Golfer's elbow

An overuse injury that commonly occurs on the medial (inner) surface of the right elbow of a right-handed golfer. Moving a golf club while applying a tight grip strains the tendons of the flexor muscles which curl the wrist and close the fingers into a fist. Most strain is produced when the club is at or near the top of the backswing, and as it goes through the downswing until just before it hits the golf ball. The strain may be so great that, in youngsters, it may pull off a piece of bone or damage the epiphyseal plate (the region of bone growth). Golfers who make large divots following a chip shot are more likely to develop golfer's elbow. Treatment consists of reducing the pain and swelling (usually by the application of ice), strengthening the muscles, and correcting any faulty swing technique contributing to the strain. A similar overuse injury occurs in javelin throwers; it can also occur when a weight-lifter rotates the arm during a snatch lift. Compare tennis elbow.

Inflammation of the tendons that attach the forearm flexor muscles onto the medial epicondyles of the humerus, on the inside of the elbow. The flexors curl the wrist and close the fingers into a fist. Repeated forceful curling and gripping can strain the tendons, damage nerves, and even pull off a piece of bone. Golfer's elbow usually affects the right elbow of right-handed golfers (or the left elbow of left-handed golfers) who place excessive stress on the forearm flexors during the acceleration and impact phases of the swing; risk is increased when making large divots. Golfer's elbow also occurs in throwers who put too great a load on the elbow, for example, when straightening the arm too forcefully. Weight-lifters acquire golfer's elbow when ‘rotating out’ during a snatch lift. Initial treatment is usually rest and ice (see RICE) and application of anti-inflammatories. Surgery may be necessary if bone fragments have been torn off the inner aspect of the elbow. Strengthening exercises and correction of faulty technique reduces the risk of recurrence. In differential diagnosis, it is important to ensure that the symptoms are not caused by nerve entrapment.

Golfer's elbow
Classification and external resources
Left elbow-joint, showing anterior and ulnar collateral ligaments. (Medial epicondyle labeled at center top.)
ICD-10	M77.0
ICD-9	726.31
DiseasesDB	5356
eMedicine	sports/74 pmr/74

Golfer's elbow, or medial epicondylitis, is an inflammatory condition of the elbow which in some ways is similar to tennis elbow.

The anterior forearm contains several muscles that are involved with flexing the fingers and thumb, and flexing and pronating the wrist. The tendons of these muscle come together in a common tendinous sheath which is inserted into the medial epicondyle of the humerus at the elbow joint. In response to minor injury, or sometimes for no obvious reason at all, this point of insertion becomes inflamed.

Contents 1 Causes 2 Treatment 3 See also 4 References

Causes

The condition is called Golfer's elbow because in making a golf swing this tendon is stressed; many people, however, who develop the condition have never handled a golf club. It is also sometimes called Pitcher's elbow^[1] due to the same tendon being stressed by the throwing of objects such as a baseball, but this usage is much less frequent.

Treatment

Simple analgesic medication has a place, as does more specific treatment with oral anti-inflammatory medications. The definitive treatment is, however, the injection into and around the inflamed and tender area of a long-acting glucocorticoid (steroid) agent. After causing an initial exacerbation of symptoms lasting 24 to 48 hours, this will produce a resolution of the condition in some five to seven days.

The ulnar nerve runs in the groove between the medial humeral epicondyle and the olecranon process of the ulna. It is most important that this nerve should not be damaged accidentally in the process of injecting a Golfer's elbow.

See also

• Tennis elbow

References

1. ^ "Pitcher's Elbow - Stanford Sports Medicine - Stanford Medical Outpatient Center". Stanford University Medical Center. http://outpatient.stanfordhospital.org/clinics/orthopaedics/sportsmedicine/procedures/shoulder/pitcher.html. Retrieved 2009-09-09. 

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