Golfer's elbow

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Golfer elbow , or medial epicondylitis , is the medial epicondyle tendinosis on the inside of the elbow. This is in some ways similar to the tennis elbow, which affects the outside of the lateral epicondyle.

The anterior arm contains some muscles involved by stretching the fingers, and flexing and flicking the wrist. These tendons of muscles come together in a common tendon sheath, derived from the medial epicondyle of the humerus on the elbow joint. In response to minor injuries, or sometimes for no apparent reason at all, this insertion point becomes inflamed.

Video Golfer's elbow

Cause

This condition is called the golfer's elbow because in making the golf swing the tendon is emphasized, especially if non-overlapping grip (baseball style) is used; many people, however, who develop the conditions never handle golf clubs. It is also sometimes called the pitcher elbow because the same tendon is under stress by throwing objects like baseball, but this use is much less frequent. Other names are the climber's elbow and the little league elbow : all the flexors of the radius and the pronator of the forearm insert in the medial epicondyle of the humerus to enter: > pronator teres , flexor carpi radialis , flexor carpi ulnar , flexor digitorum superfisialis , and palmaris longus >; making this the most common elbow injury to rock climber, who sports a very intensive grip. Pain is usually caused due to stress on the tendon as a result of the large number of handles given by the numbers and the torque of the wrist caused by the use and action of the muscle group on the ulna condyle.

Epicondylitis is much more common on the lateral side of the elbow (tennis elbow), rather than the medial side. In most cases, the onset is gradual and symptoms often persist for weeks before the patient looks for treatment. On the golfer's elbow, pain in the medial epicondyle is exacerbated by the flexion and pronounced sustained wrist, which is used to aid the diagnosis. On the other hand, tennis elbow is indicated by the presence of lateral epicondyle pain deposited by retained wrist extension. Although these conditions are poorly understood at the cellular and molecular levels, there are several hypotheses that show apoptosis and autophagic cell death as the cause of chronic lateral epicondylitis. Cell death can decrease muscle density and cause snowball effect on muscle weakness - this vulnerability may compromise the muscle's ability to maintain its integrity. So athletes, like pitchers, should try to prevent cell death through flexibility training and other preventive measures.

Maps Golfer's elbow

Diagnosis

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Treatment

Non-specific treatments include:

• Non-steroidal anti-inflammatory drugs (NSAIDs): ibuprofen, naproxen or aspirin
• Hot or Ice
• A counter-force amplifier or "elbow strap" to reduce tension on the epicondyle elbow, to limit the provocation of pain and to protect against further damage.

Before anesthesia and steroids are used, conservative treatment with occupational therapists can be tried. Before therapy can be started, treatments such as rest, ice, compression and elevation (R.I.C.E.) will usually be used. This will help reduce pain and inflammation; rest will reduce the discomfort because golfer's elbow is an excessive injury. Patients can use tennis elbow splint for compression. The pads may be placed anteromedally on the proximal forearm. Splint is made in 30-45 degree elbow flexion. The elbow pads during the day may also be useful, by limiting additional trauma to the nerves.

The therapy will include various exercises for the reconditioned muscle/tendon, starting with the stretching and gradual strengthening of the flexor-pronator muscles. Reinforcement will slowly begin with isometric and evolve into eccentric exercises that help expand the range of motion back into place. After strengthening exercises, it is common for patients to compress the area.

Simple analgesic drugs have a place, as do more specific treatment with oral anti-inflammatory drugs (NSAIDs). This will help control any pain and inflammation. More invasive treatment is injections into and around the inflamed and soft areas of long-acting glucocorticoid (steroid) agents. After causing an initial exacerbation of symptoms lasting 24 to 48 hours, this can result in improved conditions in five to seven days.

The ulnar nerve runs in the groove between the medial humerus epicondyle and the olecranon process of the ulna. It is most important that these nerves should not be accidentally damaged in the process of injecting the golfer's elbow.

If all else fails, epicondilary debridement (surgery) may be effective. The ulnar nerve may also undergo surgical decompression.

If appropriate corrective measures are taken - rest, ice, and rehabilitation and stretching exercises - recovery can follow. Few patients need to progress to steroid injections, and less than 10% will require surgical intervention.

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See also

• Tennis elbow
• Repetitive strain injury
• Radial tunnel syndrome

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References

Source of the article : Wikipedia