Medial epicondylitis is pain over the bone on the inner side of the elbow. The piece of bone that can be felt on the inner side of the elbow is called the medial epicondyle. When the tendons attached to this bone are overstretched or torn, they can become painful. This is called tendinopathy .
Medial epicondylitis is commonly called golfer's elbow, but it is not restricted to people who play golf. It can occur in tennis players and other people who repeatedly grip objects tightly.
Golfer's elbow is caused by overusing the flexor muscles of the forearms. Overusing these muscles can stretch or tear the tendons attached to the medial epicondyle.
Causes include:
A risk factor is something that increases your chance of getting a disease, condition, or injury. Risk factors for medial epicondylitis include:
Symptoms include:
The doctor will ask about your symptoms and medical history, your recent physical activity, and how the injury occurred. You may not remember the event that caused the injury because golfer's elbow pain develops over time. The doctor will examine your elbow for:
X-rays are not usually necessary, but the doctor may decide to x-ray your elbow to:
Magnetic resonance imagery (MRI) is occasionally used for diagnosis, but there is only limited evidence supporting this use.
Treatment includes:
Do not do activities that cause pain. Do not play sports, especially golf and tennis, until the pain is gone.
Apply ice or a cold pack to the inner side of the elbow for 15-20 minutes, four times a day for several days after the injury. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
The following drugs can help to reduce inflammation and pain:
If you still have tenderness in the elbow while taking these drugs, do not return to physical activity. Check with your doctor.
Wear a counter-force brace on your forearm if recommended by your healthcare professional. This brace limits the force generated by your forearm muscles when you use them.
Apply heat to the elbow only when you are returning to physical activity. Then use it before stretching or getting ready to play sports.
When the acute pain is gone, start gentle stretching as recommended by a healthcare professional. Stay within pain limits. Hold each stretch for about 10 seconds and repeat six times.
Begin strengthening exercises for the flexor muscles of the forearm as recommended.
Begin arm motions of your sport or activity (eg, golf swings, tennis strokes, painting) as recommended.
The doctor may inject cortisone into the elbow near the medial epicondyle to reduce pain and inflammation.
Take these steps to reduce your risk of getting golfer's elbow:
RESOURCES:
American Academy of Orthopaedic Surgeons
http://www.aaos.org/
American Orthopaedic Society for Sports Medicine
http://www.aossm.org/
CANADIAN RESOURCES:
Canadian Orthopaedic Association
http://www.coa-aco.org/
Canadian Orthopaedic Foundation
http://www.canorth.org/
References:
American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org/ .
American Orthopaedic Society for Sports Medicine website. Available at: http://www.aossm.org/tabs/Index.aspx .
Assessment and treatment guidelines for elbow injuries. The Physician and Sportsmedicine . 1996;24:42.
Human Tendons . Human Kinetics; 1997.
Managing golf injuries. The Physician and Sportsmedicine . 1999;29:41.
Nicholas Institute of Sports Medicine and Athletic Trauma website. Available at: http://www.nismat.org/ .
Last reviewed November 2008 by John C. Keel, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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