What is ‘Golfer’s Elbow’ ( Medial Epicondylitis) ?
Golfer’s Elbow is the name given to pain experienced on the inner aspect of the elbow, usually as a result of overuse.
It arises due to overloading of the flexor tendons of the forearm.
It is often referred to as a ‘Golfer’s Elbow’ due to the fact that this tendon bears high load when playing golf. Excessive right wrist flexion (bending the wrist in the direction of the palm) in a right handed golfer may be responsible.
Although golf players can develop a ‘golfers elbow’ the vast majority of individuals who develop symptoms do so as a result of repetitive flexion at the wrist while performing lifting and carrying tasks. Hence the term medial epicondylitis is frequently used.
Localised pain is felt directly over the common flexor tendon in the inner elbow which sometimes radiates down the inside of the forearm muscle bulk.
Symptoms are aggravated by any activity which requires forceful flexion of the forearm muscles such as gripping, lifting and carrying tasks.
How is a Golfer’s Elbow diagnosed?
A medial epicondylitis can be reliably diagnosed by your doctor or physiotherapist by taking a history of your condition. In some circumstances it may be necessary to conduct a physical examination but this is usually not necessary.
The main feature is usually pain directly over the tendon when contracting the forearm muscles (when gripping or resisting wrist flexion). X-rays or other scans are not routinely required.
How is a Golfers Elbow treated?
It can be managed very effectively by adhering to the following advice and exercise routine.
Modifying aggravating activities. If there are some particularly stressful tasks such as golf or DIY which seem to be aggravating your symptoms, then the common flexor tendon may need 4-6 weeks of relative rest initially to settle symptoms while you work on strengthening the wrist flexor muscles in the forearm and the common flexor tendon (see below):
Exercises. Regular exercises to strengthen the wrist flexor muscles and tendon in the forearm and stretch the extensor muscles:
3×15 repetitions 3-4x per week
5×30 second holds, 2x per day
These are suggested exercises only. If you are at all concerned about whether these exercises are suitable for you or if you experience any pain while doing them, please seek appropriate clinical advice from your GP or Physiotherapist.
Corticosteroid injection therapy. Evidence suggests that corticosteroid injections are best avoided as patients symptoms are more likely to get better quicker without. The steroid injection may weaken the tendon in the longer term. However, injections may be discussed with individuals who continue to suffer disabling pain (preventing work and leisure activities) and have failed physiotherapy management. You can read more about local corticosteroid injections here.