Golfers elbow is very similar to tennis elbow but it differs in its location. It affects the inside (medial) aspect of the elbow. It is also known as medial epicondylitis and flexor/pronator tendinopathy. It is an overuse injury due to excessive gripping, flexing or pronating of the elbow that causes an inflammation of the muscles and tendons of the forearm. Affected sports people include golfers, throwers and tennis players who use lots of topspin on the forehand. Occupational tool use or typing can also cause the condition.
Symptoms
- Pain around the medial epicondyle (bony bit on the inside of the elbow) that may radiate towards the wrist.
- Weakness of wrist
- Pain aggravated by flexing wrist against resistance
- Pronating wrist aggravated by pronating wrist (rotating wrist to turn palm downwards) against resistance
What you can do
- Ice therapy
- Rest with gradual return to normal activity level. A training diary may be useful to help monitor the level of activity that can be performed without aggravating symptoms and regulate progress.
- Take anti-inflammatory medication (speak to your doctor or pharmacist about a suitable product)
- Use of wrist band. This is worn below the elbow and takes the strain off the muscles attachments at the elbow
Prevention
- Golf. Visit golf coach to modify golf swing and advise on suitable grip size of club
- At home. The avoidance or reduction of repetitive tasks that aggravate symptoms.
What we can do
Massage
- Cross friction massage (short deep strokes at 90 degrees to muscle fibre direction) is used to stimulate healing. Inflammation can cause a sticking together (adhesion) between the muscle tendons and tendons sheaths preventing the muscle from gliding smoothly within its sheath. Cross friction can help prevent adhesions forming
- Stripping massage (long deep strokes throughout the width of the muscle) can help break down and release tight/knotted areas of muscle and reduce the strain at the elbow
Rehabilitation
- Prescription of stretches of finger and wrist flexors, and wrist pronators to limit of pain free range. Initially held for 10-15 seconds and building up to 40 seconds duration repeated 5 times daily.
- Prescription of strengthening exercises as permitted by pain
- Initially isometric exercises – muscle held in fixed position
- Then Concentric exercises – muscles working and shortening
- Finally Eccentric exercises – muscle working but lengthening
Medical treatment (if physical therapy does not work)
- Steroid injection – up to 2 or 3 injections per year to reduce inflammation (more injections will decrease strength of tendon)
- Surgery – last resort, good success rates.
Tags: elbow pain, medial elbow pain
