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Definition
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 become inflamed and painful.
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.
Medial Epicondylitis
2008 Nucleus Medical Art, Inc.
Causes
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.
Causes include:
- 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)
- Painting
- Raking
- Pitching
- Rowing
- Using a hammer or screwdriver
Risk Factors
A risk factor is something that increases your chance of getting a disease, condition, or injury.Risk factors for medial epicondylitis include:
Playing golf or tennisWork that requires repetitive gripping or clenching of the fingersMuscle imbalanceDecreased flexibilityAdvancing age Symptoms Symptoms include: Pain or tenderness on the inner side of the elbow Pain increases when: Shaking handsTurning doorknobsPicking up objects with your palm downHitting a forehand in tennisSwinging a golf clubApplying pressure to this areaPossibly pain extending down the forearmTightness of forearm musclesStiffness or trouble moving the elbow or hand Diagnosis The doctor will ask about your symptoms and medical history, your 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 motionsPressing on the medial epicondyleStiffness of elbow and pain with wrist movementX-rays are not usually necessary, but the doctor may decide to x-ray your elbow to: Make sure the bones of the elbow are normalLook for a calcium deposit in the injured tendonsMagnetic resonance imagery (MRI) is occasionally used for diagnosis, but there is only limited evidence supporting this use.
TreatmentTreatment includes: RestDo not do activities that cause pain. Do not play sports, especially golf and tennis, until the pain is gone. ColdApply ice or a cold pack to the inner side of the elbow for 15-20 minutes, four times a day for several days after the injury. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin. Medication Take one of the following drugs to help reduce inflammation and pain: Ibuprofen (Motrin, Advil)Naproxen (Aleve, Naprosyn)Acetaminophen (Tylenol)AspirinIf you still have tenderness in the elbow while taking these drugs, do not return to physical activity. Check with your doctor. CompressionWear 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. HeatApply heat to the elbow only when you are returning to physical activity. Then use it before stretching or getting ready to play sports. StretchingWhen 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 six times. StrengtheningBegin strengthening exercises for the flexor muscles of the forearm as recommended by a healthcare professional.
Gradual Return to Your SportBegin arm motions of your sport or activity (eg, golf swings, tennis strokes, painting) as recommended by a healthcare professional. Cortisone InjectionThe doctor may inject cortisone into the elbow near the medial epicondyle to reduce pain and inflammation. Prevention Take these steps to reduce your risk of getting golfer's elbow: 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 techniqueGripModel of golf clubs If you play tennis, ask a tennis specialist to check your: Technique for hitting a forehandRacket size and tension of racket strings RESOURCES: American Academy of Orthopaedic Surgeonshttp://www.aaos.org American Orthopaedic Society for Sports Medicinehttp://www.aossm.org/tabs/Index.aspx CANADIAN RESOURCES: Canadian Orthopaedic Associationhttp://www.coa-aco.org/ Canadian Orthopaedic Foundationhttp://www.canorth.org/ References: American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org/ .
American Orthopaedic Society for Sports Medicine website. Available at: http://www.aossm.org/tabs/Index.aspx . Assessment and treatment guidelines for elbow injuries. The Physician and Sportsmedicine . 1996;24:42. Human Tendons . Human Kinetics; 1997. Managing golf injuries. The Physician and Sportsmedicine . 1999;29:41. Nicholas Institute of Sports Medicine and Athletic Trauma website. Available at: http://www.nismat.org/ . Last reviewed October 2007 by Robert E. Leach, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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