Golfer's elbow

Golfer's elbow, or medial epicondylitis, is an inflammatory condition of the elbow in some ways similar to tennis elbow.

The anterior forearm contains several muscles that are involved with flexing the fingers and thumb, and flexing and pronating the wrist. The tendons of these muscle come together in a common tendinous sheath, which is inserted into the medial epicondyle of the humerus at the elbow joint. In response to minor injury, or sometimes for no obvious reason at all, this point of insertion becomes inflamed.

 
  

 

 


 
Causes

The condition is called Golfer's Elbow because in making a golf swing this tendon is stressed, especially if a non-overlapping (baseball style) grip is used; many people, however, who develop the condition have never handled a golf club. It is also sometimes called Pitcher's Elbow[1] due to the same tendon being stressed by the throwing of objects such as a baseball, but this usage is much less frequent. Other names are Climber's Elbow and Little League Elbow: All of the flexors of the fingers insert at the medial epichondyle, making this the most common elbow injury for rock climbers, whose sport is very grip intensive.


Treatment

Non-specific palliative treatments include:


Before anesthetics and steroids are used, conservative treatment with an occupational therapist is attempted. Before therapy can commence, treatment such as the common rest, ice, compression and elevation (R.I.C.E.) will typically be used. This will help to decrease the pain and inflammation. The rest will help with the discomfort seeing as how Golfer's Elbow is an overuse injury. The patient can use a tennis elbow splint for compression. A pad can be placed anteromedially on the proximal forearm.[2] The splint is made in 30–45 degrees of elbow flexion. A daytime elbow pad also may be useful, by limiting additional trauma to the nerve.

Therapy will include a variety of exercises for muscle/tendon reconditioning, starting with stretching and gradual strengthening of the flexor-pronator muscles. Strengthening will slowly begin with isometrics and progresses to eccentric exercises helping to extend the range of motion back to where it once was. After the strengthening exercises, it is common for the patient to ice the area.[2]

Simple analgesic medication has a place, as does more specific treatment with oral anti-inflammatory medications (NSAIDs). These will help control pain and any inflammation.[2] A more invasive treatment is the injection into and around the inflamed and tender area of a long-acting glucocorticoid (steroid) agent.[citation needed] After causing an initial exacerbation of symptoms lasting 24 to 48 hours, this may produce a resolution of the condition in some five to seven days.[citation needed]

Target injections are effective Golfer's Elbow.

If all else fails, epicondylar debridement (a surgery) may be effective.[citation needed] The ulnar nerve may also be decompressed surgically.[2]

The overall prognosis is good. Few patients will need to progress to steroid injection and even fewer, less than 10%, will need surgical intervention.[2]


See also


References

  1. ^ "Pitcher's Elbow - Stanford Sports Medicine - Stanford Medical Outpatient Center"Stanford University Medical Center. Retrieved 2009-09-09.
  2. a b c d e Gibbs, Sharon J. and Kenneth S. Dauber. "Medial Epicondylitis." eMedicine. 12 Aug. 2009. WebMD. 01 Dec. 2009 <http://emedicine.medscape.com/article/327860-overview>.
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