Medial Epicondylitis (Golfer’s Elbow)

Medial epicondylitis, often called golfer’s elbow, is an overuse injury of the muscles and tendons in the forearm that attach to the elbow’s medial epicondyle (inside portion). It causes pain inside the elbow and can extend into the forearm or wrist. The pain can range from mild to severe and can significantly affect everyday activities such as holding a cup, shaking hands or brushing teeth.

Medial epicondylitis is typically caused by repetitive motions such as gripping, twisting or throwing that strain the arm’s muscles and tendons. It can also be caused by poor technique in sports or work activities.

Some occupational activities that can cause or exacerbate medial epicondylitis are: 

• Carrying heavy objects, such as suitcases
• Chopping wood
• Daily use of hand tools
• Hammering (construction)
• Holding or carrying a heavy food or drink tray
• Poor posture and lack of joint support while typing
• Swinging a tennis racket or golf club

Medial epicondylitis is an overuse injury. Any sport, activity or occupation that requires forceful or repetitive arm movements increases the risk of injury. Athletes who play golf, tennis, baseball and javelin-throwing have a higher incidence of this condition.

Other factors that can increase risk include poor form while playing sports, smoking, age, weakness, poor flexibility and obesity.

To prevent medial epicondylitis, it is essential to practice proper mechanics, stretch and warm up before activities, and take breaks if needed. Strategies to avoid this injury include developing your forearm muscles by incorporating regular exercises, off-season sports training and regular, frequent repetitions of stretching and technique development. Additionally, using proper equipment, such as padded gloves, may help reduce the strain on the arm muscles and tendons.

The most common symptom of medial epicondylitis is pain inside the elbow that can extend into the forearm or wrist. It usually begins with an ache or burning sensation but can progress to sharp pains during everyday activities. Other common symptoms include tenderness when touching the inside of the elbow, weakness or numbness in the wrist and forearm, difficulty making a fist and reduced range of motion in the elbow.

A physician diagnoses medial epicondylitis based on the patient’s symptoms and a physical exam. X-rays or magnetic resonance imaging (MRI) scans may be recommended to rule out other causes of elbow pain. Once the diagnosis is confirmed, treatment can begin. The most common treatments for medial epicondylitis include rest, ice, anti-inflammatory medications, physical therapy and elbow braces.

Depending on the severity of the injury, treating medial epicondylitis typically involves rest, ice and bracing. More severe injuries may require surgery. The Montefiore Einstein Department of Physical Medicine and Rehabilitation develops individualized treatment plans that include:

• Physical or occupational therapy
• Non-opioid oral pain management
• Local cortisone injections

The day-to-day treatment of medial epicondylitis includes ice, rest, bracing and physical therapy to reduce inflammation and pain. Over-the-counter pain medications (ibuprofen or naproxen) can also reduce inflammation. In some cases, doctors may recommend surgery if all other treatment methods fail to repair the injury.