Golfer’s Elbow (Medial Epicondylitis): Symptoms, Relief, and Recovery

Golfer’s elbow, clinically known as medial epicondylitis, is a condition that causes pain where the tendons of your forearm muscles attach to the bony bump on the inside of your elbow. The pain may spread into your forearm and wrist. It is similar to tennis elbow, but the pain occurs on the inside rather than the outside of the joint.

Despite its name, this condition does not only affect golfers. It can be caused by any activity that involves repetitive use of the muscles used to flex the wrist and clench the fingers. This includes activities like weightlifting, racquet sports, carpentry, and even heavy gardening. In the UK, it is a common musculoskeletal complaint seen by GPs, particularly in individuals aged between 40 and 60.

The symptoms of golfer’s elbow can develop suddenly or gradually over several weeks. The primary indicator is pain and tenderness felt on the inner side of the elbow. Other common symptoms include:

• Stiffness: Your elbow may feel stiff, and it might hurt to make a fist.
• Weakness: You may notice a weakened grip when holding objects or shaking hands.
• Numbness or Tingling: These sensations might radiate into one or more fingers, most commonly the ring and little fingers.
• Increased Pain with Activity: Pain often worsens when you swing a golf club, carry heavy bags, or flex your wrist toward your forearm.

The condition is essentially an overuse injury. It results from damage to the muscles and tendons that control your wrist and fingers. The damage is often related to repeated stress, especially forceful wrist and finger motions. If the tendons are stressed beyond their capacity, small tears (micro-trauma) develop, leading to inflammation and pain.

Common triggers in the UK include:

• Improper Technique: Using an incorrect grip or swing in sports.
• Repetitive Manual Labour: Jobs involving painting, hammering, or typing.
• Improper Weightlifting: Curling the wrists during bicep exercises.
• Age and Health: It is more common in smokers and people with a higher body mass index (BMI).

Following NICE (National Institute for Health and Care Excellence) guidelines, the initial treatment for golfer’s elbow is conservative. The goal is to reduce inflammation and allow the tendon to heal. You can try the following:

Rest: Avoid the activity that caused the pain. Professional athletes and manual labourers may need to modify their duties to prevent further aggravation.

Ice: Apply an ice pack to the inner elbow for 15 to 20 minutes, three to four times a day. Always wrap the ice in a towel to protect your skin.

Pain Relief: Over-the-counter anti-inflammatories, such as ibuprofen (gel or tablets), can help reduce pain and swelling. Always consult a pharmacist or read the leaflet to ensure they are suitable for you.

Support: A counterforce brace or a compression bandage can help reduce the tension on the tendon while you perform daily tasks.

Once the acute pain has subsided, rehabilitation is vital to prevent the condition from returning. A physiotherapist can design a programme to strengthen the forearm muscles and improve flexibility. Key exercises often include:

• Wrist Eccentric Exercises: Lowering a light weight slowly with your palm facing upwards to strengthen the tendon.
• Forearm Stretches: Gently pulling the hand back with the arm extended to stretch the flexor muscles.
• Grip Strengthening: Using a soft ball or putty to rebuild hand strength.

If your elbow pain does not improve after two weeks of home treatment, it is advisable to seek medical advice. An online GP can assess your symptoms via video consultation, provide a diagnosis, and discuss further management options.

You should consult a GP if:

• The pain is interfering with your sleep or daily activities.
• The elbow is hot, inflamed, or you have a fever (which could indicate infection).
• You cannot straighten your arm or the joint feels 'locked'.
• You need a formal referral to a NHS physiotherapist or a private specialist.
• You require a sick note because your condition prevents you from performing your job.