Golfer’s Elbow

Technically known as medial epicondylitis, golfer’s elbow is a common condition of the elbow.

Golfer’s elbow is an inflammation of the tendons that attach your forearm muscles to the inside of the bone at your elbow.

The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the inside of the elbow.

Cause

Overuse of the muscles and tendons of the forearm and elbow are the most common reason people develop golfer’s elbow. Repeating some types of activities over and over again can put too much strain on the elbow tendons. These activities are not necessarily high-level sports competition. Shoveling, gardening, and hammering nails can all cause the pain of golfer’s elbow. Swimmers who try to pick up speed by powering their arm through the water can also strain the flexor tendon at the elbow.

In some cases, the symptoms of golfer’s elbow are due to inflammation. In an acute injury, the body undergoes an inflammatory response. Special inflammatory cells make their way to the injured tissues to help them heal. Conditions that involve inflammation are indicated by -itis on the end of the word. For example, inflammation in a tendon is called tendonitis. Inflammation around the medial epicondyle is called medial epicondylitis.

However, golfer’s elbow often is not caused by inflammation. Rather, it is a problem within the cells of the tendon. Doctors call this condition tendonosis. In tendonosis, wear and tear is thought to lead to tissue degeneration. A degenerated tendon usually has an abnormal arrangement of collagen fibers.

Instead of inflammatory cells, the body produces a type of cells called fibroblasts. When this happens, the collagen loses its strength. It becomes fragile and can break or be easily injured. Each time the collagen breaks down, the body responds by forming scar tissue in the tendon. Eventually, the tendon becomes thickened from extra scar tissue.

Conditions

  • Biceps Tendon Rupture
  • Bursitis
  • Coronoid Fracture
  • Distal Humerous Fracture
  • Elbow Arthritis
  • Elbow Dislocation
  • Elbow Epicondylitis
  • Elbow Fractures in Children
  • Forearm Fractures
  • Golfer’s Elbow
  • Olecranon Fracture
  • Radial Head Fracture
  • Rheumatoid Arthritis of the Elbow
  • Stiffness of the Elbow
  • Tennis Elbow
  • Throwing Injury
  • Ulnar Collateral Ligament (UCL) Tear

Treatments

  • Autograft (UCL) Tear
  • Biceps Tendon Rupture Surgery
  • Bursitis/Impingement Surgery
  • Coronoid Fracture Surgery
  • Closed Reduction (Elbow) Surgery
  • Distal Radial Fracture Surgery
  • Elbow Arthritis Surgery
  • Elbow Arthroplasty Surgery
  • Elbow Arthroscopy Surgery
  • Elbow Epicondlyitis Surgery/Tenex FAST Procedure
  • Elbow Fracture Surgery
  • Elbow Replacement Surgery
  • Olecranon Fracture Surgery
  • Radial Head Fracture Surgery
  • Tennis Elbow – Tenex FAST Surgery
  • Throwing Injury Surgery

Conservative Treatments

The Orthopedic physicians at Peninsula Bone & Joint Clinic provide conservative treatment options for Elbow conditions and injuries.

Symptoms

The main symptom of golfer’s elbow is tenderness and pain at the medial epicondyle of the elbow. Pain usually starts at the medial epicondyle and may spread down the forearm. Bending your wrist, twisting your forearm down, or grasping objects can make the pain worse. You may feel less strength when grasping items or squeezing your hand into a fist.

Diagnosis

Physical Examination & Patient History

During your first visit, your doctor will talk to you about your symptoms and medical history. During the physical examination, your doctor will check all the structures of your injury, and compare them to your non-injured anatomy.  Most injuries can be diagnosed with a thorough physical examination.

Imaging Tests

Imaging Tests Other tests which may help your doctor confirm your diagnosis include:

X-rays. Although they will not show any injury, x-rays can show whether the injury is associated with a broken bone.

