Golfers Elbow/ Medial Epichondylitis

The medical name for Golfers elbow is Medial Epichondylitis as this condition occurs where the tendons of the forearm insert onto the medial epichondyle of the elbow joint

The medial epichondyle is the site at which the muscles which bend the wrist and fingers originate. The muscles which perform this function and similarly share this common origin include the Flexor Carpi Radialis, Pronator Teres, Palmaris Longus, Flexor Carpi Ulnaris and the Flexor Digitorum Superficialis

Medial Epichondylitis is less frequently seen in the clinical setting than Lateral Epichondylitis but both share the same pathophysiology whereby overuse of the common flexor tendons affects the inherent structure of the tendon leading to a tendinopathy . This may be due to excessive DIY, an improper golf swing (hence golfers elbow) or repetitive keyboard use. In fact, any action which places a repetitive and prolonged strain on the forearm muscles, coupled with inadequate rest, will tend to strain and overwork those muscles leading to either Lateral or Medial Epichondyltis.

Common symptoms described for this condition include elbow pain and possibly localised swelling close to the medial epichondyle of the elbow which came on initially following no real inciting trauma. The pain may refer further down the forearm and tends to get aggravated by bending the wrist. The patient’s may also report tingling into the fourth and little finger if there is irritation of the ulnar nerve resulting from an associated Cubital Tunnel Syndrome

Treatment of Golfers Elbow/ Medial Epichondylitis

At our City of London based chiropractic and Sports Injuries Clinic, our treatment approach is based on initially reducing the tension on the common flexor tendon through soft tissue work, ultrasound and stretching of the muscles which act to flex and pronate the wrist and fingers. Rehabilitation exercises will also be prescribed to strengthen the common flexor tendon and promote the synthesis of Type 1 collagen. Postural exercises are also beneficial as is treatment directed at improving the mechanics of the upper limb, neck and mid back.

Although, inflammation may play a role in the initial pathogenesis of a tendinopathy, recent tendon research has uncovered that there is little or no evidence of inflammatory changes in the vast majority of tendon complaints and may explain why anti-inflammatory measures such NSAIDS (neurofen/ibruprofen) and ice have little effect in relieving symptoms. A supportive elbow strap may however, help to reduce the tension on the muscle tendon complex of the common flexor tendon and help alleviate some of the symptoms arising from this condition

One of the key elements in treating "GolfersElbow" is decifering which activities have taken place to initiate sympotms. From here, corrective training or ergonomic advice is paramount to prevent furture episodes of elbow pain.

If you would like any further advice regarding Golfers Elbow/ Medial Epichondylitis, please contact us at the EC2 clinic