Medial Epicondylitis

Medial epicondylitis, commonly referred to golfer’s elbow, is characterized by pain on the inside (medial side) of the elbow. Pain associated with medial epicondylitis often develops due to overuse of the forearm muscles that attach to the medial epicondyle. The medial epicondyle is the bony projection of the humerus bone (long bone of the arm) where the forearm muscles attach to the elbow. Medial epicondylitis is one of the most common injuries seen in individuals who play golf.

Medial epicondylitis develops due to overuse from repetitive motions, such as a golf swing. Although this condition is commonly seen in golfers, it also occurs in athletes who perform repetitive motions that place stress on the medial epicondyle of the forearm, like throwing or hitting a tennis ball.

Medial epicondylitis is common in these sports:

• Golf
• Baseball (most commonly seen in pitchers)
• Softball (most commonly seen in pitchers)
• Tennis

You may have medial epicondylitis if you are experiencing one or more of the following symptoms:

• Pain on the inside of the elbow
• Weakness grasping things
• Increased pain when flexing the hand downward

At first, you may experience pain only during sports. Over time, pain may progress and be present all the time.

If you have symptoms of medial epicondylitis that do not go away or that get worse over time, make an appointment with an orthopedic specialist. Your doctor will examine your elbow. If the exam reveals pain at the inside of the elbow, over the site of insertion of the medial epicondyle tendon, and pain with wrist flexion, this may indicate medial epicondylitis.

While most of the time the diagnosis can be made without any imaging studies, occasionally your doctor may order the following imaging tests in order to confirm or make a diagnosis:

• X-rays
• MRI

Medial epicondylitis is almost always treated using non-operative therapies, including:

• Resting the arm
• Icing the elbow intermittently throughout the day
• Nonsteroidal anti-inflammatory medications to relieve swelling
• Corticosteroid injections (administered by an orthopedic specialist)
• Platelet-rich plasma injections (administered by an orthopedic specialist)
• Wearing a brace
• Physical therapy with a licensed professional to stretch and strengthen the muscles of the forearm

Working with a physical therapist to strengthen the forearm muscles can help prevent golfer’s elbow.

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Elbow Epicondylitis

Surgery is rarely needed to treat medial epicondylitis and is usually only recommended when non-operative treatments fail to relieve pain. During surgery to relieve symptoms of medial epicondylitis, your surgeon will make a small incision over the inside of the elbow and remove  the damaged tissue and any bone spurs that may be damaging the tendon.

VIDEO: “Arthroscopic Debridement of the Elbow” from Viewmedica.com

You can return to play when you have complete pain relief and have regained full range of motion and strength of the arm. If non-operative treatments are successful, recovery usually takes four to six weeks. If you require surgery, you may need at least three to four months to fully recover.

Ask your physical therapist if there are changes you can make to your throwing technique or to your golf swing in order to prevent medial epicondylitis from reoccurring. Correcting improper mechanics and/or techniques can help you avoid further damage to the arm.