Medial Epicondylitis

Definition – Medial epicondylitis, also referred to as “Golfer’s Elbow”, is elbow pain caused by an overuse of the wrist flexor and forearm pronator muscle groups. These muscles and tendons become inflamed at their attachment to the bony inside area of the elbow.

 

Cause – This injury is usually classified as an “overuse” type of injury and is caused by a repetitive active motion of the upper extremity. This repetitive motion causes micro traumas/strains to the common flexor muscles and tendons at the inside of the elbow. These micro traumas can build up over time and cause inflammation at the elbow and a sharp or burning pain. Other than overuse, this injury can be caused by a single strain of the muscles or an insidious (unknown) onset. Most commonly affected population is the athlete performing repetitive actions such as overhead throwing pitchers, golfers, and tennis players performing a forehand stroke. Construction workers and other physical jobs requiring repetitive motions or vibrations in upper extremities may feel symptoms as well.

 

Signs and Symptoms – Pain that gradually gets worse, sharp or burning pain at the inner surface of the elbow, weak grip, and difficulty lifting or grasping. Possible tingling/numbness into hand, pinky and ring fingers.

 

Tests/Assessment – X-rays may be taken to rule out any structural damage to the bones or joints. Specific orthopedic special tests to rule in/out golfer’s elbow. MRI may be taken, if conservative treatment fails, to determine severity of injury and if there is any ulnar collateral ligament involvement in the overhead throwing athlete.

 

Treatment Options – Physical therapy, rest and ice, nonsteroidal anti-inflammatory drugs, activity modification (sitting out from sport), elbow bracing or taping, ultrasound, phonophoresis, iontophoresis, steroid injections to decrease pain and inflammation, patient education for pain prevention, possible surgery

 

What PT can do – You can expect your physical therapist to provide a regimen of stretching, strengthening, skilled manual therapy, modalities to help decrease pain, functional tasks to return to work or sport, and education to prevent reoccurrence

 

Advice and Solutions – If you are just noticing these symptoms begin with rest and ice 15-20 min to the painful area, multiple times a day. Begin stretching the wrist flexors by placing your effected arm out in front of you with your palm facing up, use your opposite hand to press your fingers and hand of your effected hand down toward the ground, you should feel a pull/stretch at the elbow and area of pain.

 

Final Statement – Contact your Doctor or Physical Therapist for further care and to begin a course of rehabilitation 

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