Golfer’s elbow or thrower’s elbow (medial epicondylitis) is a condition that develops when the tendons on the inside of the forearm become irritated, inflamed, and painful due to repetitive use of the hand, wrist, forearm and elbow especially those that play sports. Even using a computer or performing yard work can cause the condition. It is most common in men over the age of 35. At Progressive Physical Therapy we have advanced training to help decrease the pain and improve the affected elbow’s motion, strength, and function.
What is golfer’s elbow?
Medial epicondylitis is a condition that occurs when the tendons on the inside of the forearm become irritated, inflamed, and painful due to repetitive use of the hand, wrist, and forearm. A tendon is a soft tissue that attaches a muscle to a bone. The group of muscles affected by medial epicondylitis are those that function to flex (bend) the wrist, fingers, and thumb and pronate (rotate palm-down) the wrist and forearm. The muscle group comes together into a common sheath and attaches to the humerus bone of the upper arm. This bony prominence, called the medial epicondyle, is located along the inside of the elbow. Pain occurs on or near the medial epicondyle, at the area where the tendon connects to the bone. Repetitive forces can cause the tendon to become tender and irritated, and without treatment, can cause it to even tear away from the bone. In addition, as the muscle groups travel across both the elbow and the wrist, they function to stabilize at the elbow allowing for wrist movement. As this is a 2-joint tendon, it is more vulnerable to injury.
Persons with medial epicondylitis may experience:
- Pain along the inside of the forearm with wrist, hand, or elbow movements.
- Pain or numbness and tingling that radiates from the inside of the elbow down into the hand and fingers, with gripping or squeezing movements.
- Tenderness to touch and swelling along the inside of the forearm.
- Weakness in the hand and forearm when attempting to grip objects.
- Elbow stiffness.
How can a physical therapist help?
It is important to get proper treatment for medial epicondylitis as soon as it occurs, as tendons do not have a good blood supply. An inflamed tendon that is not treated can begin to tear, causing a more serious condition.
When a diagnosis of medial epicondylitis is made, our expert physical therapists at Progressive Physical therapy will devise a treatment plan that is specific to your condition and goals. Your individual treatment program may include:
Pain Management. Your physical therapist will help you identify and avoid painful movements to allow the inflamed tendon to heal. Ice, ice massage, or moist heat may be used for pain management. Therapeutic modalities, such as iontophoresis (medication delivered through an electrically charged patch), and ultrasound may be applied. Bracing or splinting may also be prescribed. In severe cases, it may be necessary to rest the elbow and not perform work or sport activities that continue causing pain, which may slow the recovery process.
Manual Therapy. Your physical therapist may use manual techniques, such as gentle joint movements, soft-tissue massage, and elbow, forearm, and wrist stretches to help the muscles regain full movement. Your therapist may also do manual stretching and manual techniques to your shoulder and thoracic spine, as your tendons along the medial elbow can be affected by muscle imbalances all the way up the chain.
Range-of-Motion Exercises. You will learn mobility exercises and self-stretches to help your elbow and wrist maintain proper movement.
Strengthening Exercises. Your physical therapist will determine which strengthening exercises are right for you, depending on your specific condition, as your pain subsides. You may use weights, medicine balls, resistance bands, and other types of resistance training to challenge your weaker muscles. You will receive a home-exercise program to maintain your arm, forearm, elbow, and hand strength long after you have completed your formal physical therapy.
Patient Education. Education is an important part of rehabilitation. Your physical therapist may suggest adjustments to how you perform various tasks, and make suggestions to improve your form and reduce any chance of injury. Adjustments made in your golf swing, throwing techniques, or work tasks can help reduce pressure placed on the tendons in the forearm region.
Functional Training. As your symptoms improve, your physical therapist will help you return to your previous level of function. Functional training will include modifications in specific movement patterns, promoting less stress on the medial tendons. As mentioned previously in patient education, you and your physical therapist will decide what your goals are, and safely get you back to your prior performance levels as soon as possible.