The population of individuals that experience medial epicondylitis may find themselves in the clinic for a variety of reasons, with a round of golf potentially being one. Patients most commonly schedule an appointment with their doctor because of the pain and subsequently the inability to perform certain activities from that pain. Medial epicondylitis, or Golfer’s Elbow as most individuals know it, is a reflection of Lateral Epicondylitis (Tennis Elbow). Instead of the tendon issues on the lateral (outside) of the elbow, the pain emerges from the medial (inside) epicondyle. To locate the medial epicondyle, palpate the elbow’s bony protuberances until you feel the one on the middle of the elbow. This is also where the “Funny Bone” resides, and where you can excite the ulnar nerve upon impact. This tendon injury affects many populations rather than just the golfing community, but the pain should not inhibit you from performing your routine.
This injury occurs commonly in the dominant arm and wrist. The tendon and muscle whose integrity is in question are the Flexor Carpi Radialis (FCR) and its tendon. Much of the impairment to its tendon has recognizable origins. Some of the causes include:
- Playing racket sports – the grip alone can cause stress and compression to the wrist flexors and tendon
- Ulnar Neuropoathy – the ulnar nerve sits between the medial epicondyle and the olecranon (tip of the elbow), which exposes it to possible trauma and compression. This impact can result in medial Golfer’s Elbow
- Improper weight training form – the overuse to the FCR can result in this tendonitis
- Trauma – less common, however just as important a consideration in this injury
Signs and Symptoms
- Sharp or dull pain over the medial epicondyle
- Weakness in the wrist, particularly when grasping items
- Pain worsens when you grasp items
- Decreased range of motion in the elbow
The elbow’s bony constituents are the humerus (upper arm bone), radius and ulna (forearm bones). On the humerus, two main bumps protrude called the epicondyles. The medial epicondyle is the main site of concern in Golfer’s Elbow. Along with the main bones, there are muscles, ligaments, and tendons, and nerves that envelop the joint. One of the main nerves in Medial Epicondylitis is the ulnar nerve, which is also referred to as the “Funny Bone.” As stated previously, the FCR and its tendon contribute most to the pain in Golfer’s Elbow. This particular muscle engages during wrist flexion, and contributes to the pain when flexion is exacerbated or resisted.
If you want a more in-depth anatomy of the elbow, check out this video.
How Can You Treat Some of the Symptoms?
Some of the remedies to abate the symptoms are readily available in your very own household. Medical professionals everywhere encourage patients to implement the RICE method. Rice stands for:
- Rest – Limit or completely stop the activity that aggravates the pain, such as playing racket sports or working in a field that relies heavily on grip strength.
- Ice – Without putting ice directly on the skin, apply a cold pack for approximately 20 minutes (your physical therapist may recommend heat dependent on your individual circumstances; we ask you are cognizant of this).
- Compression – Compress with a bandage or a specialized brace (and direction from a professional). This brace wraps around the forearm below the elbow to reduce the stress on the tendon.
- Elevate – This does not always apply to the elbow. When resting/icing/stimulating, keep the elbow in a neutral position.
NSAIDS, or non-steroidal anti-inflammatory drugs such as ibuprofen, can also provide short-term pain relief. We encourage you to receive an assessment from the physical therapist if the pain continues or increases in intensity. Other drugs that your doctor may prescribe under close watch and guidance include:
- Muscle relaxers
- Various others; please consult your primary physician
There are several other treatment methods that are potentially beneficial to the individual:
- Physical Therapy: They provide a thorough evaluation, dictate an exercise and stretching plan, and use modalities such as Electrical Stimulation and Ultrasound to decrease the pain. They can also professionally apply the Kinesio Tape and focus on your form and how it relates to your injury.
- Steroid injections: This is usually done by a specialized spine doctor. They inject the area with an anti-inflammatory medication that can help treat and limit the pain.
- Surgery: Consult with your Physical Therapist and Primary Physician about this route.
Mid-County Physical Therapy Can Help You
During your one-on-one evaluation with the skilled therapist at Mid-County Physical Therapy, they will get to know you and your physical habits to help establish a foundation for your treatment. They will monitor and document your range of motion, techniques, and current pain-level to get a better idea of what they can do for your improvement. Before you receive treatment, it can also be beneficial to document some things such as:
- What movements cause it?
- When does it begin during activity?
- How long does it last?
- Have your home remedies stopped working?
- Do you want to maintain or improve your current fitness level?
- What are your goals?
Keeping track of this information can be essential for both you and your physical therapist.
Mid-County Physical Therapy also offers a wide variety of treatments to treat and heal your pain. Your condition could improve with a strengthening plan, which the therapist constructs based off of your individual experience. The clinic’s open-plan gym includes equipment to suit your strengthening needs while our therapists and technicians monitor to encourage proper form and maximum pain relief.
If the therapist determines you may need technique retraining, they will create a personal plan to work individually with you on form and techniques. Our clinic is also proud to offer dry-needling, kinesio taping, and even the BioQPulse. Call or contact us today to learn more about our treatment plans.