Medial Epicondylitis (Golfer’s Elbow)

Medial Epicondylitis or “Golfer’s Elbow” isn’t just an injury you can get from swinging golf clubs.

This tendon injury plagues athletes across sports and occupations; anything involving repetitive wrist motions and gripping with an overworked tendon desperate for rest and rehabilitation underneath it all.

As the forearm flexor muscles travel toward the medial elbow, their tendon anchors into a bony bump called the medial epicondyle.

Microscopic tears develop in this tendon from excessive loading and medial epicondylitis is the resulting condition with pain and inflammation.

Physiotherapy can have you back in action within a few weeks, and a few sporting technique adjustments can help it from reoccurring.

Symptoms of Medial Epicondylitis

• Pain on the inside of the elbow, potentially radiating down the forearm.
• Inability to swing, throw, or use familiar arm movements.
• Tenderness pressing into the medial epicondyle.
• Elbow stiffness, especially with gripping or wrist flexion.
• Visible swelling or warmth along the inner elbow region.
• Weakness when giving a firm handshake or gripping firmly.

Causes of Medial Epicondylitis

The root cause is a cumulative overloading of the medial tendon, typically from repetitive occupational stresses or athletic demands involving:

Club and Racket Sports

Gripping and grasping racket sports like tennis have heavy topspin strokes that torque the forearm into pronation—the motion of turning the palm downward. Even footballers can get medial epicondylitis from throwing the ball.

Similarly, golf swings stress the medial flexor tendons, and fitness occupations requiring gripping, like weightlifting, increase the strain through the tendons.

Repetitive Wrist Motions

Repetitive wrist flexion—that bending motion that points your hand towards the floor. This can stress the forearm flexor muscles and tendons, placing excessive loads that surpass the tissues’ recovery capabilities.

Impact injuries

A blunt force impact to the inner elbow region – such as a ball hitting you on the arm – can potentially initiate or exacerbate golfer’s elbow symptoms.

The violent jolt from a fall or collision can stretch and strain the forearm flexor muscles and tendons beyond their typical functional limits.

Basketball players may take an inadvertent elbow while fighting for rebounding positions, while martial artists risk strikes sheering into the elbow complex.

If You Think You Have Symptoms…

• Stop the activity causing your elbow pain or find an alternative way of performing it. If the pain persists, stop.
• Apply ice packs to your elbow for 20 minutes three times daily and see if there is any improvement after 24 hours.
• Use topical ibuprofen or Deep Heat to manage pain.
• If you play a sport involving repeated arm movements, such as golf or tennis, get professional advice about your technique to prevent further straining your elbow.

Diagnosis for Medial Epicondylitis

Your physiotherapist will start with a detailed history of symptoms, examine what activities that aggravate or ease the pain, and any previous injuries. They’ll want to know your job demands and sporting pursuits to identify repetitive tendon stressors.

Palpation over the medial elbow can assess for tenderness, warmth and swelling indicative of an inflamed tendon. Grip strength tests monitor any weakness in the affected forearm flexors. Resisted wrist flexion or forearm pronation against their hand pressure reproduces pain through the strained muscle-tendon unit.

In complex cases, where a tear or more serious injury is suspected, ultrasound or MRI imaging can visualise the tendon integrity more precisely which is particularly helpful for diagnosing professional athletes.

However, most medial epicondylitis cases are clinically diagnosed via the examination alone, with no requirement for imaging.

Treatment

The first line of treatment involves offloading the aggravated tendon through activity modification and ergonomic adjustments. Your physiotherapist will educate you on modifying movements and postures that strain the elbow.

Adjustments to technique, equipment sizing, and muscle conditioning can help you avoid pain while recovering.

Targeted massage over and around the flexor tendon relaxes taut muscle fibres, releases myofascial restrictions, and prepares the tendon and surrounding tissue for movement.

Gentle oscillatory movements applied to the elbow and wrist joints improve mobility and reduce compressive tendon loading. Restoring natural joint movement primes the tendon to handle heavier rehab.

Targeted treatments then accelerate recovery from there:

• Ice packs reduce local inflammation in acute flare-ups.
• Soft tissue massage over the forearm flexors and tendons improves blood flow while combating soft tissue restrictions and spasms.
• Eccentric loading exercises apply a controlled, lengthening load through the tendon to increase strength.
• Taping and bracing the elbow with strapping can redistribute tendon forces and inhibit excessive wrist flexion.
• Stretching addresses any mobility deficits in surrounding structures that disrupt normal joint mechanics.
• Forearm strengthening phases in isometrics, isotonic, and eventually plyometrics to systematically restore power and endurance.

Recovery Timeline for Medial Epicondylitis

With appropriate offloading from aggravating activities and regular progressive physiotherapy, most golfer’s elbow cases improve within 6-8 weeks.

However, injury severity, individual healing capacity, and compliance with recovery schedules can affect recovery length.

Most of the time:

• Mild cases may only require 3-4 weeks of focused elbow rehab.
• Cases with significant tendon degeneration can take 3-6 months.
• Full return to demanding occupations or sports is usually 12-16 weeks.

Patience through each rehab stage is critical. Rushing can easily re-inflame the tendon and set recovery back. Your physiotherapist will guide you gradually by safely reintroducing load to return your elbow to normality.

Summing Up

Medial epicondylitis may seem severe and unresolvable when that nagging pain and stiffness prevents you from gripping, lifting, or performing the activities you love. However, it’s important to remember that this injury is very treatable, and recovery can come sooner than you think, frequently within just a few weeks with the proper care and rehabilitation.

A physiotherapy programme building flexibility, strength, and proper movement patterns can systematically restore full, pain-free function.

Contact us to discuss physiotherapy for golfer’s elbow and injury prevention strategies that’ll help you perform at your best.