to the inner forearm. Symptoms can come on suddenly after a forcible use of the hand or wrist but more commonly develop gradually over time. Onset is often related to an increase or change in either sports or work-related activity. Weakness may be present with gripping or use of the hand. The pain can be worse with activities such as shaking hands, turning a door knob, using a racquet/golf club.
The primary method for diagnosis is through a clinical examination which may be performed by a physical therapist. Diagnostic imaging such as x-ray, ultrasound or MRI may be included in the diagnostic process but are typically only used by a physician to rule out other possible causes of medial elbow pain such as fracture or arthritis.
Physical therapy is considered the primary management strategy for medial epicondylitis. Treatment involves a an exercise strengthening program that features strength exercises in addition to stretching exercises that are designed to assist in the gradual repair of damaged tendons and muscles. During the course of this treatment program, the physical therapist will monitor the patient to ensure that there is no worsening of symptoms. In addition to an exercise and stretching routine, the physical therapist will work with the patient to mobilize the joint of the elbow to work to decrease the stiffness and gradually improve the ability to move without experiencing any painful sensation.
Trigger point dry needling may be used to reduce built up tension in the forearm muscles in order to reduce pain and improve exercise tolerance. Anti-inflammatory medication and/or a steroid injection may also reduce inflammation and allow an acceleration of the strengthening process over time. Supportive braces can allow a greater tolerance of return to activity and may be recommended by your therapist.
With proper physical therapy treatment most cases resolve while achieving full and pain free elbow and wrist motion.
A few easy steps can be taken to prevent Golfer’s Elbow. Know when to take break. If you begin to notice elbow soreness and or stiffness with repetitive activity it is best to rest to allow the symptoms to resolve instead of attempting to push through the pain. Strengthen your forearm muscles: using light weight to strengthen your wrist flexors and performing gripping exercises may help to improve your tolerance to elbow stressing activities.
Check your form and equipment. It may be a good idea to work with a therapist or coach to ensure you have correct form and proper fitting equipment for athletic activity. Having correct technique and equipment may reduce stress to your elbow and in turn reduce your risk for injury.