Medial epicondylitis, commonly known as Golfer’s Elbow, is a condition causing irritation and pain on the inner side of the elbow. This discomfort arises from strain in the forearm tendons that attach to the arm bone at this location. Although the name suggests a link to golf, this condition is frequent among athletes and individuals whose activities involve repetitive wrist and finger actions, like gripping or swinging.
Understanding Medial Epicondylitis
The condition involves the flexor and pronator muscle group of the forearm, where their tendons connect to the bony prominence on the inside of the elbow, called the medial epicondyle. Repeated, forceful use of the wrist, such as constant gripping or twisting motions, creates excessive tension on this tendon attachment point.
This repetitive stress causes microscopic tears and structural changes within the tendon tissue, leading to a degenerative state often termed tendinosis, rather than a purely inflammatory issue. Symptoms typically include a localized aching pain on the inner elbow that can radiate down the forearm toward the wrist. Patients often report increased pain when bending the wrist against resistance, weakened grip strength, and sometimes stiffness or numbness that may extend into the hand.
Immediate Pain Relief Strategies
The initial approach focuses on reducing strain and calming the irritated tissues. Activity modification means temporarily avoiding or greatly reducing the specific movements that trigger elbow pain, like heavy lifting or forceful gripping. Applying cold therapy, such as an ice pack, to the painful area for about ten minutes several times a day can help soothe local discomfort.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to manage pain in the short term. The use of a counterforce brace or an elbow strap positioned just below the elbow joint can also be beneficial. This device works by compressing the forearm muscles, which shifts the tension away from the damaged tendon attachment, offering immediate relief during daily activities.
Structured Rehabilitation and Strengthening
Once the initial acute pain subsides, a structured, progressive physical activity program is necessary for long-term healing and strengthening. This active recovery begins with gentle stretching to improve the flexibility of the wrist flexor muscles. A common stretch involves extending the affected arm straight out with the palm facing down. Use the opposite hand to gently pull the fingers back toward the body until a light stretch is felt along the inner forearm, holding for up to 30 seconds.
The next step involves gradual strengthening, with eccentric exercises being particularly effective for tendon repair. Eccentric training involves lengthening the muscle under tension, which stimulates positive adaptations in the affected tendon tissue. An example is an eccentric wrist flexion exercise: rest the forearm palm-up on a table with the hand hanging over the edge, holding a very light weight.
The movement involves using the unaffected hand to lift the weight up into wrist flexion. Then, slowly lower the weight back down using only the affected arm over a count of four to five seconds. This slow, controlled lowering is the eccentric phase that loads the tendon. Repeat this for three sets of ten to fifteen repetitions, maintaining low weight and high repetition. Stop immediately if the exercise causes sharp or increasing pain.
Preventing Recurrence and Seeking Professional Help
Long-term recovery requires integrating preventative strategies into regular activities to protect the healing tendon. Before engaging in sports or strenuous work, perform a proper warm-up routine that includes dynamic stretching of the forearm muscles. Reviewing the technique used in repetitive tasks, such as a golf swing or throwing motion, is also important to ensure correct biomechanics are not overstressing the elbow.
Equipment changes, like ensuring a correct golf grip size or using lighter tools, can significantly reduce the load on the flexor tendons. If self-care measures do not provide significant relief within four to six weeks, professional medical advice is necessary. Immediate attention is required if there is severe swelling, a fever, an inability to bend the elbow, or persistent numbness or weakness in the hand. A physician may recommend specialized treatments:
- Physical therapy referral.
- Corticosteroid injections for short-term pain relief.
- Platelet-rich plasma (PRP) injections to promote healing.