Golfer’s elbow, or medial epicondylitis, is less common than tennis elbow (lateral epicondylitis) – and, probably for this reason, seems less well-known – and yet it can also affect players of tennis and other racquet sports, as well as weight lifters and some manual labourers.
Golfer’s elbow affects the medial epicondyle, the bony prominence on the “inside” of your elbow (on the left side of your right elbow, if your palms are facing forward). It can be acute, which means it occurs suddenly, leading to tendinitis (inflammation); or chronic, where it develops over time when the tissues do not get to repair fully in between bouts of mild stress, and leads to tendinosis (degeneration).
Like tennis elbow, golfer’s elbow is an overuse injury, arising from repeatedly stressing muscles of the forearms – this time, the muscles and tendons that are overworked are those that attach to the medial epicondyle. As always, when we refer to “overuse” in sports injuries, this can mean an increase in training volume or intensity (i.e. training more, or training harder), or an increase in load, which could be the result of improper equipment or poor technique placing additional strain on certain tissues.
Localised pain and tenderness will be felt over the medial epicondyle. There may also be some pain down the inside of the forearm. The pain will worsen on certain movements, namely gripping and pronating (turning the palm face down, or rotating an object counter- clockwise).
Sometimes, there will be tingling or numbness in the 4th and 5th fingers, and weakness when trying to grip. This suggests that the inflammation is pinching the ulnar nerve, which runs through the area. Needless to say, if treatment has not already been sought by this point, it really is important to see a professional to prevent the issue worsening or causing knock-on effects.
X-rays will not show signs of golfer’s elbow, but will rule out any other concerns (e.g. bone spurs) if these are being considered. An MRI will show whether there is tearing of any of the ligaments. However, scans are usually not warranted for a diagnosis of golfer’s elbow.
As with any overuse injury, rest – at least avoiding actions that place stress on the forearm muscles – should be the first course of action. Ice, compression, elevation and the use of over-the-counter medication to reduce inflammation can all be used over the first 72 hours or so of a flare-up.
Although it is tempting to return to your normal activities once pain has subsided, visiting a professional such as a physiotherapist or an osteopath who can properly diagnose your condition is important; they can help you identify what caused your injury and how to address this in the most efficient way – you may only need to perform a couple of specific stretches and a couple of exercises, or you may only need to change your golf club or tennis racquet, rather than doing everything all at once.
Similarly to rehabilitating tennis elbow, is it likely that your therapist will recommend some specific forearm-strengthening exercises. They may massage your arms or use other techniques to reduce tension and swelling, or recommend you see a massage therapist specifically to work on these areas. They may also recommend treatment on your shoulders, neck and/or upper back, all of which are tight areas for many of us, but which will specifically have carried some of the burden of protecting your injury.
Overuse injuries, especially those that develop gradually over a period of time, are a sign that something is not right with your current set-up, so take some time to investigate your equipment and your technique. Ideally, you will be working with a therapist who is familiar with your sport; if not, they may be able to recommend someone, or you may know someone in your club or amongst your training partners who can recommend an equipment shop with knowledgeable staff and/or a good coach who can assess your technique and give you some tips.
It may all seem like overkill for what is often perceived to be a minor injury or niggle, but over time it really will pay off to identify the root cause and get it fixed!