What is golfer's elbow?

What is golfer's elbow or medial epicondylitis?

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Golfer's elbow, medically known as medial epicondylitis, is a condition that causes pain and inflammation in the tendons on the inner side of the elbow. Despite its name, this condition is not limited to golfers and can affect anyone who engages in repetitive wrist and forearm movements such as swinging a golf club, pitching a ball, or work-related grasping, shuffling papers and lifting heavy objects, which strain the tendons in the area.

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Golfer's elbow is similar to tennis elbow (lateral epicondylitis), but the affected tendons are on the inner side of the elbow rather than the outer side. The primary tendon involved is the flexor tendon, which helps to flex the wrist and fingers.

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Common symptoms of golfer's elbow

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Symptoms of golfer's elbow may include:

1. Pain and tenderness on the inner side of the elbow, near the bony bump called the medial epicondyle after excessive activity of the wrist and forearm, or when the involved muscle is stretched.
2. Weakness in the wrist and hand.
3. Stiffness and discomfort in the elbow, especially in the morning.

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To diagnose golfer's elbow, a healthcare professional will typically perform a physical examination and may order imaging tests such as X-rays or MRI to rule out other possible causes of the pain.

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What causes a golfer's elbow?

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The condition typically develops due to overuse or repetitive strain on the flexor tendons, leading to small tears and degeneration of the tendon fibers when the strain exceeds the strength of the tissues, and when the demand exceeds the repair process. Activities that involve gripping, lifting, or repetitive wrist flexion can contribute to the development of golfer's elbow. Some common causes include golfing (particularly when using poor swing technique), repetitive hammering, throwing, or using hand tools extensively.

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Treatment for golfer's elbow usually involves a combination of rest, ice, over-the-counter pain medications, and modifying or avoiding activities that aggravate the condition. Physical therapy is often prescribed to strengthen the forearm muscles gradually, improve flexibility, and promote healing. In some cases, a healthcare provider may recommend corticosteroid injections to reduce inflammation.

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Preventive measures for golfer's elbow include using proper techniques and equipment during activities, taking breaks to avoid overuse, and performing stretching and strengthening exercises to keep the forearm muscles in good condition.

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If you suspect you have golfer's elbow or experience persistent elbow pain, it's important to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan.

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How can physical therapy help? 

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Physical therapy can play a significant role in the management and rehabilitation of golfer's elbow (medial epicondylitis). A physical therapist can provide targeted interventions to reduce pain, promote healing, and strengthen the affected muscles and tendons. Here's how physical therapy can help with golfer's elbow:

1. Pain Management: Physical therapists may use various modalities such as ice, heat, ultrasound and electrical stimulation to help reduce pain and inflammation in the affected area.
2. Rest and Activity Modification: Physical therapists will advise to rest the muscles by immobilizing the wrist in a splint and to avoid or modify all aggravating activities such as strong or repetitive gripping actions to allow the injured tendons to heal.
3. Stretching Exercises: Gentle stretching exercises such as manual stretching, and self-stretching techniques are prescribed to improve the flexibility of the tight wrist and forearm muscles and tendons. These stretches can help increase the range of motion of the affected area. 
4. Strengthening Exercises: Physical therapists will design a customized strengthening program to gradually improve the strength of the wrist and forearm muscles. Initially, low-intensity resistance exercises with multiple repetitions for muscular endurance are given, and will progress to more intense resistance to strengthen the muscles in preparation for functional demands. Elastic resistance and free weights are also utilized for this type of exercise. 
5. Manual Therapy: Hands-on techniques like cross-fiber (friction) massage and manual manipulation can help improve soft tissue mobility, reduce muscle tension and improve blood flow to the affected area.
6. Graston Technique or Instrument-Assisted Soft Tissue Mobilization: Some physical therapists may use specialized tools to perform soft tissue mobilization, which can help break down scar tissue and promote tissue healing.
7. Eccentric Exercises: Eccentric exercises involve lengthening the muscle while it contracts, which has been found to be particularly effective in reducing pain associated with epicondylitis, improving grip strength and gradually restoring physical functioning of the upper extremity. Physical therapists may incorporate eccentric exercises into the treatment plan.
8. Functional Exercises: As the muscle flexibility and strength improve and the pain is under control, functional exercises are incorporated. It simulates the patient’s desired functional activity, as well as occupational or recreational tasks. This exercise helps to improve the patient’s overall function.
9. Biomechanical Assessment: Physical therapists can assess movement patterns and identify any biomechanical issues that may be contributing to the development or persistence of golfer's elbow. They can then provide guidance on correcting these issues.
10. Home Exercise Program: To facilitate ongoing progress, physical therapists often provide patients with a home exercise program that includes home instructions to continue their exercises and self-management between therapy sessions.
11. Education: Physical therapists provide patient education which includes advice and techniques on prevention, recognition of provoking factors and identification of symptoms. They also teach the patient how to reduce repetitive motions that caused the problem and retrain the patient in proper techniques. 

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It's important to note that the treatment plan for golfer's elbow will be tailored to the individual's specific needs and the severity of the condition. Following the guidance of a qualified physical therapist and committing to the prescribed exercises and therapies can significantly improve the outcomes for individuals with golfer's elbow. If you suspect you have golfer's elbow or experience persistent elbow pain, consult a healthcare professional for an accurate diagnosis and appropriate treatment plan.

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