Golfer’s elbow — also known as medial epicondylitis — is pain and inflammation on the inner side of the elbow, where the tendons of the forearm muscles attach to the bony bump on the inside of the elbow (medial epicondyle). The pain may spread into your forearm and wrist. Golfer’s elbow is similar to tennis elbow. But it occurs on the inside — rather than the outside — of the elbow. And it’s not limited to golfers. Tennis players and others who repeatedly use their wrists or clench their fingers can develop golfer’s elbow. The pain of golfer’s elbow doesn’t have to keep you off the course or away from your favourite activities. With rest and appropriate treatment, you can get back into the swing of things.
Signs and symptoms
Golfer’s elbow is characterized by pain and tenderness on the inner side of the elbow. Sometimes the pain extends along the inner side of the forearm. Your elbow may feel stiff, and it may hurt to make a fist. You may have weakness in your hands and wrists.
The pain of golfer’s elbow may appear suddenly or gradually. The pain may get worse when you:
- Swing a golf club or racket
- Squeeze or pitch a ball
- Shake hands
- Turn a doorknob
- Pick up something with your palm down
- Flex your wrist toward your forearm
Causes
Golfer’s elbow is caused by damage to the muscles and tendons that control the wrist and fingers. The damage is typically related to excess or repetitive stress — especially forceful wrist and finger motions. Sometimes golfer’s elbow begins after a sudden force to the elbow or wrist.
Many activities can lead to golfer’s elbow, including:
- Golf. Gripping or swinging the clubs incorrectly can take a toll on your muscles and tendons.
- Racket sports. Excessive topspin can hurt your elbow. Using a racket that’s too small, heavy or tightly strung also can lead to injury.
- Throwing sports. Improper pitching technique in baseball or softball can be another culprit.
- Other activities. Painting, raking, hammering, chopping wood, typing and other repetitive wrist, hand or arm movements can result in golfer’s elbow as well.
Treatment
The sooner you begin treatment, the sooner you’ll be able to return to your usual activities.
- Rest. Put your golf game or other repetitive activities on hold until the pain is gone. If you return to the links too soon, you may only make it worse.
- Ice the affected area. Apply ice packs to your elbow for 15 to 20 minutes at a time, four times a day for several days. To protect your skin, wrap the ice packs in a thin towel. It also may help to massage the inner elbow with ice for five minutes at a time, two to three times a day.
- Reduce the load on your elbow. Wrap your elbow with an elastic bandage or use a forearm strap.
- Take an over-the-counter pain reliever. Try ibuprofen (Advil, Motrin, others), naproxen (Aleve), acetaminophen (Tylenol, others) or aspirin.
- Consider other medications. If over-the-counter pain relievers aren’t effective, your doctor may recommend a cortisone injection to reduce pain and swelling.
- Stretch and strengthen the affected area. Your doctor may suggest specific stretching and strengthening exercises. Physical or occupational therapy can be helpful, too.
- Gradually return to your usual activities. When you’re no longer in pain, practice the arm motions of your sport or activity. Review your golf or tennis swing with an instructor and make adjustments if needed.
- Ask your doctor when surgery is appropriate. Surgery is seldom necessary. But if your signs and symptoms don’t respond to conservative treatment, surgery may be an option.
- Depending on the severity of your condition, the pain may linger for several months — even if you take it easy and follow instructions to exercise your arm. Sometimes the pain returns or becomes chronic. While you’re recovering, remember the importance of rest. Sneaking in a round of golf before your elbow heals won’t help you feel better. It will only prolong your recovery.
Jonathan Smith
Director of Thorpes Physiotherapy