Medial epicondylitis or “golfer’s elbow”, is a painful tendinitis condition that causes discomfort along the inside of the elbow. The muscles that flex the wrist and fingers insert into a portion of the bone on the inside of the elbow called the “medial epicondyle”. Small tears of the muscle at its insertion site (the tendon) is a common cause of pain in the area that is experienced when lifting or grasping objects, or activities such as closing doors, throwing objects or swinging a golf club.
Common causes include overuse, or trauma to the forearm muscles, such sports (golfing, racket sports, throwing sports), weightlifting, or use of tools. It is more common in the dominant hand, and tends to occur in individuals between 30 and 60 years of age.
Medial epicondylitis can be diagnosed by talking with your doctor and having them examine your elbow. There is often pain when pushing on the “medial epicondyle”, and when resisting wrist or finger flexion, or when pronating the forearm (turning the palm towards the floor). Sometime the inflammation may irritate the nearly ulnar nerve, which can cause tingling or pain in the small and ring finger, and weakness in the hand muscles.
Activity modification – avoid aggravating activities
Anti-inflammatories (if medically safe)
Diclofenac gel (Voltaren or Pennsaid)
Oral over-the-counter NSAIDs (ibuprofen or naproxen)
Therapy to stretch the forearm muscles
Steroid injection into site of pain and inflammation
Treatment for golfers
Stretch before playing and warm up appropriately
Avoid overuse and over-swinging
Ice after use
Focusing on strengthening back (latissimus dorsi) and chest (pectoralis) muscles
Weakness in chest and back muscles can alter posture and swing mechanics, thereby producing excessive stress on the elbow
Eccentric stretching of forearm muscles
Graphite shafts – more flexible and absorb shocks better than steel shafts
Cavity backed irons (larger sweet spot) dampen vibrations transmitted through forearm to elbow
Woods and hybrids produce less resistance and reverberations at impact
Surgery is rarely required, as the condition tends to improve with time
If over 6 months have passed, one may consider surgically repairing the torn muscle/tendon back to the bone. Oftentimes an MRI is first performed to evaluate the extent and location of the injury
Dr. Schreiber is a board certified orthopedic surgeon specializing in hand, wrist, and elbow conditions. Dr. Schreiber practices at the Raleigh Orthopaedic Clinic in Raleigh, North Carolina.