Golfer's Elbow (Medial Epicondylitis)

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KEY POINTS

• Golfer’s elbow is a problem with the tendons that connect the bony bump on the inside of your elbow to the muscles used to bend your wrist.
• You will need to change or stop doing the activities that cause pain until the tendon has healed.
• Treatment may include an elastic bandage around your elbow, or a strap just below the tender spot on your elbow, or a wrist brace to prevent bending of your fingers and wrist. Your healthcare provider may also recommend stretching and strengthening exercises and medicine. In severe cases, you may need surgery.
• Wearing an elbow strap and doing warm-up exercises and stretching before activities may help prevent this problem.

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What is golfer's elbow?

Golfer’s elbow is a problem with the tendons that connect the bony bump on the inside of your elbow to the muscles used to bend your wrist. Tendons are strong bands of tissue that connect muscle to bone.

Tendons can be injured suddenly or they may be slowly damaged over time. You can have tiny or partial tears in your tendon. If you have a complete tear of your tendon, it is called a rupture. Golfer’s elbow is also called medial epicondylitis, tendinosis, wrist flexor tendinopathy or elbow tendinopathy.

What is the cause?

Golfer's elbow is usually caused by overuse of the tendons and muscles that you use to bend your fingers and wrist. This commonly happens if you play golf, throwing sports, and racquet sports. It may also happen with some work activities like carpentry or typing. Golfer's elbow can also be caused by a sudden injury that twists or tears your tendon.

What are the symptoms?

Symptoms may include:

• Pain along the entire inner side of your forearm when you bend your wrist
• Pain when you make a fist or roll your wrist

How is it diagnosed?

Your healthcare provider will examine you and ask about your symptoms, activities, and medical history. Tests may include:

• X-rays
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of your elbow area

How is it treated?

You will need to change or stop doing the activities that cause pain until the tendon has healed. For example, you could walk instead of play golf, or write things out by hand instead of typing.

Your provider may recommend putting an elastic bandage around your elbow, or a strap just below the tender spot on your elbow, to help support and protect your elbow. It may help to wear a wrist brace to prevent bending of your fingers and wrist. Your healthcare provider may also recommend stretching and strengthening exercises to help you heal. You may need golf lessons to help correct your swing.

If you keep having pain, your provider may give you a shot of a steroid medicine. In severe cases, you may need surgery to repair the tendon.

The pain often gets better within a few weeks with self-care, but some injuries may take several months or longer to heal. It’s important to follow all of your healthcare provider’s instructions.

How can I take care of myself?

To help relieve swelling and pain:

• Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth, on the area every 3 to 4 hours for up to 20 minutes at a time.
• Do ice massage. To do this, first freeze water in a Styrofoam cup, then peel the top of the cup away to expose the ice. Hold the bottom of the cup and rub the ice over your tendon for 5 to 10 minutes. Do this several times a day while you have pain.
• Keep your elbow up on a pillow when you are sitting or lying down.
• Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don't take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.

Moist heat may help relax your muscles and make it easier to move your arm. Put moist heat on the injured area for 10 to 15 minutes at a time before you do warm-up and stretching exercises. Moist heat includes heat patches or moist heating pads that you can purchase at most drugstores, a wet washcloth or towel that has been heated in the dryer, or a hot shower. Don’t use heat if you have swelling.

Follow your healthcare provider's instructions, including any exercises recommended by your provider. Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid, including how much you can lift, and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent golfer's elbow?

Warm-up exercises and stretching before activities can help prevent injuries. If your arm hurts after exercise, putting ice on it may help keep it from getting injured. Follow safety rules and use any protective equipment recommended for your work or sport. For example, wearing an elbow strap and doing exercises that stretch your elbow may help prevent this problem.