Introduction
Golfer's Elbow, medically known as medial epicondylitis, is a repetitive strain injury that affects the tendons connecting to the inner elbow. This condition arises when these tendons undergo degeneration, often due to repetitive motions, such as those encountered during a golf swing or various work activities. Pain typically manifests where the tendons attach to the elbow bone (medial epicondyle) and may radiate down the forearm. Most individuals with Golfer's Elbow experience relief through non-surgical treatments, but surgical options are available if necessary.
Anatomy
Golfer's Elbow involves the common flexor tendon, which links the forearm flexor muscles to the inner side of the elbow bone (epicondyle). The flexor muscles are responsible for bending the wrist and moving it toward the palm.
Causes
The primary cause of Golfer's Elbow is repetitive motion and cumulative stress, which lead to deterioration of the tendons on the inner side of the elbow. Such motions can occur during activities like golfing or through muscle overuse in other contexts.
Symptoms
The hallmark symptom of Golfer's Elbow is pain and tenderness on the inner elbow, which tends to worsen during wrist flexion or gripping actions. This pain may also radiate down the forearm.
Diagnosis
A diagnosis of Golfer's Elbow involves a thorough examination by a physician, who will assess the patient’s medical and activity history. The physician will perform basic tests to evaluate the forearm and elbow structure. X-rays, and occasionally MRI scans, may be utilized to confirm the diagnosis and rule out other potential sources of elbow pain.
Treatment
Most cases of Golfer's Elbow respond well to non-surgical interventions. Treatment generally focuses on rest or modifications to activities. Patients often benefit from specific stretching and exercises prescribed by a physical therapist, who may also apply ultrasound or other therapies to facilitate healing. Recommendations may include using a splint, brace, or wrapping for the elbow, as well as applying ice to the affected area. Pain relief may be achieved through medications, and while cortisone injections are commonly used, their effectiveness is not well-supported by evidence.
Surgery
Surgical intervention is rarely needed for Golfer's Elbow; it is usually considered only when significant pain persists after extensive non-surgical treatments. Surgical options for Golfer's Elbow are typically performed on an outpatient basis, aiming to remove the damaged tendon and reconnect the healthy tendon to the bone. Techniques include open surgery, percutaneous procedures, and arthroscopic surgery.
Arthroscopic surgery employs a small camera (arthroscope) to guide the procedure through minimal incisions, avoiding the need to fully open the joint. This method is associated with favorable outcomes and potentially shorter recovery times.
Following surgery, elbow motion is encouraged to begin almost immediately, with gradual increases based on the surgeon's guidance. Full recovery may take several months.
Recovery
Recovery from Golfer's Elbow can extend over several months. It is crucial to manage the condition through rest, rehabilitation, and adjustments in lifestyle or sports techniques, such as altering the golf swing method.