Magnetic resonance imaging (MRI) scan. If your injury requires an MRI, this study is utilized to create a better image of soft tissues injuries. However, an MRI may not be required for your particular injury circumstance and will be ordered based on a thorough examination by your Peninsula Bone & Joint Clinic Orthopedic physician.

Treatment Options

One of the best ways to avoid elbow problems is to strengthen your forearm muscles and slow your golf swing so that there will be less shock in the arm when the ball is hit.

The following simple exercises can help build up your forearm muscles and help you avoid golfer’s elbow.

For best results, do these exercises during the off-season, as well.

  • Squeeze a tennis ball. Squeezing an old tennis ball for 5 minutes at a time is a simple, effective exercise that will strengthen your forearm muscles.

  • Wrist curls. Use a lightweight dumbbell. Lower the weight to the end of your fingers, and then curl the weight back into your palm, followed by curling up your wrist to lift the weight an inch or two higher. Perform 10 repetitions with one arm, and then repeat with the other arm.

  • Reverse wrist curls. Use a lightweight dumbbell. Place your hands in front of you, palm side down. Using your wrist, lift the weight up and down. Hold the arm that you are exercising above your elbow with your other hand in order to limit the motion to your forearm. Perform 10 repetitions with one arm, and then repeat with the other arm.

 

If your discomfort persists:

The sooner you begin treatment, the sooner you’ll be able to return to your usual activities.

Rest. Put your golf game or other repetitive activities on hold until the pain is gone. If you return to activity too soon, you may make it worse.
Ice the affected area. Apply ice packs to your elbow for 15 to 20 minutes at a time, three to four times a day for several days. To protect your skin, wrap the ice packs in a thin towel. It might help to massage the inner elbow with ice for five minutes at a time, two to three times a day.
Take an over-the-counter pain reliever. Try ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, others) or acetaminophen (Tylenol, others).
Use a brace. Your doctor might recommend that you wear a counter force brace on your affected arm, which might reduce tendon and muscle strain.
Stretch and strengthen the affected area. Your doctor may suggest stretching and strengthening exercises. Physical or occupational therapy can be helpful, too. A type of strengthening (eccentric) that lengthens the tendon of the wrist extensor muscles has been shown to be particularly effective in treating chronic tendon irritation.
Reduce the load on your elbow tendons. Wrap your elbow with an elastic bandage or use a splint.
Gradually return to your usual activities. When your pain is gone, practice the arm motions of your sport or activity. Review your golf or tennis swing with an instructor and make adjustments if needed.

Ask your doctor when surgery is appropriate. Surgery is seldom necessary. But if your signs and symptoms don’t respond to conservative treatment in six to 12 months, surgery may be an option. A new procedure involves minimally invasive, ultrasound-guided removal of scar tissue in the region of the tendon pain. 

 

Conservative Treatment Options

  • Non-Operative Golfer’s Elbow Treatment

  • Non-Operative Olecranon Fracture Treatment

  • Non-Operative Tennis Elbow – Lateral Epicondylitis Treatment

  • Non-Operative Radial Head Fracture Treatment

  • Non-Operative Throwing Injury Treatment

  • Non-Operative Ulnar Collateral Ligament (UCL) Injury Treatment

Treatment Highlights

Tenex Procedure

Tenex Procedure

Tenex procedure is an innovative procedure utilized by Dr. Paul Abeyta to address Tennis Elbow – Elbow Epicondylitis injuries and accelerate the treatment options available to patients.

Procedure Advantages:

  • Removes damaged tissue through a microincision and stimulates healing response. Uses gentle ultrasonic technology

  • Involves no general anesthesia or stitches. Local anesthetic (numbing medicine) only. Twenty minutes or less to perform. No need for physical therapy or additional treatments. Your individual results may vary.

  • Full return to normal activity in 6 weeks or less. Your individual results may vary.

Peninsula Bone & Joint Clinic

The Orthopaedic physicians at Peninsula Bone & Joint Clinic provide comprehensive services to all members of the family.
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