Golfers elbow or medial epicondylitis is an overuse injury similar to tennis elbow (on the outside of the arm) but causing pain on the inside of the elbow instead. It is sometimes known as throwers elbow or little league elbow. We explain the symptoms, causes and treatment to return you back to full fitness in the shortest time.
The main symptoms are pain and tenderness on the bony bit on the inside of the elbow called the medial epicondyle, particularly when gripping hard with the hand. There will be general weakness in the wrist and pain will be reproduced by bending the wrist palm downwards against resistance and resisting pronation or rotating the wrist inwards.
Medial epicondylitis usually comes on gradually over time and is an uncomfotable niggle with recurrent stiffness before it develops into a painful injury causing the athlete loss of function.
Medial epicondylitis is caused by repeated wrist flexion or bending the wrist, particularly against resistance such as holding a golf club. It can also occur from throwing actions, as well as in occupations such as through manual jobs like carpentry or working at a computer work station. It tends to occur after a period of repeated overuse.
The tendon of the wrist flexor muscles on the inside of the elbow becomes painful and inflamed at their attachment point on the inner elbow.
Apply the PRICE principles of protection, rest, ice, compression and elevation when the injury is acutely painful. A cold therapy and compression wrap can be applied for 10 to 15 minutes every hour. After the first few hours this can be reduced to 3 to 4 times a day as required. Later in the rehabilitation program or if the injury becomes chronic applying heat may be more beneficial.
Rest is very important. Golfers elbow will not heal if it is not allowed to rest. Continuing to use the wrist may result in the injury becoming chronic which is much more difficult to treat. After 3 days apply heat and use a heat retainer or elbow support. Heat will help stimulate blood flow. A tennis elbow brace can be worn which will help by taking the strain off the tendon by applying pressure across the muscles and changing the angle of pull on the tendon and relieving tension on the painful part of the tendon.
A physiotherapist or similar may use electrotherapy such as ultrasound or laser treatment to help reduce pain and inflammation and aid the healing process. Anti inflammatory medication such as ibuprofen may be prescribed by a Doctor to reduce pain and inflammation.
Sports massage techniques may be applied to both the tendon and the connecting muscles. Cross friction massage to the tendon is sometimes used if the injury has become chronic or does not respond to initial rest and ice treatment. Applying sports massage to the muscles of the forearm can help reduce tension in the muscles improving their function which long term should help reduce the strain on the tendon at the elbow.
A steroid injection may be considered if more conservative treatment is not effective. Rest is a very important component in the healing of this injury. It may heal quickly within two weeks but you could suffer with Golfers elbow for months, particularly if it is not allowed to rest in the early days.