In the last blog we looked at the common injury of tennis elbow. Golfer’s elbow (medial epicondylitis) is less common than tennis elbow, but can still be very painful.
Golfer’s elbow usually begins as a tendinopathy. A tendinopathy is an injury to the tendon causing pain, inflammation, and limited movement. In golfer’s elbow, the tendinopathy occurs in the wrist flexor muscles and tendons. These muscles and tendons are located on the medial aspect (inside portion) of the elbow and attach to the medial epicondyle. Micro tearing develops in these tendons, and as a response, inflammation develops. Typically the tendons will lose their extensibility and a chronic condition can progress. Golfer’s elbow is not usually related to a direct trauma, but more commonly due to overuse.
Golfer’s elbow usually presents as pain and tenderness over the inside of the elbow. Patients may feel stiffness in the elbow and it hurts to make a fist. Weakness of the hand and wrist is also common. The pain is usually worse with wrist flexion (curling the wrist up) and pronation (turning the wrist over). Patients may find gripping objects to be painful and this may include activities like swinging a golf club, lifting weights, or turning a doorknob.
The early stages of intervention involve rest, activity modification, and modalities such as ultrasound and interferential current. Once the acute phase of the injury passes, focus is on range of motion exercises, correcting muscle imbalances and strengthening exercises. In some cases splinting may be used to help with recovery. Complete immobilization is not recommended, as it eliminates the stresses needed to allow the tissue to heal strong enough for a return to regular activity. Although golfer’s elbow can be painful, conservative intervention like physiotherapy can be quite successful.
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