Golfer’s arm or golfer’s elbow (medial humeral epicondylitis) is tendonitis of the tendons that attach to the medial epicondyle of the forearm.
Golfer’s elbow is the result of tendinitis and degeneration of the flexors and pronators of the wrist.
It is an overuse tendinopathy that develops particularly in sports such as golf, bowling , tennis, weightlifting, football, and baseball.
The medial epicondyle is a protrusion on the inside of the elbow where the wrist flexor tendons attach to the humerus (ex: rounded pronunciator, radial palmar flexor, and palmar long).
The pain can be mild or stabbing and can be debilitating during everyday activities and sports.
Symptoms can radiate from the forearm to the wrist.
While the onset of golfer’s elbow can be traumatic, it usually progresses progressively and the symptoms gradually worsen.
Golfer’s elbow is much less common than tennis elbow .
The medial epicondyle of the dominant arm is usually affected.
The movements that lead to the development of golfer’s elbow are primarily: throwing, picking up and grasping objects.
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Tendinose
The main problem is not the acute inflammation of the tendons, but the degeneration of the connective tissues that make up the tendons.
This is due to the numerous microlesions that occur on the epicondyle when practicing certain sports.
Microscopic examinations revealed tendon changes characterized by disorganization of tendon fibers and scar tissue.
As for the cells, mechanical overstrain induces the differentiation of tendon stem cells into adipogenic, osteogenic and chondrogenic cells.
With the result that these cells can develop lipid formations, calcifications and mucoid degeneration instead of repairing the tendon.
Who Suffers from Golfer’s Elbow?
Almost anyone can get golfer’s elbow, but it commonly affects golfers, baseball players, archers, and musicians.
Athletes are more likely because they suffer a lot of micro trauma.
Golfer’s elbow is predominantly found in men and the age group affected is between 20 and 50 years old.
Causes of golfer’s elbow
The most common cause of golfer’s elbow is overuse of the tendon.
It can also be triggered by an external force, but this is rarely the case.
The main risk factors are:
- age: adults no longer have such elastic tendons and carry out repetitive activities at work or in sports;
- Diabetes increases the likelihood of golfer’s elbow;
- incorrect technique when performing a sporting movement can be the cause;
- weak forearm muscles, unsuitable for practicing certain sports.
What Are the Signs and Symptoms of Tendonitis?
The tendonitis causes pain on the inside of the elbow, weakness when rotating and flexing the wrist, and sometimes swelling above the medial epicondyle.
The pain is moderate but gets progressively worse over time.
Symptoms worsen when the tendon is stretched and squeezed, when grasping objects, and when the wrist is flexed/inwardly rotated.
Over time, not only the tendons but also the muscle bellies become weaker.
In the case of an advanced golfer’s arm, there may also be a restricted movement.
Diagnosis of golfer’s elbow
The doctor examines the patient’s medical history to determine if there are any risk factors, such as sports or work activities that cause a lot of microtrauma.
The doctor needs to know if the pain developed slowly or resulted from direct trauma to the epicondyle.
He also needs to know what symptoms are occurring and how long they last.
Physical examination
Examination includes examining the painful elbow and palpating the medial epicondyle to pinpoint where the symptoms are occurring.
There is a test to diagnose golfer’s elbow.
The examiner performs passive supination (outward rotation) and extension (stretching) of the wrist and elbow.
The test is positive if there is pain at the medial epicondyle.
To rule out a pinched nerve , the tendon-muscle reflexes of the elbow also need to be checked.
Differential diagnosis
The doctor must exclude the following diseases:
- Arthritis;
- fracture of the epicondyle ;
- Carpal tunnel syndrome ;
- cervical radiculopathy ;
- entrapment of the ulnar nerve;
- Bursitis at the elbow .
- Therapy for golfer’s elbow
- Tennis Elbow Tennis Elbows Epicondylitis
- Shoulder bursitis or subacromial bursitis
