Golfers Elbow (Medial Epicondylitis)

What is it?

This is a condition which commonly affects golfers but can affect anyone who has overused the muscles on the underside of their forearm.  It is chacterised by pain on the inside of the elbow where the muscles taper down to connect via a tendon to a point called the common flexor origin. You can locate this point by holding your hand palm upwards and feeling the bony lump on the innerside of your elbow. The pain can be reproduced by movements which either stretch or contract these muscles, such as bending the wrist backwards or performing gripping type activities.

Causes

Golfers elbow can develop either traumatically, due to a direct blow or gradually as a consequence of overusing the muscles which connect the underside of the wrist to the elbow (wrist flexors). It is thought that the reason golfers elbow can develop with little or no warning is that the tendon which inserts to the bone at the elbow suffers from degeneration over time. This combined with a poor blood supply and a reduced ability to heal itself leads to initial inflammation and subsequent pain.  It is more common in people in their 40s and 50s but can affect people of any age. Occasionally, areas away from the site of pain can be implicated in the exacerbation of this condition. Sometimes the lower neck and upper back region can refer pain to this area or perhaps compromise the normal functioning of a nerve which services the elbow region.

Treatment

Following a thorough examination and assessment of the presenting problem, advice and treatment may include the following:

• Rest from the aggravating activity

• Use of Ice packs to reduce inflammation and swelling

• Taping / Strapping to offload the injured tissues

• Electrotherapy i.e. Ultrasound or Laser treatment to control pain and inflammation

• Soft tissue manipulation to restore normal tissue feel and function

• Joint mobilisations to the neck, shoulder and elbow

• Acupuncture to reduce pain, normalise tissue tone and improve blood flow

• Individually tailored exercise programme to stretch, strengthen and rehabilitate back to fitness and minimise injury recurrence