Medial Epicondylitis or Golfer's Elbow

What is Medial Epicondylitis (Epitrochleitis) or Golfer's Elbow?


It is a chronic overload injury that originates in the medial region of the elbow, where a set of tendons originate that together flex the wrist and pronate the forearm. It is relatively rare, especially when compared to injuries to the lateral side of the elbow, and occurs in individuals of working age, mainly on the dominant side.

Mechanism of injury Medial Epicondylitis (Epitrochleitis) or Golfer's Elbow?

Performing repetitive wrist flexion and forearm pronation movements during sports or work activities

 

What are the risk factors?


Golf practice. Repetitive work with heavy weights.

 

Signs and Symptoms of Medial Epicondylitis (Epitrochleitis) or Golfer's Elbow

The pain typically appears a few millimeters below the medial epicondyle of the elbow in a progressive manner and, more rarely, as an acute form after a certain amount of effort. It is important to rule out paresthesias or tingling in the 4th and 5th fingers, which would imply involvement of the ulnar nerve, which passes just posterior to the insertion of these tendons in the medial region of the elbow.

 

Diagnosis Medial Epicondylitis (Epitrochleitis) or Golfer's Elbow?


Physical examination


 

Mobility is generally normal. When flexing the wrist and fingers and pronating against resistance, there is an increase in pain in the medial region of the elbow.

X-ray


 

It allows you to see the alignment of the elbow, the existence of osteoarthritis or other pathologies that may justify the patient’s pain.

Ultrasound and Magnetic Resonance Imaging

 

These are the usual tests of choice to diagnose this pathology, which can range from a small inflammation to a rupture of these tendons.

 

Treatment Medial Epicondylitis (Epitrochleitis) or Golfer's Elbow?


Conservative

      • When to perform? –  Always first-line treatment.
       

    Treatment options?

      • What to do? – Medication – In the first phase (in the first days or weeks after the onset of symptoms) treatment with anti-inflammatories and analgesics should be attempted.
      • Physiotherapy/Rehabilitation – If this is not enough or the symptoms have been progressing for a few months, it becomes necessary to start physiotherapy rehabilitation with the aim of re-educating the elbow.
      • Elbow Infiltration – In cases that are more refractory to physiotherapy, symptomatic relief can be attempted with infiltration of the medial epicondyle with corticosteroids and PRPs (platelet-rich plasma).
      • PRPs or platelet-rich plasma are growth factors that can help heal the inflammatory process and regenerate the degenerated tendon. This technique involves using the patient’s own plasma and platelets, which are previously extracted and then centrifuged to prepare these growth factors for later infiltration into the injured area. This procedure is performed on an outpatient basis and the patient is discharged immediately after the infiltration, if clinically stable.

      Surgical

      • When to perform? -In the rare cases where everything fails.
      • Technique – Debridement of devitalized tissue: which consists of removing degenerated tissue and then stimulating the healing of new tissue.

      Postoperative


        • This is a procedure with a small incision of just a few centimeters and, therefore, the patient can be discharged on the same day or the day after surgery.
        • Remove the stitches within 2 weeks of surgery.
        • It is permitted to begin elbow mobilization the day after surgery.
        • You should start physical rehabilitation following surgery.

        How to prevent Medial Epicondylitis (Epitrochleitis) or Golfer's Elbow?


        Healthy lifestyle and practice exercises correctly. Avoid repetitive movements.

         

        When to seek an Orthopedic Specialist?


        When elbow pain persists for more than 5 consecutive days.

         

        Schedule an Appointment

          Related topics


          Lateral Epicondylitis or Tennis Elbow
          Elbow Infiltration
          Infiltration with Platelet Rich Plasma (PRPs)
          Orthobiologicals

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