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Golfer’s Elbow (Medial Epicondylitis)

This painful problem is an inflammatory condition of the elbow which in some ways is similar to tennis elbow. The primary differences between these conditions are the location of the pain and the activity that leads to injury. Both conditions are caused by overuse of the muscles and tendons of the forearm, leading to inflammation and pain around the elbow joint.

The flexor muscles of the forearm, the muscles responsible for bending the fingers and thumb, clenching the fist and supinating the hand excluding biceps brachialis, come together in a common tendon which is inserted in to the medial epicondyle of the humerus at the elbow joint. In response to minor injury, or sometimes for no obvious reason at all, the point of insertion becomes inflamed.

The mechanism of this injury can vary from a single violent action to, more commonly, repetitive stress injury where an action is performed repeatedly and pain gradually develops.

Golf is one common cause of these symptoms, but many other sport- and work-related activities can cause the same problem. In America, for example, this is also known as Pitcher’s elbow, since the same muscles are affected in baseball pitchers, leading to identical symptoms. Golfer’s elbow is usually a self-limited problem, and does not cause any long-term disability. Treatment is rarely surgical, as this condition is well managed with a little rest and proper rehabilitation. Steps in treatment include activity modification, physiotherapy and steroid injection to the trigger area.

However, some severe cases are resistant to the measures and require surgery. Surgical release of the affected tendon is performed through a small incision. This procedure is performed as a day-case operation and usually results in rapid resolution of all symptoms.

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