Medial Epicondylopathy (Golfer’s Elbow)
What is Golfer’s Elbow?
Golfer’s elbow, otherwise known in the medical world as medial epicondylopathy, is a tendinous overload injury that causes pain on the inside part of the elbow.
It is caused by repetitive forces to the flexor and pronator muscles of the forearm.
- Pain at the elbow around the medial epicondyle which can radiate up and/or down the arm.
- Local tenderness over the medial epicondyle and the tendinous insertion points of the forearm flexors.
- Pain is brought on by resisted flexion of the wrist and pronation of the elbow.
- There can be grip weakness associated with this diagnosis as well.
- The pain tends to come on gradually and gets worse over time.
Who Gets Golfers Elbow?
Being that it is a repetitive injury, overuse or large changes to the amount of work the wrist, forearms, and elbow have to perform are the major contributors to pain.
Populations that are often affected by this condition are: (1)
- Athletes who play sports such as golf, weightlifting, or “throwing sports” (e.g. javelin, shot put)
- Those who provide manual work such as painting, hammering, repairing cars, and chopping wood
- Those who work at a computer
- Those who frequently cook (e.g. chopping or peeling)
Other Potential Diagnoses
Nerve Entrapments of the Ulnar or Median Nerve and C6-C7 Radiculopathy
Being that medial epicondylopathy pain can radiate up and/or down the forearm, and occasionally into the hand and fingers, we need to be mindful that your pain may not be due to repetitive load to the tendon but rather it could be neurogenic in nature.
Tendinopathies are a breaking down/degeneration of the tendons from overuse. A muscular strain is a tearing of the muscle or tendon due to too much force. Both of these can have similar presentations as far as pain goes, but the rehab will be a little different.
Ulnar/Medial Collateral Ligament Sprain
This is seen more in athletes that throw and cause instability at the elbow joint. Being that these ligaments are located near the medial epicondyle, these injuries can be mistaken for Golfer’s Elbow. Valgus stress testing at the elbow will be a clear differentiator when it comes to finding the appropriate diagnosis.
Addressing Golfer’s Elbow
In the initial treatment, removing the loads that recreate your pain is important.
This does not mean you need to be inactive. As long as an activity does not make your pain levels worse you are allowed to do as much of it as you like. Just keep in mind that doing too much too fast can lead to an exacerbation of symptoms.
Once we remove the irritating stimuli, a thorough assessment of the body is necessary to figure out which areas are not working optimally.
The rehab process then starts with adding in pain-free wrist and elbow range of motion exercises. As we get to full wrist flexion with an extended elbow we can start the process of adding isometrics, eccentrics, and concentrics. Throughout the process, it is important to make sure that the surrounding joints (neck, shoulder, scapula) all work well.
Below you’ll find a couple of videos that may be helpful. You can always click the button at the bottom of this post to set up a free discovery call so we can figure out how to best get you out of pain.
Wrist Flexion PAILs/RAILs
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