Medial Epicondylitis

Pathophysiology

Also known as golfers elbow is an overload of the tendon which attaches to the medial epicondyle which is a bony prominence on the inside of the elbow. Tendon attaches muscle to bone which is why pain can also radiate into the forearm muscle on activity. Generally affects those aged 30-50 years. Medial epicondylitis is less common than lateral epicondylitis (tennis elbow), it is more common in those with type 2 diabetes and those who smoke.

Symptoms

  • Pain over the inside of the elbow which may radiate into the forearm
  • Pain on lifting, twisting, wrist flexion and gripping tasks e.g. turning keys, lifting kettle
  • Worse with repetitive actions e.g. carpentry or plumbing
  • Weakness in gripping activities
  • Movement of the elbow generally full although painful

Management

  • Activity modification
  • Ice or heat
  • Pain relief
  • Physiotherapy to include range of movement exercises and strengthening exercises
  • Orthopaedic options include injection if symptoms not improving in expected timeframes

Investigations

  • Generally not appropriate

Helpful Documents

Exercises to try:

Elbow

Wrist Flexion Exercises 

With your forearm rested on a table and wrist/hand over the edge 

With your palm up to the ceiling (with or without a weight)

Bend your wrist up and slowly return to the starting position

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