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Elbow Pain
Medial epicondylitis or golfers elbow is caused by tendonitis of the flexor and pronator tendons. The overuse of the flexor and extensor muscles causes pain to arise at the origin on medial epicondyle. Tendinopathy results when long-term overuse to the tendons continues and the tissues begin to breakdown.
The condition is characterized by tenderness over the inside of the elbow, pain with gripping, and pain with a passive stretch of the muscles. Pain worsens with wrist flexion and forearm pronation activities. Patients may report discomfort even when simply shaking hands with someone.
It is thought that overuse of the wrist extensors creates cumulative stress, and small tears in the tendon, which causes the inflammation and pain of tendinitis. Tendinopathy results when long-term overuse to the tendons continues and the tissues begin to breakdown.
What Is Tendinitis?
Repetitive stress at the musculotendinous junction (where tendons attach to the bone) leads to tendinitis in its most acute form and to tendinosis in its more chronic form. Initially, this results with obvious pain and acute inflammation, but tendinosis that can occur is primarily the result of failure of the damaged tendon to heal.
Management
With both medial epicondylitis and lateral epicondylitis the goal is to decrease pain, decrease inflammation, increase range of motion, and strengthen the area. Clinically, we accomplish this in a 2-stage approach: in-office treatment and at-home care.
In-office care is comprised of therapeutic ultrasound, joint manipulation of the elbow, wrist, and shoulder, bracing/support, stretching, and lastly, strengthening. At home, it is important to continue to ice the area and perform stretching, and eventually perform the strengthening exercises.
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