Medial epicondylitis, commonly known as golfer’s elbow, is similar to lateral epicondylitis (“tennis elbow”). It is typically a problem that develops over time rather than one that occurs after a specific event. Like lateral epicondylitis, which causes pain on the outside of the elbow, medial epicondylitis causes pain on the inside of the elbow. It is typically most painful just past the bony process on the inside of the elbow. It is less common in my experience than lateral epicondylitis, but it can be seen in throwing athletes and golfers.
Signs and symptoms of golfer’s elbow
Athletes or active people with medial epicondylitis will complain of pain on the inside of the elbow with specific athletic activities, especially those that involve flexing the wrist or pronating the forearm. Occasionally they develop pain in this area with activities of daily living. A sports medicine physician will usually be able to recreate the symptoms by having the athlete flex the wrist or pronate the forearm against resistance. Also the location of tenderness, just distal to the medial epicondyle, is characteristic. X-rays are usually unremarkable. An MRI can be used to evaluate the integrity of the flexor-pronator tendon and to rule out other causes of medial elbow pain.
Treatment of golfer’s elbow
Like lateral epicondylitis, treatment is almost always nonsurgical. Rest and avoiding offending activities are usually the first treatments. After that, use of a counterforce strap, anti-inflammatory medications, ice, and physical therapy are among the treatment options. Cortisone is infrequently used, as there is a concern about the effects of cortisone on a tendon. Also this problem is very close to the ulnar nerve, so the physician is often concerned about an injection in this area. Occasionally surgery to debride a small part of the diseased tendon and to repair the tendon primarily can be attempted if conservative treatments do not relieve pain. Platelet Rich Plasma treatments.
Return to sports and exercise
Return to sports or athletic activities depends on the treatment needed. Usually return to activities is started when symptoms improve with nonsurgical treatment. Initially limiting stress on the tendon is warranted. If surgery is needed, it can often take 6-12 weeks to return to the activities that place a lot of stress on the elbow. Fortunately return to sports is likely if the medial epicondylitis resolves.
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