Medial epicondylitis, commonly referred to as “golfer’s elbow” can be described as an overuse injury to the medial elbow, or inner surface of the elbow. Muscles that start on the inner surface of the elbow are damaged or develop small microtears due to degeneration of the tendons.
Other Common Names:
Most common symptoms are pain along the inner surface of elbow to wrist (same side as small finger), pain with resisted wrist flexion (wrist forward), and pain with squeezing/gripping. Muscles that help produce forearm pronation (palm down) and wrist flexion (wrist toward palm) are commonly the muscles involved with this type of overuse injury. These muscle groups all originate from the medial aspect of the elbow. Activities that may cause pain include:
If someone suspects of medial elbow pain it is advised to seek out an orthopedic specialist to ensure accurate diagnosing. There are some initial options a doctor may recommend prior to initiating therapy services. Some of these recommendations include:
After seeing an orthopedic doctor, the doctor may recommend Occupational Therapy (OT) services to return to a prior level of function. Rehab for medial epicondylitis can be classified into three phases: Acute, Restorative and Functional. Based on client’s goals the Therapist can incorporate a baseline return to work and return to sport recommendations. Upon arrival at the OT initial evaluation, the OT will collect a series of subjective and objective measurements to further assess plan of care. These items include Pain, Daily routine/tasks, Work demands, Range of motion, Palpation to tender/painful areas, Grip strength, Special testing, Observation of posture, Rounded shoulders, Kyphotic posture, Increased muscle tension in neck and shoulder muscles Treatment Interventions.
Modalities including: Moist heat, Promote lengthening of muscles and increase blood flow to area, Cold pack, Reduce inflammation and pain, Orthotic Intervention, Wrist support orthosis, Pre-fabricated orthosis can be bought at local drug store or the Therapist can make custom made wrist immobilization orthosis, Elbow sleeve, Counterforce brace, Taping, Manual Therapy Techniques, Joint mobilizations, Joint manipulation, Soft tissue massage, Cross friction massage, Dry needling, Stretching, Passive stretches using uninvolved arm (not using muscle power) may be given to patient to help decrease forearm muscle tightness.
Therapeutic Exercise is recommended after the acute phase. The Therapist may progress to strengthening to address certain total arm strengthening and parascapular muscles (shoulder blade), Isometric strengthening exercises for the elbow, forearm, and wrist, Eccentric strengthening, Isometric gripping, and Addressing Posture. The Therapist may address posture to decrease load/force put on distal extremities (i.e. arms, wrists) and increase proximal strength (i.e. core/back muscles) and include Posture stretches and Periscapular strengthening.
If you or someone you know is suffering from a shoulder or elbow injury, we encourage you to schedule a consultation with one of our experienced orthopaedic surgeons at CAO. We are committed to helping our patients achieve optimal outcomes and return to their active lifestyles as quickly and safely as possible. Schedule an appointment with a hand and upper extremity specialist today!