Golfer's Elbow

(Medial Epicondylitis)

Medial epicondylitis, also known as golfer's elbow is characterized by pain from the elbow to the wrist on the palm side of the forearm. The pain is caused by damage to the tendons that bend the wrist toward the palm. The most common symptom of medial epicondylitis is pain along the palm side of the forearm, from the elbow to the wrist, on the same side as the little finger. The pain can be felt when bending the wrist toward the palm against resistance, or when squeezing a rubber ball.

Golfer’s elbow is caused by the excessive force used to bend the wrist toward the palm, such as swinging a golf club or pitching a baseball. Other possible causes include the following:

  • serving with great force in golfer's or using a spin serve
  • weak shoulder and wrist muscles
  • using a too tightly strung, too short, and/or too heavy tennis racket
  • throwing a javelin
  • carrying a heavy suitcase
  • chopping wood with an ax
  • operating a chain saw
  • frequent use of other hand tools on a continuous basis

The diagnosis of medial epicondylitis usually can be made based on a physical examination. The physician may rest the arm on a table, palm side up, and ask the patient to raise the hand by bending the wrist against resistance. If a person has medial epicondylitis, pain usually is felt in the elbow.

Initial treatment of golfer’s elbow may include:

  • Analyzing your job tasks to determine the best steps to reduce stress on your injured tissue. This may mean taking ergonomic steps at work to ensure that your wrist and forearm movements don't continue to contribute to your symptoms.

  • Analyze your golf swing for proper wrist, elbow and shoulder positions.

  • Rehabilitation. Your doctor or therapist may suggest exercises to gradually stretch and strengthen your muscles, especially the muscles of your forearm. A Corrective Exercise Specialist is trained to locate and address muscular and functional imbalances that may have contributed to the forearm pain. A specific rehab program needs to be designed for each patient for every injury is different.

  • Physiotherapy: Conservative treatment including ultra-sound, electrical stimulation and joint mobilization. Active Release Techniques (ART) is a very effective way to treat golfer’s elbow. A Certified Chiropractic Sports Physician is trained to adjust the elbow for proper realignment. The wrist, shoulder and spine should also be adjusted for proper alignment.

These steps may help you prevent a golfer's elbow injury:

  • Build your strength and prepare for any sport season with appropriate preseason conditioning. Your exercise program should be designed by a professional, such as a
  • Corrective Exercise Specialist or Performance Enhancement Specialist, for optimal results.
  • Have your golf swing analyzed by a professional.
  • Use ice. After heavy use of your arm, apply an ice pack or use ice massage. For ice massage, fill a sturdy paper or plastic foam cup with water and freeze it. Then, roll the ice directly on the outside of your elbow for five to seven minutes.

Follow the instructions for P.R.I.C.E. — protection, rest, ice, compression, elevation:

  • Protection. Protect your elbow from further injury by not using the joint. If a particular sport or work activity causes symptoms, you may have to stop the activity until your symptoms improve.

  • Rest. Give your elbow a rest. But don't avoid all activity. Sometimes, wearing a forearm splint at night helps reduce morning symptoms.

  • Ice. Use a cold pack, ice massage, slush bath or compression sleeve filled with cold water to limit swelling after an injury. Try to apply ice as soon as possible after the injury.

  • Compression. Use an elastic wrap or bandage to compress the injured area.

  • Elevation. Keep your elbow above heart level when possible to help prevent or limit swelling.