Because of the twisting and flexing motion in the arm and hand necessary for certain sports, especially golf and baseball, and the grasping motions required in some occupations, you may have tenderness and pain at the tendon attachments on the inside portion of the elbow. This is called Medial Epicondylitis. Like other therapists, I do not believe people have to live with pain. So let’s look into this nagging condition.
What exactly is golf elbow? Turn your thumb away from your body. There is a muscle that starts above the elbow on the inside and runs across the top of your lower arm. It hooks to the hand on the first and second fingers. This muscle is the flexor carpi radialis. You can also feel it if you squeeze your hand and many times the muscle will pop up. When the tendon of this muscle becomes aggravated or over used a person can develop “golf elbow”.
What is a tendon? Tendons hold the muscle to the bone and are very strong. However, when they tear, scar tissue forms, weakening the muscle’s integrity. Tendons do not heal well because of limited blood supply.
Signs & Symptoms
- Severe, burning pain on the outside part of the elbow
- Possible Swelling
- Point tenderness along the origin of the pronators teres, FCR, Palmaris longus, and FCU
- Pain can radiate to the forearm.
- Possible pain radiation to medial forearm and fingers caused by ulnar nerve compression
What causes this particular tendon to become aggravated? Most of the time, “golf elbow” is caused by stress, overuse, or form (the way you swing the club). Many times the grip on the club can cause stress, ask your Golf Pro for any recommendations.
What can you do about it? You have several ways to take care of this situation.
Rest is the best step to take first, but do not stop there. Use Ice as often as possible.
Why use ice? Ice helps release metabolites (waste products). When you use ice there are four sensations you will feel – cold, burning, aching, and numbness. When your arm reaches the numbness stage (10-20 minutes), take the ice off. Ice cups are good to use.
To make an ice cup: freeze water in a paper cup, then peel away the paper moving the ice up and down your arm until the you reach the four stages. After your arm is numb, get a tennis ball and squeeze 6 to 10 time for three sets, keep the arm slightly bent and the wrist straight. Then repeat the ice and the exercise. If possible, do this 2 to 3 times each night. There are several other exercises in addition to the tennis ball squeeze; however, this one is very effective.
Can you alternate heat and ice? Yes. This can sometimes be very effective in the healing process. When alternating, always let your skin go to normal body temperature before switching methods.
How long should this be continued? You should see some positive results within 4 to 6 weeks. If you are continuing to play golf while you are still having discomfort, realize the tendon will take longer to heal and may never fully recover. If you have had chronic or long-term “golf elbow” it may take even longer to heal.
What other alternatives are there? Massage is wonderful for “golf elbow,” especially when incorporating the ice routine above. Stretching is also very effective, especially before and after playing golf. If the pain still persists, see a qualified Orthopedic physician. They may have other options including injections with a corticosteroid which is another form of treatment; however, realize many times injections can deteriorate the muscle grouping.
Remember, you do not have to live with pain!
Terry Cross, HHP, LMT
Laurel J. Freeman, BA, LMT