Golfer's elbow is described as pain and tendinitis along the "medial epicondyle" of the elbow, which is the inner side of the elbow when your palm is facing upwards. Another name for this is also "climber's elbow," or medial epicondylitis. This is usually caused by increased stress on the tendons that attach your hand and wrist flexors to this bony point on your elbow; these muscles curl your fingers and wrist. Another commonly overused muscle which attaches to this same point is called the pronator teres, which rotates your hand to turn palm down.
When these muscles get overused and tight from repetitive stress, the tendons can get microtears or inflamed, thus causing pain. We often see these lower arm muscles overworking when upper arm and shoulder muscles are not strong enough or do not have proper mechanics to stabilize the arm. These injuries can happen to anyone who uses their arms and hands a lot for work and daily life, not just golfers or rock climbers!
Physical therapy is a great way to treat the tendinitis. While previous treatment strategies were targeted towards resting the tendons and reducing inflammation, we now understand that inflammation is part of the healing process. This means less icing and fewer NSAIDs! We work to reduce the tension in your forearm with soft tissue techniques, dry needling, myofascial release, and joint mobilization as needed. We then work to strengthen supporting muscles in your arm while fixing shoulder mechanics to reduce the tendon strain and prevent the injury from coming back.
When someone has chronic tendinitis in this area, it can be very slow to heal, so your physician may recommend getting platelet-rich plasma (PRP) as an additional treatment before proceeding with strengthening. Overall, we see great results with progressive strengthening and loading your muscles in a safe way under guidance from your physical therapist.