Golfer’s Elbow Explained: The Must-Know Guide to Diagnosis, Treatment & Recovery

What is Golfer’s Elbow?

Medial epicondylitis, also called “golfer’s elbow” or “pitcher’s elbow”, is a type of chronic tendonitis, called tendinosis, of a group of forearm muscles. This group of muscles are called the flexor-pronator group, because they are responsible for flexing the wrist and turning the palm downwards (pronation). These muscles are all attached through a conjoined tendon to the inside of the humerus (arm) bone (to the medial epicondyle). The tendon develops microtears from repeated valgus (outside to inside) force, or gripping or throwing actions, often due to poor technique or improperly fitted equipment. These microtears cannot heal properly because the healing is impaired by continuing to do the movements that caused the tears initially.

People participating in activities with lots of throwing, gripping, or repeated flexion-pronation, such tennis and golf, have an increased risk of developing medial epicondylitis.

Patients with medial epicondylitis often feel pain that travels from their elbow to their forearm and wrist. There may also be some numbness or tingling at the outside palm and through 4th and 5th fingers; this is because the ulnar nerve is very close to where the affected tendon is. The area over the tendon may be swollen and is often tender to the touch. The athlete also may experience decreased grip strength and weak forearm pronation or flexion against resistance.

How is Golfer’s Elbow Diagnosed?

The range of motion and strength of the muscles in the arm and forearm are assessed to determine which muscles are affected. The conjoined tendon at the inner elbow is also palpated to feel any structural differences compared to the unaffected side. Occasionally, a physician may request imaging to further examine the tendon and the stage of the tendinosis if the symptoms are progressively worsening, even with treatment.

How is Golfer’s Elbow Typically Treated?

Treatment for medial epicondylitis begins with rest and modifying daily activities to break the cycle of continuous inflammation. Electrical modalities, such as LASER, can help decrease the inflammation and progress healing. A counterforce strap or a night splint can be worn to provide additional support to the healing tendon. As the microtears heal and inflammation decreases, exercises are started to gradually restore full range of motion and strengthen the muscles. Muscle strengthening is crucial when treating epicondylitis because it stabilizes the joint and helps to prevent the microtears from forming again. However, addressing the original cause of the injury is the best preventative method.

Best Treatment Options for Golfer’s Elbow

Seeking professional care from a physiotherapist or athletic therapist can greatly improve recovery outcomes for golfer’s elbow. Physiotherapists and athletic therapists create individualized treatment plans that may include:

• Manual Therapy: Hands-on techniques such as soft tissue release, joint mobilization, and myofascial release can help reduce tension and improve mobility in the forearm and elbow.
• Exercise Therapy: Progressive strengthening exercises targeting the flexor-pronator muscles, wrist, and forearm help rebuild strength and prevent recurrence.
• Dry Needling or Acupuncture: In some cases, these techniques may help reduce muscle tightness and promote blood flow to the affected tendon.
• Ergonomic and Technique Correction: Identifying and modifying improper technique in sports or work-related activities is crucial in preventing re-injury.
• Bracing and Taping: A counterforce brace or kinesiology taping can help offload stress on the affected tendon and support movement during daily activities.

A comprehensive approach combining these treatments can significantly accelerate recovery and improve function.

When can I return to my normal activities?

Return to normal levels of activity can typically begin once repeated movements of the wrist and elbow can be fully performed without pain. This timeline depends on several factors, including the stage of tendinosis, individual physiology, and lifestyle habits. It is important to remember that every person heals differently, so following your medical advice carefully is critical for a safe and effective injury rehabilitation.

Written by Madelene Scola, Hons. BA. Kin.; CAT(C)