Golfer’s Elbow

Technically known as medial epicondylitis, golfer’s elbow is a common condition of the elbow.

Golfer’s elbow is an inflammation of the tendons that attach your forearm muscles to the inside of the bone at your elbow.

The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the inside of the elbow.

The main symptom of golfer’s elbow is tenderness and pain at the medial epicondyle of the elbow. Pain usually starts at the medial epicondyle and may spread down the forearm. Bending your wrist, twisting your forearm down, or grasping objects can make the pain worse. You may feel less strength when grasping items or squeezing your hand into a fist.

During your first visit, your doctor will talk to you about your symptoms and medical history. During the physical examination, your doctor will check all the structures of your injury, and compare them to your non-injured anatomy.  Most injuries can be diagnosed with a thorough physical examination.

Imaging Tests Other tests which may help your doctor confirm your diagnosis include:

X-rays. Although they will not show any injury, x-rays can show whether the injury is associated with a broken bone.

Magnetic resonance imaging (MRI) scan. If your injury requires an MRI, this study is utilized to create a better image of soft tissues injuries. However, an MRI may not be required for your particular injury circumstance and will be ordered based on a thorough examination by your Peninsula Bone & Joint Clinic Orthopedic physician.

One of the best ways to avoid elbow problems is to strengthen your forearm muscles and slow your golf swing so that there will be less shock in the arm when the ball is hit.

The following simple exercises can help build up your forearm muscles and help you avoid golfer’s elbow.

For best results, do these exercises during the off-season, as well.

• Squeeze a tennis ball. Squeezing an old tennis ball for 5 minutes at a time is a simple, effective exercise that will strengthen your forearm muscles.

• Wrist curls. Use a lightweight dumbbell. Lower the weight to the end of your fingers, and then curl the weight back into your palm, followed by curling up your wrist to lift the weight an inch or two higher. Perform 10 repetitions with one arm, and then repeat with the other arm.

• Reverse wrist curls. Use a lightweight dumbbell. Place your hands in front of you, palm side down. Using your wrist, lift the weight up and down. Hold the arm that you are exercising above your elbow with your other hand in order to limit the motion to your forearm. Perform 10 repetitions with one arm, and then repeat with the other arm.

If your discomfort persists:

The sooner you begin treatment, the sooner you’ll be able to return to your usual activities.

Rest. Put your golf game or other repetitive activities on hold until the pain is gone. If you return to activity too soon, you may make it worse.
Ice the affected area. Apply ice packs to your elbow for 15 to 20 minutes at a time, three to four times a day for several days. To protect your skin, wrap the ice packs in a thin towel. It might help to massage the inner elbow with ice for five minutes at a time, two to three times a day.
Take an over-the-counter pain reliever. Try ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, others) or acetaminophen (Tylenol, others).
Use a brace. Your doctor might recommend that you wear a counter force brace on your affected arm, which might reduce tendon and muscle strain.
Stretch and strengthen the affected area. Your doctor may suggest stretching and strengthening exercises. Physical or occupational therapy can be helpful, too. A type of strengthening (eccentric) that lengthens the tendon of the wrist extensor muscles has been shown to be particularly effective in treating chronic tendon irritation.
Reduce the load on your elbow tendons. Wrap your elbow with an elastic bandage or use a splint.
Gradually return to your usual activities. When your pain is gone, practice the arm motions of your sport or activity. Review your golf or tennis swing with an instructor and make adjustments if needed.

Ask your doctor when surgery is appropriate. Surgery is seldom necessary. But if your signs and symptoms don’t respond to conservative treatment in six to 12 months, surgery may be an option. A new procedure involves minimally invasive, ultrasound-guided removal of scar tissue in the region of the tendon pain.