Golfer’s elbow




Golfer’s elbow, or medial epicondylitis.



It is a tendinosis of the medial epicondyle on the inside of the 



It is similar to tennis elbow, which affects the outside at the lateral epicondyle.



The anterior forearm muscles are involved with flexing the digits of the hand, and flexing and pronating the wrist. 



The tendons of these muscles come together in a common tendinous sheath, which originates from the medial epicondyle of the humerus at the elbow joint. 





This point of insertion becomes inflamed, causing pain, with injury.



During a golf swing this tendon is stressed.



Many people develop the condition without playing golf: pitcher’s elbow, climber’s elbow.



All the flexors of the fingers and the pronators of the forearm insert at the medial epicondyle of the humerus to include: pronator teres, flexor carpi radialis, flexor carpi ulnaris, flexor digitorum superficialis, and palmaris longus.



Golfer’s elbow is the most common elbow injury for rock climbers, whose sport is grip intensive. 



The large amount of grip exerted by the digits and torsion of the wrist which is caused by the use and action of the cluster of muscles, above,  on the condyle of the ulna, causes the pain due to the stress on the tendon.



More than 90% of cases of golfer’s elbow are not from sports-related injuries, but rather from labor-related occupations with forceful repetitive activities, such as construction and plumbing.



Epicondylitis is much more common on the lateral side of the elbow (tennis elbow), rather than the medial side. 



Golfer’s elbow  onset is usually gradual and symptoms often persist for weeks before care. 



Golfer’s elbow pain that occurs at the medial epicondyle is aggravated by resisted wrist flexion and pronation, which is used to aid diagnosis. 



Tennis elbow is indicated by the presence of lateral epicondylar pain precipitated by resisted wrist extension.



Applying force to the elbow and wrist, that elicits pain or inability to resist on the medial side, suggests golfer’s elbow.




X-rays, ultrasound and magnetic resonance imaging (MRI) can be used to assess the structural integrity of the elbow and may assist in making a more accurate diagnosis.



Non-specific treatments include:



Non-steroidal anti-inflammatory drugs 



A brace or elbow strap to reduce strain at the elbow epicondyle, to limit pain provocation and to protect against further damage.



Treatment such as rest, ice, compression and elevation is typically be used. 



Rest alleviates discomfort because golfer’s elbow is an overuse injury. 



A tennis elbow splint is made in 30–45 degrees of elbow flexion. 



Therapy includes exercises for muscle and tendon reconditioning, starting with stretching and gradual strengthening of the flexor-pronator muscles.



Oral anti-inflammatory medications help control pain and any inflammation.



The injection of glucocorticoid into and around the inflamed and tender area may produce an improvement of the condition in some five to seven days.



Physical therapy includes exercises for muscle and tendon reconditioning, starting with stretching and gradual strengthening of the flexor-pronator muscles. 



For symptoms persistent after 6 months , surgery may be recommended. 



Surgical debridement is  a common treatment.



With rest, ice, and rehabilitative exercise and stretching recovery may follow, and  few subjects progress to steroid injection, and less than 10% will require surgical intervention.



Arthroscopy is not an effective option for treating golfer’s elbow.