Golfer’s elbow or medial epicondylitis is similar in nature to lateral epicondylitis. It involves the muscles that flex the fingers and pronate the forearm. It is an overuse injury that causes micro tears in the tendons attachments to the bone.
Activities besides golfing that contribute to developing medial epicondylitis include rock climbing and pitching.
SYMPTOMS & DIAGNOSIS
Symptoms include pain along the medial epicondyle that is aggravated by resisted wrist flexion. Pain can radiate into the forearm. The ulnar nerve is in close proximity to the medial epicondyle and tingling in the forearm can sometimes occur.
Diagnosis is made by history and physical exam. X-rays can rule out any bony abnormalities. Ultrasound can help determine the extent of the tendonitis. EMG studies can help determine if the ulnar nerve is being compressed.
Non-operative treatment is very similar to lateral epicondylitis.
Surgical treatment is considered after a trial of conservative measures. Less than 10% of patients will require surgery. Debridement of the tendon and the epicondyle is performed. If the ulnar nerve is involved, it is also addressed at the time of surgery. There is a period of immobilization after surgery. Physical therapy and a slow progression to return to activity will have patients back to normal activity within 4-6 months.