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Medial Epicondylitis

(Golfer's Elbow)

Definition

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.
Medial Epicondylitis
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Causes

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:

Risk Factors

Factors that may increase your chance of medial epicondylitis include:

Symptoms

Symptoms include:

Diagnosis

The doctor will ask about your symptoms, medical history, 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. However, an x-ray may be needed if the doctor suspects other problems.
An MRI scan is occasionally used for diagnosis, but there is only limited evidence supporting this use.

Treatment

Treatment includes:

Rest

Do not do activities that cause pain. Do not play sports, especially golf and tennis, until the pain is gone. You may need to alter how you do certain activities.

Cold

Regular ice application may help decrease some discomfort and swelling.

Medication

The following drugs can help to reduce inflammation and pain:
  • Nonsteroid anti-inflammatory drugs (NSAIDs)
  • Acetaminophen
  • Topical pain relievers that are applied to the skin
If you still have tenderness in the elbow while taking these drugs, do not return to physical activity. Check with your doctor.

Compression

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.

Heat

Apply heat to the elbow only when you are returning to physical activity. Then use it before stretching or getting ready to play sports.

Stretching

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 6 times.

Strengthening

Begin strengthening exercises for the flexor muscles of the forearm as recommended.

Gradual Return to Your Sport

Begin arm motions of your sport or activity (such as golf swings, tennis strokes, painting) as recommended.

Cortisone Injection

The doctor may inject cortisone into the elbow near the medial epicondyle to reduce pain and inflammation.

Prevention

To help reduce your chance of medial epicondylitis:

RESOURCES

Ortho Info— American Academy of Orthopaedic Surgeons http://www.orthoinfo.org

Sports Med—American Orthopaedic Society for Sports Medicine http://www.sportsmed.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org

Canadian Orthopaedic Foundation http://www.canorth.org

References

Chumbley EM, O'Connor FG. Evaluation of overuse elbow injuries. Am Fam Physician. 2000;61(3):691-700.

Golf injury prevention. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00137. Updated August 2011. Accessed December 17, 2014.

JoĢzsa LG, Kannus P. Human tendons. Human Kinetics; 1997.

Medial epicondylitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 20, 2014. Accessed December 17, 2014.

Metz JP. Managing golf injuries: Technique and equipment changes that aid treatment. Phys Sportsmed. 1999;27(7):41-56.

Overuse injuries. American Orthopaedic Society for Sports Medicine website. Available at: http://www.sportsmed.org/downloads/tips/AOSSM%5FOveruse%20Injuries.pdf. Accessed December 17, 2014.

Petersen B, Rovati S. Diclofenac epolamine (Flector) patch: Evidence for topical activity. Clin Drug Investig. 2009;29(1):1-9.

Shiri R, Viikari-Juntura E. Lateral and medial epicondylitis: Role of occupational factors. Best Pract Res Clin Rheumatol. 2011;25(1):43-57.

10/26/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Massey T, Derry S, et al. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

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