Medial epicondylitis, commonly known as Golfer’s Elbow, is a painful condition resulting from an overuse injury to the tendons on the inside of the elbow. This area, the medial epicondyle, is the attachment point for the forearm muscles responsible for bending the wrist and gripping. While the name suggests a link to golf, this injury affects anyone engaging in repetitive wrist flexion, forearm rotation, or forceful gripping, such as in racket sports, weightlifting, or various trades. Recovery requires a systematic approach that first manages acute pain before transitioning into a focused regimen to rebuild tendon strength.
Immediate Steps for Pain Relief and Rest
The most important first step is identifying and strictly avoiding the specific activities that provoke the pain, which allows the microscopic tears in the tendon to begin the healing process. Continuing to perform the aggravating motion will compound the existing damage, making recovery significantly longer.
Applying ice to the inner elbow for 15 to 20 minutes, three or four times daily, can help manage acute pain, especially within the first 72 hours of symptom flare-up. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may be used for short-term pain relief and to manage inflammation.
Wearing a counterforce brace or strap on the forearm, positioned one to two inches below the elbow, can provide compression and reduce the load transmitted to the tendon attachment. This compression strap works by changing the angle of pull on the muscle, effectively relieving tension at the painful tendon origin.
Targeted Stretching and Strengthening Regimens
Once the acute pain subsides, which may take several weeks, the focus must shift to active rehabilitation to promote long-term tendon healing and remodeling. Start with gentle, static stretching of the wrist flexor muscles, holding the stretch for 20 to 30 seconds and repeating it three times per session.
Eccentric strengthening involves slowly lengthening the muscle while it is under tension. To perform an eccentric wrist curl, sit with your forearm palm-up, resting on a table, and hold a very light dumbbell. Use your unaffected hand to lift the weight into a flexed position, then slowly lower the weight back down with the affected arm over a controlled count of three to five seconds. Begin with a weight low enough to perform three sets of 10 to 15 repetitions without experiencing sharp pain. Integrating grip strengthening exercises, such as squeezing a stress ball, also helps enhance overall forearm stability and endurance.
When to Seek Professional Medical Treatment
If the elbow pain persists for more than six to eight weeks despite consistent rest, activity modification, and home exercises, consult a healthcare provider. Seek immediate attention if you experience severe swelling, a hot or inflamed elbow accompanied by a fever, or an inability to fully bend or straighten the joint.
Numbness or tingling that radiates down the forearm and into the fingers, or a significant loss of grip strength, could also signal a more complex issue, such as nerve involvement. A therapist can provide personalized manual therapy and guide a progressive strengthening program when home exercises plateau.
For persistent cases, specialized treatments may be considered. Corticosteroid injections can offer rapid, short-term pain relief, but they are generally used sparingly due to concerns that they may weaken the tendon tissue over time. Newer options, like Platelet-Rich Plasma (PRP) therapy, involve injecting the patient’s own healing factors into the damaged area. Surgery is only considered in rare instances, typically after six to twelve months of failed non-surgical treatment, to remove damaged tissue and repair the tendon.
Strategies for Preventing Recurrence
Analyzing and correcting the technique used in repetitive activities is fundamental, whether it involves a golf swing, a racket stroke, or the way objects are lifted in daily life. Focusing on maintaining a stable and rigid wrist position when gripping or lifting reduces the harmful strain placed directly on the elbow tendons.
For athletes, ensuring that golf grips or racket handles are the correct size and not worn can significantly reduce the force required for a secure hold. Using lighter tools or upgrading to lighter-weight sporting equipment, such as graphite clubs, can lessen the impact transferred to the elbow joint.
A thorough warm-up and cool-down routine should be integrated into any activity involving the forearm. Before starting, a few minutes of light cardio followed by gentle stretching prepares the muscles and increases blood flow to the tendons. Continuing to perform the strengthening exercises, even after the pain has resolved, helps maintain tendon resilience and prevents the condition from returning.