Golfer’s Elbow (Medial Epicondylitis)
What is medial epicondylitis? Medial epicondylitis (or golfer’s elbow) is a common condition affecting the medial (or inside) aspect of the elbow where the flexor/pronator muscles originate, although much less common than lateral epicondylitis. This condition causes medial elbow and forearm pain, especially resisted forearm pronation or wrist flexion.
http://en.wikipedia.org/wiki/File:Gray414.png
What causes medial epicondylitis? A distinct cause has not been clearly defined.
What are the treatments for medial epicondylitis? Much controversy in treatment exists.
- Nonsurgical options: include NSAIDS, physical therapy, modalities such as ultrasound, extracorporeal shock wave therapy (ESWT), stretching, bracing, steroid injections, botulinum toxin and platlet-rich-plasma (PRP) injections. PRP injections have not been adequately studied for this condition.
- Surgical options: Multiple surgical procedures have been proposed for this condition, from percutaneous release to open epicondylectomy, all of which have not been adequately studied and have associated risks.
Recommendations:
Based on several years of successful experience in treating this condition by the senior author (RJS), the current research, and our desire for a minimalist, nonsurgical approach to this condition, we recommend the following two things:
- DO NOT RUB THE INSIDE OF YOUR ELBOW (Medial Epicondyle): Rubbing it or massaging it seems to make it worse despite what therapists recommend.
- MOST IMPORTANT: PERFORM THE FOLLOWING STRETCH EVERY HOUR WHILE AWAKE FOR THE COUNT OF 5 SECONDS. This stretches the flexor/pronator tendons to help alleviate the symptoms. Your elbow fully extended (straight), and wrist fully extended, fingers pointing toward the ceiling, while pulling on your fingers with your other hand, then again with your wrist fully flexed, fingers pointed towards the floor, while pulling on your fingers.
Authors: Patrick R. Olson, MD and Robert J. Strauch MD
