People talk about tennis elbow all the time. It has become part of the vernacular with people who have never touched a racket using the term to describe lateral-sided elbow pain. Less talked about, but no less debilitating to those affected by it is “golfer’s elbow” or medial epicondylitis.
Medial epicondylitis refers to inflammation or, less commonly tearing, of the tendons that attach to the medial epicondyle of the humerus (or arm bone). These tendons are attached to the muscles responsible for flexing your wrist (bring it down) and pronating your forearm (rotating your forearm palm down). This inflammation commonly occurs in golfers, but it can affect anyone who performs the motions described above repetitively. Clearly, it can occur while playing golf but even everyday activities such as shaking hands can incite the pain.
The majority of cases are due to chronic overuse, but acute epicondylitis can occur. Any sport that requires repetitive and strenuous forearm and wrist movements such as golf, tennis or throwing a baseball, increases the risk of one developing the condition.
People with golfer’s elbow will complain of pain along the medial aspect of their elbow (the side of your elbow closest to your body when your palm is facing up). Pain can sometimes radiate down the forearm. Any activities that require repetitive or resisted wrist flexion or forearm pronation may be painful.
Typically the symptoms will subside with avoidance of the inciting activity. If they persist, you should probably see your local orthopedist to make sure something else isn’t causing the pain. Typically, they will prescribe anti-inflammatory medications, ice, and stretching/strengthening exercises. Most cases will respond to the above treatments within about 4 to 6 weeks. It is extremely important, however, to avoid returning to your sport before the symptoms have resolved, as this can be a setup for further injury.
More chronic cases and cases that are recalcitrant to the above-mentioned treatment modalities may benefit from an injection of cortisone into the area. Cortisone is a steroid that helps reduce inflammation. Though it may help the symptoms, it shouldn’t be done as a first-line treatment; as it can actually weaken muscle and tendon tissue. More recently, platelet-rich plasma, which involves isolating the growth factors from one’s own blood and injecting into the site of maximal tenderness, has been used with anecdotal success. Rarely, patients will require surgery for the condition. Surgery involves removing the inflamed area of the tendon and, if a tear is present, repairing it.
Clearly, the best treatment is prevention. Before starting your golf, tennis or baseball season, make sure you start a gradual stretching and strengthening program. And, early in the season, you may feel some aches and pains. Listen to your body. You don’t want to make a relatively minor condition into something more severe by playing through pain. With golf season starting, you may start to hear more of your friends complaining of this…