Sports and musculoskeletal physician Dr Ralph Rogers continues our series on therapeutic exercises with a guide to medial epicondylitis
Golfer's elbow is less common than tennis elbow – which is diagnosed around seven times more often – but is still often seen in primary care. Golfer's elbow is not restricted to golfers, but the golf swing is a common cause – as are many other sporting activities such as throwing a ball and weightlifting. There are also occupational causes like carpentry, plumbing and meat cutting. Pain is felt on the inside of the elbow – the medial epicondyle – which can be aggravated by movements involving lifting when the palm is upwards. The condition is an overuse injury of the common flexor tendon that attaches to the medial epicondyle.
The diagnosis is made by clinical signs and symptoms. There is normally point tenderness over the inside of the elbow and pain in the forearm is not unusual.
Physiotherapy along with analgesia is the first line of treatment. The literature also suggests that exercises to strengthen and stretch the muscles attached to the injured tendon will help with the healing process.1
Squeezing a tennis ball for five minutes is an effective exercise that strengthens forearm muscles. Finger flexor stretches are described in the box below, as well as in the accompanying video and patient information leaflet. Patients bring the affected arm out straight, palm up, and use the other hand to push the palm down. This creates a stretch on the inside of the forearm.
Exercises should be repeated five times, three times a day.
Dr Ralph Rogers is a sports and musculoskeletal physician at the London Orthopaedic Clinic
The London Orthopaedic Clinic holds free monthly education sessions for GPs. For more information: www.londonorthopaedic.com.
Patient leaflet for golfer's elbow Patient leaflet for golfer's elbow Patient leaflet for golfer's elbow Patient leaflet for golfer's elbow