Medial Epicondylitis (Golfers Elbow)

FAQS on Medial Epicondylitis or Golfer’s Elbow

 

Medial epicondylitis or golfer’s elbow found its first medical recognition as a disorder of the elbow in 1882 when Henry J Morris published his article Rider’s Sprain in the July edition of the Lancet journal. A common reason for pain in the medial elbow, it mostly affects people between 30 and 60 years. Less widespread than the tennis elbow, the condition has a gender predilection with men twice more often diagnosed with it than women.

What is golfer’s elbow or medial epicondylitis?

Medial epicondylitis or golfer’s elbow is characterized with pain on the inner elbow. Traced to inflammation or injury to the inner elbow muscles and tendons, the pain gradually radiates to forearm and wrist.

It is called golfer’s elbow because the elbow is stressed when one makes a golf swing. Golfer’s elbow is not limited to golfers. Any one engaged in sports and activities requiring repeated wrist motions and finger clenching. Medial epicondylitis accounts for about a fifth of incidents when compared to tennis elbow.

What are the symptoms of golfer’s elbow or medial epicondylitis?

  • Dull ache, pain in the inner side of the elbow
  • Tenderness in the inner part of the elbow
  • Pain radiating to the forearm
  • Worsening pain as you bend the wrist or grasp things
  • Weakness in grasping or squeezing things
  • Elbow stiffness
  • Numbness or tingling in fingers
  • Pain worsens as you squeeze your fingers, flex the wrist, grip something, lift weights, pick up something, or swing a golf club

How does Golfer’s elbow or medial epicondylitis occur?

Medial epicondyle is a bony bump on the inner part of the elbow connected by a tendon with forearm muscles responsible for wrist flexing. Known as the common flexor tendon, it moves back and forth as wrist flexors help the palm, wrist, and fingers flex.

When you grip something or twist the forearm, muscles contract. This pulls the common flexor tendon, which in turn moves the bone connected with the elbow joint. No doubt the tendon has a superior tensile strength to withstand greater forces. But due to overuse or too much repeated strain, collagens in the tendon were damaged or frayed. This causes formation of scar tissues and pain leading to diagnosis of golfer’s elbow or medial epicondylitis.

What causes Golfer’s elbow or medial epicondylitis?

  • Injury to or tears in the flexor tendon
  • Excessive, repeated strain on forearm muscles, wrist flexors
  • Wear and tear in the flexor tendon
  • Overuse of elbow muscles and tendons
  • Tendonitis around medial epicondyle
  • Scar tissue formation in elbow muscles and tendons
  • Forceful wrist and finger movements

What are the risk factors?

Medial epicondylitis is more likely to occur in those

  • engaged in occupational activities, such as gardening, hammering , digging, hitting, and lifting
  • participating in sports, such as golf, racket sports, throwing sports, and weight lifting
  • above 40 years

When to see a doctor?

Visit your doctor when you have pain in the inner part of the elbow restricting you ability to bend the elbow. It may or may not accompany with fever, but a sense of elbow deformity is there.

How is golfer’s elbow or medial epicondylitis diagnosed?

Doctors examine symptoms and compare them to that of golfer’s elbow. Information on the occupational and sports participation history is also vital to identify the painful elbow disorder. Imaging tests, including x-ray, MRI, and ultrasound, are only suggested to check any possibility off joint injury, bone damage, or nerve injury.

What are the treatment methods available for golfer’s elbow or medial epicondylitis?

  • Nonsurgical Treatment

The non-surgical methods focus on preventing further injury to tendons and muscles while assisting in the healing process.

  • Self-care: Allow you elbow to have adequate rest from high-impact exercises that may aggravate the injury and pain. No further stress or injury prevents more damage and allows healing to take place.
  • Medication: Take anti-inflammatory medicines prescribed by your doctor to reduce pain and inflammation. Reduced inflammation ensures the healing.
  • Physical therapy: Ice massage, moderate stretching and strengthening workouts, muscle-stimulating techniques, heat therapy, pulsed ultrasound therapy, soft tissue massage, etc.
  • Orthotics and Brace: Use of splints, braces, or elbow strap relieves any stress or pressure on the injured elbow. This helps the healing process to progress without any fear of further injury.
  • Shock wave therapy: Muscular microtrauma created using sound waves encourages the self-healing process.
  • Cortisone injection: Offering semi-permanent relief for months, the steroid inhibits pain and inflammation.

 

  • Surgical Treatment

Surgery for medial epicondylitis or golfer’s elbow focuses on the following types of treatment.

  • Release of pinched tendon nerves
  • Tendon repair
  • Reattaching the tendon
  • Removal of the scar tissues
  • Removal of bone spurs

 

  • Prolotherapy:

Platelet rich plasma or stem cell injections offer a successful way to treat medial epicondylitis or golfer’s elbow traced to tendon or muscle wear and tear. Promoting regenerative process of the body, it replaces damaged of dead tissues with new tissues in the tendons. Prolotherapy stimulates the body to repair injured tissues and restore the original strength of tendons.

References

A Donna. Prolotherapy for Golfing Injuries and Pain. Practical PAIN MANAGEMENT, June 2008, 56-64

Rabago D, Best TM, Beamsley M, Patterson J. A systematic review of prolotherapy for chronic musculoskeletal pain. Clin J Sport Med 2005; 15:376.

Tullos, H. Elbow instability. The Hughston Clinic Sports Medicine Book. Philadelphia, PA. 1995. pp. 317-323.

Gosheger G, et al. Injuries and overuse syndromes in golf.Am J Sports Med. 2003 May-Jun;31(3):438-43.

McCarroll JR. Overuse injuries of the upper extremity in golf. Clin Sports Med. 2001 Jul;20(3):469-79

Jobe, et al. “Lateral and Medial Epicondylitis of the Elbow” J. Am. Acad. Ortho. Surg., Jan 1994; 2: 1 – 8.

Walz DM, Newman JS, Konin GP et-al. Epicondylitis: pathogenesis, imaging, and treatment. Radiographics. 2010;30 (1): 167-84.

Shiri R, Viikari-Juntura E; Lateral and medial epicondylitis: role of occupational factors. Best Pract Res Clin Rheumatol. 2011 Feb;25(1):43-57

Wilson, JJ; Best, TM. “Common overuse tendon problems: A review and recommendations for treatment”. Am Fam Physician 72 (5): 811–8.
 

 

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