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Golfer's elbow

1. What is it and symptoms
2. Causes
3. Treatment
4. Medication

 

1. What is it and symptoms

Golfer's elbow, or medial epicondylitis, is an inflammatory condition of the medial epicondyle (the big bone on the inside of the elbow) of the elbow. It is in some ways similar to tennis elbow.

The inside of the forearm becomes very tender to touch or when trying to grip something or even just typing.

This part of the arm contains several muscles that are involved with flexing the fingers and thumb, and flexing and pronating the wrist. The tendons of these muscles come together in a common tendinous sheath, which is inserted into the medial epicondyle of the humerus at the elbow joint.

2. Causes

All of the flexors of the fingers insert at the medial epicondyle, making this the most common elbow injury in activities which are very grip intensive, like rock climbing In response to overuse, strains, minor injury, or sometimes for no obvious reason at all, this point of insertion becomes inflamed.

The condition is called Golfer's Elbow because when swinging a golf club this tendon is stressed, especially if a non-overlapping (baseball style) grip is used; many people, however, who develop the condition have never handled a golf club. It is also sometimes called Pitcher's Elbow due to the same tendon being stressed by the throwing of objects such as a baseball. Other names are Climber's Elbow and Little League Elbow.

In most cases, the onset of the Medial Epicondylitis is gradual and symptoms often persist for weeks before patients seek care. The pain is aggravated by resisted wrist flexion and pronation.

3. Treatment

Treatments given at swissphysio always aim to solve the problems from the root. For this reason an experienced chartered physiotherapist or/and qualified TCM acupuncturist will first thoroughly assess you focusing not only on your elbow but also the whole body and the biomechanics of neck, trunk and arm in relation to your daily activities and your actual and past medical history.

Treatment  usually include mobilization and manipulation of soft tissue and joints, electrotherapy, kinesio taping, stretching and strengthening exercises for the arm, shoulder, neck and core. Heat or ice can be used

We create an exercise program specific to the need of the patient and if requested we can assess the workstation or the position of the car seat. A parallel treatment with a fully qualified acupuncturist can be suggested to support the healing of chronic conditions.

Therapy will include a variety of exercises for muscle/tendon reconditioning, starting with stretching and gradual strengthening of the flexor-pronator muscles. Strengthening will slowly begin with isometrics and progresses to eccentric exercises helping to extend the range of motion back to where it once was. After the strengthening exercises, it is common for the patient to ice the area.

The use of a counter-force brace or "elbow strap" to reduce strain at the elbow epicondyle, to limit pain provocation and to protect against further damage might be suggested. A daytime elbow pad also may be useful, by limiting additional trauma to the nerve.

4. Medication

Before anesthetics and steroids are used, simple analgesic medication has a place, as does more specific treatment with oral anti-inflammatory medications (NSAIDs). These will help control pain and any inflammation, but won’t solve the cause of the problem.

A more invasive treatment is the injection into and around the inflamed and tender area with steroid agent.

If all else fails, epicondylar debridement (a surgery) may be effective The ulnar nerve may also be decompressed surgically.