Medial Epicondylitis, like Lateral Epicondylitis tends to be a condition of overuse/repetitive strain that produces pain at the attachment of the forearm flexors on the inside of the elbow. While medial epicondylitis is known as Golfer’s elbow, it is not a condition of just golfers or other athletes. It is commonly seen in golf, in tennis with serving, forehand, and hits that put spin on the ball, as well as throwing activities to name a few. These activities all put stress through the forearm flexors. However, it is also commonly seen in people that do computer work, yard work, and having to carry objects repetitively. Both medial and lateral epicondylitis hit a wide variety of the population, and can be very frustrating and painful conditions that make normally simple daily tasks painful and hard to do.
Where do you start?
Medial epicondylitis isn’t usually brought on by a traumatic event, but rather over time through repetitive stresses. At a certain point the tissue reaches a point of failure resulting in pain and loss of function. While the obvious thing to do is assess the area of pain, but you can’t be completely blinded by the pain. While the area of pain may be where the tissue is being overworked, there are many factors that contribute to the forearm flexors being overworked.
If you are an athlete and develop medial epicondylitis, we have to look away from the site of pain. If you are an overhead athlete and have poor shoulder stability and/or poor thoracic (mid-back) mobility it can cause you to put more strain on the elbow. Unfortunately most sports are repeated in nature, so that repetitive strain on the elbow in practice and games adds up. It is important to breakdown areas outside of the elbow to see what can be causing the increased strain on the forearm flexors.
If you are not an athlete and develop medial epicondylitis because of a hobby, working out, work, etc. we still have to look outside the area of pain. We still need to assess shoulder stability, thoracic mobility, and core stability since we are a kinetic chain; if we are not functioning properly in one area it has an effect further up or down the chain. Looking into work ergonomics is another big factor to see if we can make changes to reduce strain on the forearm flexors while at work.
The start of treatment focuses more on the area of pain, to reduce discomfort and improve function. Medial epicondylitis responds well to manual therapy coupled with rehabilitation exercises. Manual therapies include:
Since medial epicondylitis is a condition that primarily affects the tendons of the forearm flexors, rehab exercises should focus on loading the tendons. Research has shown loading tendons helps to create change and adaptation within the tendons, starting with isometric holds and progressing to eccentric loading.
At TROSS we strive to provide our patients with the best care possible. We have additional training in a variety of techniques to continue to provide our patients with the most up to date care. Our doctors have training in a variety of manual therapy techniques, as well as rehabilitation to not only get you out of pain but keep you moving pain-free. If you have any questions or would like a complimentary consultation contact TROSS today! TROSS proudly serves the Cottleville, St. Peters, St. Charles, O’Fallon, and St. Louis area!