Medial Epicondylitis Causes, Symptoms & Treatment Options
Medial epicondylitis, commonly known as golfer’s elbow, is a condition that causes elbow pain along the inner (medial)side of the elbow. It develops when the forearm muscles and tendons that attach to the medial epicondyle become irritated or damaged due to repetitive stress. The medial epicondyle is the bony prominence on the inside of the humerus (upper arm bone) and serves as the attachment point for muscles responsible for wrist and finger movement. Medial epicondylitis is an overuse injury that causes pain, weakness, and stiffness in the inner elbow, often triggered by repetitive gripping, swinging, or throwing motions.
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Medial epicondylitis is a tendon injury characterized by pain on the inside (medial side) of the elbow. This pain develops when repetitive stress leads to small tears and inflammation in the tendons that connect the forearm muscles to the medial epicondyle. These muscles help bend the wrist and turn the forearm , which explains why gripping and downward wrist motion often worsen symptoms.
Although commonly associated with golfers, medial epicondylitis affects many individuals who perform repetitive arm motions. It is one of the more frequent overuse injuries seen in athletes and people with physically demanding occupations.
What causes Medial Epicondylitis?
Medial epicondylitis develops primarily due to overuse and repetitive strain placed on the forearm muscles and tendons.
1. How the Injury Occurs
The condition occurs when repeated wrist flexion and forearm rotation place excessive tension on the tendons attaching to the medial epicondyle. Over time, this stress causes microtears in the tendon, leading to pain, inflammation, and weakened tendon structure.
2. Common Everyday Causes
Medial epicondylitis is not limited to sports. It can also result from everyday activities such as:
- Repetitive lifting
- Prolonged gripping of tools
- Typing or manual labor
- Improper ergonomics at work
- Home improvement or yard work
3. Sports Commonly Associated With Medial Epicondylitis
This condition is frequently seen in sports that involve repetitive throwing, swinging, or gripping motions, including:
- Golf, where improper swing mechanics strain the inner elbow
- Baseball, especially in pitchers, is due to repetitive throwing
- Softball, particularly pitchers
- Tennis, especially players who generate force with wrist flexion
Symptoms
You may have medial epicondylitis if you experience persistent or worsening medial elbow pain, especially during activity. Common golfer’s elbow symptoms include:
- Pain or tenderness on the inside of the elbow
- Weakness when gripping or holding objects
- Increased pain when flexing the wrist downward
- Stiffness in the elbow or forearm
Initially, pain may occur only during sports or repetitive activities. Over time, symptoms may worsen and become constant, even during rest.
When to see a doctor
If symptoms of medial epicondylitis do not improve with rest or worsen over time, you should schedule an appointment with an orthopedic specialist. Your doctor will examine your elbow and assess for tenderness over the medial epicondyle and pain during wrist flexion or gripping activities.
Imaging Tests
In most cases, medial epicondylitis can be diagnosed with a physical exam alone. However, imaging may be recommended to rule out other conditions or confirm the diagnosis:
- X-rays to evaluate bone structure and rule out arthritis or bone spurs
- MRI to assess tendon damage, inflammation, or tears
Non-operative treatment
Most cases of golfer’s elbow respond well to non-surgical treatment. Common non-operative options include:
- Resting the affected arm
- Icing the elbow several times a day
- Nonsteroidal anti-inflammatory medications to reduce pain and swelling
- Corticosteroid injections administered by an orthopedic specialist
- Platelet-rich plasma (PRP) injections to promote healing
- Wearing an elbow brace to reduce tendon strain
- Physical therapy to improve flexibility, strength, and muscle balance
Working with a physical therapist or athletic trainer to strengthen the forearm muscles can significantly reduce symptoms and help prevent recurrence of medial epicondylitis.
Exercise Program
A targeted exercise program can improve recovery and prevent future injury.
Below is a PDF of the Exercise Program:
Surgical Treatment
Surgery is rarely required for medial epicondylitis and is considered only when conservative treatments fail to relieve pain. During the procedure, the surgeon makes a small incision over the inner elbow to remove damaged tendon tissue and any bone spurs contributing to irritation.
VIDEO: “Arthroscopic Debridement of the Elbow” from Viewmedica.com
Recovery
You may return to sports or regular activities once pain has resolved and full strength and range of motion have returned. With successful non-operative treatment, recovery typically takes four to six weeks. If surgery is required, full recovery may take three to four months.
To prevent recurrence, ask your physical therapist about modifying your golf swing or throwing mechanics. Correcting improper technique can significantly reduce stress on the medial elbow and lower the risk of future injury.
Dr. Jay Kimmel is a board-certified orthopedic surgeon specializing in sports medicine, arthroscopic surgery, and shoulder and knee disorders. He completed his orthopedic training at New York-Presbyterian/Columbia University Medical Center and a Sports Medicine Fellowship at Temple University.
Dr. Kimmel previously served as the Director of the Connecticut Sports Medicine Institute at Saint Francis Hospital and has held faculty appointments as Clinical Assistant Professor in the Departments of Orthopedics and Family Medicine at the University of Connecticut. He has extensive experience caring for athletes as a team physician for high school and collegiate programs and continues to teach in the athletic training departments at Westfield State University and Springfield College.
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/MonthFrequently Asked Questions
What’s the best treatment?
Rest, physical therapy, and activity modification are the most effective treatments for most patients.
How long does it last?
Symptoms typically improve within four to six weeks with proper treatment.
Is heating helpful?
Ice is generally recommended during the early stages to reduce inflammation. Heat may be helpful later to relieve stiffness.
What are the symptoms of medial epicondylitis?
Common symptoms include medial elbow pain, weakness in gripping, stiffness, and pain during wrist flexion—classic golf elbow symptoms.