Medial epicondylitis is pain over the bone on the inner side of the elbow. The piece of bone that can be felt on the inner side of the elbow is called the medial epicondyle. When the tendons attached to this bone are overstretched or torn, they can become painful. This is called tendinopathy .
Medial epicondylitis is commonly called golfer's elbow, but it is not restricted to people who play golf. It can occur in tennis players and other people who repeatedly grip objects tightly.
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Golfer's elbow is caused by overusing the flexor muscles of the forearms. Overusing these muscles can stretch or tear the tendons attached to the medial epicondyle.
- Improper golf swing technique or grip of golf clubs
- Wrong model of golf clubs
- Improper technique for hitting a tennis ball
- Improper size of tennis racquet or tension of racquet strings
Doing certain arm motions too much, such as:
- Golf swings
- Tennis strokes (forehand or serve)
- Using a hammer or screwdriver
Factors that may increase your chance of medial epicondylitis include:
- Playing golf or tennis
- Work that requires repetitive gripping or clenching of the fingers (especially when the hand is bent up or down at the wrist)
- Muscle imbalance
- Decreased flexibility
- Advancing age
- Pain or tenderness on the inner side of the elbow
Pain increases when:
- Shaking hands
- Turning doorknobs
- Picking up objects with your palm down
- Hitting a forehand in tennis
- Swinging a golf club
- Applying pressure to this area
- Possibly pain extending down the forearm
- Tightness of forearm muscles
- Stiffness or trouble moving the elbow or hand
The doctor will ask about your symptoms, medical history, recent physical activity, and how the injury occurred. You may not remember the event that caused the injury because golfer's elbow pain develops over time. The doctor will examine your elbow for:
Pain on the inner side of the elbow when:
- Doing certain arm motions
- Pressing on the medial epicondyle
- Stiffness of elbow and pain with wrist movement
X-rays are not usually necessary. However, an x-ray may be needed if the doctor suspects other problems.
An MRI scan is occasionally used for diagnosis, but there is only limited evidence supporting this use.
Do not do activities that cause pain. Do not play sports, especially golf and tennis, until the pain is gone. You may need to alter how you do certain activities.
Regular ice application may help decrease some discomfort and swelling.
The following drugs can help to reduce inflammation and pain:
- Nonsteroid anti-inflammatory drugs (NSAIDs)
- Topical pain relievers that are applied to the skin
If you still have tenderness in the elbow while taking these drugs, do not return to physical activity. Check with your doctor.
Wear a counter-force brace on your forearm if recommended by your healthcare professional. This brace limits the force generated by your forearm muscles when you use them.
Apply heat to the elbow only when you are returning to physical activity. Then use it before stretching or getting ready to play sports.
When the acute pain is gone, start gentle stretching as recommended by a healthcare professional. Stay within pain limits. Hold each stretch for about 10 seconds and repeat 6 times.
Begin strengthening exercises for the flexor muscles of the forearm as recommended.
Gradual Return to Your Sport
Begin arm motions of your sport or activity (such as golf swings, tennis strokes, painting) as recommended.
The doctor may inject cortisone into the elbow near the medial epicondyle to reduce pain and inflammation.
To help reduce your chance of medial epicondylitis:
- Keep your arm muscles strong so they can absorb the energy of sudden physical stress.
- After a short warm-up period, stretch your arm muscles before physical activity.
- Learn the proper technique for activities that require forearm motion.
If you play golf, ask a golf specialist to check your:
- Swing technique
- Model of golf clubs
If you play tennis, ask a tennis specialist to check your:
- Technique for hitting a forehand
- Racket size and tension of racket strings
- Teresa Briedwell, PT, DPT, OCS, CSCS
- Reviewed: 12/2014
- Updated: 12/20/2014
Please note, not all procedures included in this resource library are available at Allegiance Health or performed by Allegiance Health physicians.
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