The Golfer's Elbow: From Four to the Floor!

Four!! You’re in the middle of a 9 hole round of golf, or you’re using a wrench on your old hot rod outside, or maybe you’re chopping veggies for dinner this evening, and you notice pain in the inside of your elbow. What is that? Why does it hurt?

Let’s break down a little anatomy. Right near your elbow, on the inside and the outside of the arm, you have a little bump, where the upper arm bone (the humerus) meets the lower arm. Those bumps are called the Condyles. You have one on the outside of the arm (lateral Condyle) and one on the inside of the arm (medial Condyle). These bumps act as an anchor point for the muscles in your forearm to hook up to and let them do their jobs. In the case of pain on the inside of the elbow region, that’s usually called “medial epicondylitis,” which is a fancy way of saying some issue around the bump on the inside of the elbow area…. Ok, so its shorter too.

So, what causes medial epicondylitis? The short answer is repetitive overuse injury. In other words, the constant gripping of objects like golf clubs, wrenches, knives, and that sort, along with movements that put pressure on the inside of the elbow like a golf swing, throwing a ball overhand, or chopping veggies like Gordon Ramsey is watching, can agitate the tendons that link up with the medial epicondyle. Medial epicondylitis is a chronic condition in most cases, which means it has taken a while to get to the point where it now hurts. It usually starts with generalized inflammation in the area. With constant use, we get micro-tears in the tendons that don’t heal the way they should. This can continue for quite a while before we ever even know something is wrong. The pain kicks in usually after the damage is already done.

The next big question is, how can we treat it? Conservative, non-operative, treatment is the way to go for most cases. We generally start with physical therapy ( PT ) protocols like stretching and strengthening and often combine that with muscle work and soft issue stretching. We often will have patients stop doing the thing that set off the pain for a time, so the patient can get out of pain. Then, work back up to performing the activity without pain. Finally, further strengthening beyond that of the pre-injury state so the patient isn’t as prone to getting hurt in the future. During that PT phase, patients can also wear some super functional, and sometimes fashionable devices called counterforce elbow straps. They are those thick arm bands you might have seen some people wear just below the elbow at times. They squeeze the muscles in the forearm just below the elbow area to “offload” the tendons some, and give them a helpful nudge toward recovering. Of course, your doctor may recommend some medications like Tylenol or Ibuprofen along side of the PT and muscle work to help make things a little less painful. Surgery is not normally required, unless the pain continues after 6 to 12 months of normal conservative care.

The moral of the story is, that if you notice pain in the elbow region, or in any region for that matter, seek out your local healthcare provider, as there is likely already injury to the area. Don’t try and “muscle” through it, or just quit being active. Come and give us call at Edinboro Health & Wellness Center and see how we can help you get out of pain and back to the golf green, or to your veggies that are long overdue for some chopping!