Golfer’s Elbow (Medial Epicondylitis)

Golfer’s Elbow (Medial Epicondylitis)

Overuse injuries of the elbow are common and can result in pain and reduced tolerance for activity. Medial epicondylitis, or golfer’s elbow, is the most common cause of pain on the lateral aspect of the elbow. This area of the elbow is frequently injured by both athletes and workers who engage in repetitive forearm pronation/wrist flexion. 

Anatomy

During repetitive wrist pronation, the flexor-pronator mass on the forearm is activated and its proximal attachment at the medial epicondyle is repeatedly tugged. Inflammation and/or small tears of the tendon tissue result in pain.

Physical Examination and Work-up

On examination, pinpoint tenderness over the medial epicondyle and the flexor-pronator mass is often present. Pain is reproduced with resisted forearm pronation. X-rays assess for calcifications that may be seen adjacent to the medial epicondyle. MRI may demonstrate flexor tendon thickening or small tears, but it is often not necessary to make a diagnosis of medial epicondylitis. 

Treatment

Initial management of medial epicondylitis includes icing, activity modification, physical therapy, and a home exercise/stretching. The literature reports nonsurgical treatment occurs in 85 to 90% of cases.