Golfer’s elbow (medial epicondylitis) is pain on the inside of the elbow, where the muscles that bend the wrist and fingers attach. It is less common than tennis elbow, but it develops in a similar way: from repeated gripping and bending of the wrist. Besides golfers, it is common in people who work with tools, carry heavy things or train in the gym. It usually affects the arm you work with.
Symptoms
- Pain on the inside of the elbow, sometimes along the forearm.
- Pain when you grip, bend the wrist or turn your palm down.
- A weaker grip.
- Pain when you lift a heavy bag or throw.
- Stiffness in the elbow in the morning.
- Sometimes numbness towards the ring and little fingers, if the ulnar nerve is irritated.
The pain usually builds up gradually, over weeks. Many people first notice it during one particular exercise in the gym or while using a tool, and later with everyday tasks. If the ulnar nerve is irritated, the numbness gets worse when the elbow is bent for a long time, for example when you are on the phone or asleep.
Why it happens
- Working with hand tools: a hammer, a screwdriver, pliers.
- Golf, racket sports, climbing, throwing.
- Weight training with a lot of wrist flexion, such as biceps curls and pull-ups.
- A sudden increase in load.
- Weak forearm and shoulder muscles, so the elbow takes more of the strain.
As with tennis elbow, the tendon is overloaded rather than inflamed in the classic sense. Complete rest calms it for a short time, but the pain comes back as soon as the load does. It often starts after a week of extra work, a renovation or a new training plan.
How we treat it
Kaloyan finds the exact spot of the pain and which movements bring it on. He also checks the ulnar nerve, which runs right next to the sore area, because numbness in the fingers needs a different approach. For the irritated tendon he usually starts with ultrasound therapy. If the forearm muscles are tight and have sore spots, he uses dry needling. Kinesio taping takes the load off the tendon during work or training.
The core of treatment is exercises that gradually load the tendon, and you carry on with them at home. If you train, Kaloyan will also look at your programme: which exercises to cut back for a while and how to change your grip. The first exercises are light and shouldn’t make the pain worse. Little by little Kaloyan adds weight, until the tendon can cope with the load of your work or sport. Most people need 2–5 sessions over 2–4 weeks and a few more weeks of exercises at home. If the numbness in your fingers doesn’t go away, Kaloyan will refer you to a neurologist to have the nerve tested.
What you can do yourself
- Cut back for a while on the movements that cause pain, but keep moving your arm.
- In the gym, change your grip or lower the weight on arm exercises.
- Apply cold for a short time after effort, if it eases the pain.
- Warm up your arms before training or working with tools.
- If you work with tools for a long time, take a short break every hour.
- Don’t rest your elbow on a hard surface for long, for example on the desk or on the car window. It presses on the ulnar nerve.
When to see a doctor first
Golfer’s elbow isn’t dangerous, but pain on the inside of the elbow sometimes has another cause. See a doctor first in these cases:
- The pain started after a fall or a blow.
- The elbow is swollen, warm or red.
- The numbness in your little finger doesn’t go away, or your arm is getting weaker.
- The elbow locks or doesn’t straighten fully.
