Treatments Classes

Golfer's Elbow

Golfer’s elbow, also known as medial epicondylitis, is a condition characterised by pain and inflammation on the inner side of the elbow. This area is where the tendons of the forearm muscles attached to the bony bump on the inside of the elbow (the medial epicondyle). Despite its name, golfer’s elbow is not exclusive to golfers and can affect anyone who performs repetitive wrist and forearm motions. Golfer’s elbow is caused by damage to the muscles and tendons that control the wrist and fingers. This damage is typically the result of repetitive stress, overuse, or improper technique in activities that involve swinging a golf club or racket, throwing a ball, lifting weights, or performing forceful or repetitive occupational tasks such as hammering or typing.

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Symptoms

1. Pain and tenderness on the inner side of the elbow, which may extend along the inner side of the forearm.
2. Stiffness in the elbow, with pain potentially worsening when making a fist.
3. Weakness in the hands and wrists.
4. Numbness or tingling radiating into one or more fingers (usually the ring and little fingers).

Treatments

Golfer’s elbow can be treated using a variety of methods, and your physiotherapist will identify which ones are most appropriate for you.
Non-operative management is the preferred approach for golfer’s elbow. This often includes a period of rest to facilitate recovery, whilst also investigating methods to modify the aggravating activities [1]. Activity modification may include altering working positioning and posture, load management, temporarily reducing frequency of training, or altering sporting mechanics. Stretching and strengthening exercises are also beneficial. Stretching of the forearm muscles improves flexibility and has been shown to decrease the tenderness around the medial elbow. Strengthening of the upper arm and forearm musculature, particularly with progressive eccentric exercises, helps to restore the muscle-tendon unit and relieve symptoms [2,3].
In cases that other modalities are unable to significantly improve symptoms and surgical intervention is not required, Extracorporeal shockwave therapy (ESWT) may be used. ESWT has been shown to be effective with many tendinopathies and is believed to stimulate new blood vessels and induce tissue repair and regeneration within the tendon [3]. In golfer’s elbow, ESWT has been shown to be as effective as a local steroid injection for reducing pain [4]. If no improvement after attempting multiple conservative treatment methods, a surgical intervention may be required.

References

1. Ciccotti, M. C., Schwartz, M. A., & Ciccotti, M. G. (2004). Diagnosis and treatment of medial epicondylitis of the elbow. Clinics in sports medicine, 23(4), 693-705.
2. Mishra, A., Pirolo, J. M., & Gosens, T. (2014). Treatment of medial epicondylar tendinopathy in athletes. Sports medicine and arthroscopy review, 22(3), 164-168.
3. Brady, C., & Dutta, A. (2016). Medial epicondylitis and medial elbow pain syndrome: Current treatment strategies. J Musculoskelet Disord Treat, 2(2), 1-5.
4. Lee, S. S., Kang, S., Park, N. K., Lee, C. W., Song, H. S., Sohn, M. K., ... & Kim, J. H. (2012). Effectiveness of initial extracorporeal shock wave therapy on the newly diagnosed lateral or medial epicondylitis. Annals of rehabilitation medicine, 36(5), 681-687.
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