What is Golfer’s Elbow?
Golfer’s elbow is also known as medial epicondylitis, and it typically involves pain in the inside corner of your elbow. This is the insertion point for the muscles that flex and pronate your wrist. Although it is called Golfer’s elbow it is also a common injury in throwers. The stress placed at the elbow during the cocking phase into the acceleration phase of a high velocity pitch puts a lot of tensile stretch at the medial elbow. In addition, when the thrower transitions from a bent elbow to fully straight, without proper control, it can lead to various elbow injuries with medial epicondylitis as one example.
In people who have an acute onset or more recent pain in their elbow this is likely epicondylitis. The suffix “-itis” refers to inflammation, specifically at the tendinous insertion. The treatment for this condition will focus on decreasing pain and inflammation with gradual progression to improve muscular strength. Some initial treatment may include ice, rest, NSAIDs, stretching, and light strengthening. The initial goal is to stimulate the repair process. Then, your therapist will gradually guide you to return to daily activities without overstressing the elbow. If the patient’s goal is to return to sports such as pitching, they will slowly progress back into sport specific activities with an interval program.
In other cases, individuals who have been experiencing pain for a while may be experiencing epicondylosis rather than epicondylitis. The primary difference between the two is that epicondylosis is a more chronic condition that leads to neurologic inflammation rather than microtearing or macro tearing of the tissues themselves. Neurogenic inflammation is the release of neurologic inflammatory markers leading to increased pain signals without increased damage to the tendinous tissues. Treatment differs with emphasis on transverse friction massage, stretching, and eccentric strengthening to promote tendon regeneration in epicondylosis.
Your therapist will determine the most accurate diagnosis with a thorough history and assessment. In summary, the treatment for tendonitis will emphasize decreasing inflammation, and the treatment for tendinosis focus on tendon regeneration. To decrease the risk of reinjury in both cases, your therapist may watch your throwing or golfing mechanics and discuss minor changes to promote optimal ergonomics.
Jill Hoffman PT, DPT is a physical therapist specializing in treating orthopedic conditions.
References
- Wilk KE, Reinold MM, Andrews JR. Rehabilitation of the thrower’s elbow. Clin Sports Med. 2004 Oct;23(4):765-801, xii. doi: 10.1016/j.csm.2004.06.006. PMID: 15474234.
- Waugh, Esther J. “Lateral Epicondylalgia or Epicondylitis: What’s in a Name?” Journal of Orthopaedic & Sports Physical Therapy, vol. 35, no. 4, 2005, pp. 200–202., https://doi.org/10.2519/jospt.2005.0104.
