Golfer’s Elbow (Medial Epicondylitis)
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Description
Our Physical Therapy Center
provides complete care.
Medical epicondylitis is characterized by inflammation and pain on the inner side of the elbow where muscles and tendons attach to the bone. The structures involved are the muscles and tendons of the forearm that bring your wrist down (flex the wrist). This occurs not only in golfers but in anyone who performs repeated resisted motions of the wrist. Without proper intervention, this may develop into a chronic problem.
Common Signs and Symptoms
- Pain and tenderness on the inner side of the elbow
- Pain or weakness with gripping activities
- Pain with twisting motions of the wrist, such as using a screwdriver, playing golf, or bowling
Causes
- Chronic, repetitive stress and strain to the muscles and tendons of the wrist and forearm to the elbow
- Sudden strain on the forearm, including wrist snap when serving balls with racket sports or throwing a baseball
Risk Increases With
- Sports or occupations that require repetitive and strenuous forearm and wrist movements (such as pitching a baseball, golfing, or carpentry)
- Poor physical conditioning (strength and flexibility)
- Inadequate warm-up before practice or play
- Resumption of activity before healing and rehabilitation and conditioning are complete
Preventive Measures
- Appropriately warm up and stretch before practice or competition.
- Maintain appropriate conditioning:
- Wrist and forearm flexibility
- Muscle strength and endurance
- Cardiovascular fitness
- Ensure proper equipment fit.
- Use proper technique and have a coach correct improper technique.
- Wear an elbow (counterforce) brace.
Expected Outcome
- Acute cases, in which symptoms are present less than 4 weeks, are usually resolvable in 2 to 6 weeks.
- Chronic (repetitive) cases, in which symptoms have been present for more than 8 weeks, may require 3 to 6 months to resolve and often require referral to a physical therapist or athletic trainer.
Possible Complications
- Frequent recurrence of symptoms, resulting in a chronic problem; appropriately addressing the problem the first time decreases frequency of recurrence
- Chronic inflammation, scarring, and partial tendon tear requiring surgery
- Delayed healing or resolution of symptoms
General Treatment Considerations
Initial treatment consists of medications and ice to relieve pain, stretching and strengthening exercises, and modification of the activity that initially caused the problem. These can all be carried out at home for acute cases. Chronic cases often require referral to a physical therapist or athletic trainer for further evaluation and treatment. A counterforce (“tennis elbow”) brace may be recommended to reduce the forces to the damaged tendon. If symptoms persist, an injection of cortisone and anesthetics or surgical intervention may be required. Surgery is occasionally necessary to excise the damaged tissue. This is done on an outpatient basis (you go home the same day), with resumption of sports at 3 to 6 months.
Medication
- Nonsteroidal anti-inflammatory medications, such as aspirin and ibuprofen (do not take within 7 days before surgery), or other minor pain relievers, such as acetaminophen, are often recommended. Take these as directed by your physician. Contact your physician immediately if any bleeding, stomach upset, or signs of an allergic reaction occur.
- Cortisone injections reduce inflammation. However, this is done only in extreme cases; there is a limit to the number of times cortisone may be given due to the fact it weakens
Printed Information (PDF)
This information is provided by Orthopedic Spine and Sport Medicine Center as basic information about a specific orthopedic topic. It is not intended as a personal reply to your specific questions or concerns. It is hoped that the contents of this instruction will help you understand the nature of your orthopedic problem and the possibilities of treatment. The final decision regarding treatment, however, must take into account the possibilities of outcomes and complications and should be made only after consideration and further discussion with your physician. For more information, please contact Orthopedic Spine and Sports Medicine Center at 201-587-1111.