Golfer's elbow

At HCA we offer:

• Swift and accurate golfer's elbow diagnosis 
• Non-surgical and surgical treatment options
• Consultation and diagnostic appointments available on the same day
• Orthopaedic care rated good or excellent by 97% of patients

What is golfer's elbow?

Medial epicondylitis is the medical name for golfer's elbow. Epicondylitis is a repetitive strain injury to the tendons (tendonitis) that connect the flexor muscles in your forearm to your elbow. Despite its common name, this is not an injury that is only suffered by those who play golf. Any activity that overuses the forearm muscles, especially motions that flex the wrist inwards, can lead to medial epicondylitis.

It may occur as a result of forceful swinging of the arms to play a golf shot or bowl a cricket ball but it can also arise when using power tools, carrying heavy loads or doing manual labour. The condition is much more common in people's dominant arms, as they are more likely to be used.

It is not to be confused with tennis elbow. This is a slightly different condition called lateral epicondylitis with similar causes and symptoms to golfer's elbow but affecting the outside of the forearm.

What causes golfer's elbow?

The flexor muscles and tendons in your arm control movement in your wrist and fingers, so it is often issues with these areas that are the root cause of golfer's elbow.

Flexor tendons are connected to the bony protrusion on the inside of your elbow – the medial epicondyle. A repeated action (such as swinging a golf club) or overexertion through this area (like attempting to lift a heavy suitcase) can result in small tears forming in the tendons as the muscles stretch beyond their limits. These tears can cause pain, while the area is likely to become inflamed as part of the body's natural response to the injury. This can also cause discomfort.

Golfer's elbow heals naturally over time for the vast majority of people. However, if your symptoms persist or you want to get back to full fitness quicker, it is a treatable condition.

Non-surgical medial epicondylitis treatment

• RICE: Rest, ice, compression and elevation. These will help your tendons recover and manage any inflammation around the joint.
• Changing activities: No golfer ever wants to spend time away from the course but, if your symptoms are affecting your swing or even your everyday life, a period of less strenuous activity is vital in allowing your joint time to recover. 
• Medication: Taking painkillers and non-steroidal anti-inflammatory drugs can help you keep on top of any discomfort and may help ease some of the swelling in the elbow joint.
• Wear a brace: Small strappings specifically designed to aid golfer's elbow are available. They work by adding gentle pressure to the affected area, adding support as you perform whatever motion that has previously caused pain.
• Cortisone or PRP injections: A steroid called cortisone can relieve joint pain when injected into the affected area. It works as an anti-inflammatory and can counter any swelling in your tendons. Platelet-rich plasma injections work by promoting faster healing by adding naturally occurring substances found in the blood into the area causing you pain.
• Extracorporeal shockwave therapy: This is a non-invasive way of applying sound waves to your elbow to help heal it.

Physio for golfer's elbow

Our experts can recommend a course of physical therapy that will include exercises to strengthen the muscles around the damaged tendon and maintain flexibility in the joint. Some exercises they may suggest include:

• Forearm rotation
• Wrist stretches
• Forearm stretches
• Eccentric strengthening

Medial epicondylitis surgery

If chronic golfer's elbow treatment has not eased your symptoms or you are in significant discomfort, medial epicondylitis surgery may be recommended.

The operation may be performed via elbow arthroscopy (keyhole surgery), where the surgeon will use a camera to see inside your joint, or by open surgery, where a slightly larger incision will give the surgeon access to the affected area.

Your consultant will discuss anaesthetic options with you. General anaesthetic (you are put to sleep) is common for this kind of procedure, however, if opting for a local anaesthetic, you will not feel any pain during the procedure and will avoid any side effects of general anaesthetic such as nausea.

The damaged area of your tendon will be removed and any necessary repairs will be done to promote healing and a strong connection between your tendon and the elbow bone.

You will likely undergo this surgery as a day case, so you will be able to go home on the same day, although you will need to arrange transport as you won't be able to drive after the operation. You will be given some exercises to help you recover from the surgery, with a full recovery likely in around three months.

Can I prevent golfer's elbow?

• Improve form: Be mindful of how you perform each task. Keeping your wrist as straight as possible reduces strain on your forearm muscles and tendons. If your golf swing is causing you issues, discussing your technique with a coach may help
• Strengthen the muscles: Exercises that target the forearm muscles may help you keep golfer's elbow at bay.
• Warm up and stretch: Prepare your forearms for work before every round, practice or match. A quick stretch before can also stop symptoms from developing.
• Check equipment: Heavy sporting equipment like golf clubs and tennis rackets may increase your chances of developing this condition. If you're able to replace them with lighter alternatives, it will put less strain on the tendons while you play.