Golfer's Elbow: Causes, Symptoms & Treatment
Golfer's elbow is a painful overuse condition affecting the tendon attachments on the inner side of the elbow, often caused by repetitive arm movements.
Things worth knowing about "Golfer's elbow"
Golfer's elbow is a painful overuse condition affecting the tendon attachments on the inner side of the elbow, often caused by repetitive arm movements.
What is Golfer's Elbow?
Golfer's elbow (medically known as medial epicondylitis or epicondylitis humeri ulnaris) is a painful condition caused by irritation or inflammation of the tendon attachments on the inner side of the elbow. The muscles and tendons responsible for flexing the wrist and fingers are primarily affected. Despite its name, golfer's elbow can affect anyone who regularly performs repetitive arm and wrist movements, not just golfers.
Causes
Golfer's elbow typically develops due to overuse of the forearm muscles. Contributing factors include:
- Repetitive gripping, flexing, or rotating movements of the wrist and forearm
- Sports activities such as golf, tennis, baseball, or rock climbing
- Occupational tasks such as typing, writing, carpentry, or using hand tools
- Sudden overexertion from unaccustomed physical activity
- Muscle weakness or poor movement mechanics
Symptoms
The typical symptoms of golfer's elbow include:
- Pain on the inner side of the elbow, which may radiate down the forearm
- Tenderness when pressing on the medial epicondyle (the bony prominence on the inside of the elbow)
- Increased pain when flexing the wrist or gripping objects
- Stiffness and weakness in the forearm, especially in the morning
- Tingling or numbness in the fingers (particularly the ring and little fingers) if the ulnar nerve is involved
Diagnosis
The diagnosis of golfer's elbow is usually made clinically. The doctor will first take a detailed medical history and then perform a physical examination. Key diagnostic steps include:
- Medical history: Reviewing the patient's activities, symptoms, and their progression
- Palpation test: Pressing on the medial epicondyle to check for tenderness
- Provocation tests: Such as the wrist flexion test or forearm pronation test
- Imaging: Ultrasound or MRI may be used to visualize tendon changes or associated injuries when the diagnosis is unclear
Treatment
Conservative Treatment
In most cases, golfer's elbow heals with conservative measures:
- Rest and activity modification: Avoiding painful movements and reducing overload
- Cooling: Ice application for pain relief during the acute phase
- Physiotherapy: Stretching and strengthening exercises to stabilize the forearm muscles
- Orthoses and braces: Forearm straps or bands can help offload the tendon attachment
- Medications: Pain relievers or anti-inflammatory drugs (e.g., ibuprofen) may be used short-term
- Shockwave therapy: Extracorporeal shockwave therapy may be beneficial for persistent cases
- Corticosteroid injections: A targeted cortisone injection may be considered for severe pain
Surgical Treatment
If conservative treatments fail to provide sufficient relief after several months, surgery may be considered. The procedure involves removing damaged tendon tissue and reattaching the tendon. Surgery is rarely required.
Prevention
To prevent golfer's elbow, the following measures are recommended:
- Warming up thoroughly before sports activities
- Regularly strengthening and stretching the forearm muscles
- Setting up an ergonomic workspace
- Adapting training intensity and technique in sports
- Using appropriate sports equipment (e.g., correct grip size in golf)
References
- Shiri R, Viikari-Juntura E. - Lateral and medial epicondylitis: role of occupational factors. Best Practice & Research Clinical Rheumatology. 2011;25(1):43-57. PubMed PMID: 21663852.
- Svernlov B, Adolfsson L. - Non-operative treatment regime including eccentric training for lateral humeral epicondylalgia. Scandinavian Journal of Medicine & Science in Sports. 2001;11(6):328-334.
- World Health Organization (WHO): Musculoskeletal conditions - Overview and management strategies. WHO Technical Report, Geneva, 2021.
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