Elbow Injuries and Conditions
Rush Copley Hand and Upper Extremity Center treats injuries and conditions of the elbow. Here are some of the most common, why they occur and how they are treated.
What is Medial Epicondylitis?
Medial epicondylitis of the elbow is an inflammation of the tendons that attach your forearm muscles to the inside of the bone at the elbow. The inside of the elbow can be painful to pressure or touch and pain can be aggravated with continued use of the forearm
The elbow joint consists of three bones: your upper arm bone (humerus) and two forearm bones (radius and ulna). The two bumps at the bottom of the humerus bone are called epicondyles. The bony bump on the inside of the elbow is called the medial epicondyle. This is where tendons in the forearm attach to the humerus bone.
How does Medial Epicondylitis occur?
Medial epicondylitis is typically caused by repetitive motion or excess stress on the tendons that attach to the inside of the elbow. These tendons flex the wrist and twist the forearm. Forceful wrist and finger motions, improper lifting technique, throwing or hitting, as well as poor conditioning of the muscles can all contribute to this condition. It is commonly seen in golfer’s on their dominant arm and has been called “golfer’s elbow” because of this. Medial epicondylitis can also be seen in racket sports, especially if trying to place topspin using forehand swing. Throwing sports such as baseball and softball can also cause medial epicondylitis. Weight training can cause medial epicondylitis. Avoiding poor technique and over lifting are usually the causes.
Forceful, repetitive occupational movements can inflame the tendons. Risk factors include: age 40 or older, obesity, smoker, and performing repetitive activities for at least two hours a day.
How is Medial Epicondylitis treated?
Initially,medial epicondylitis is treated with rest and avoiding the stress or repetitive activity. Non-steroidal anti-inflammatory drugs (NSAIDS), like ibuprofen or naproxen, can reduce pain and swelling. A brace placed on the forearm can reduce the stress where the tendons attach to the bone at the elbow.
Physical therapy can help by strengthening the forearm and wrist and stretch the inflammed tissue. Modalities may aid in healing and decrease pain. Steroid injections may decrease the inflammation and pain. Checking one’s equipment and evaluating technique may decrease the stress at the elbow and prevent recurrence of symptoms.
If the elbow continues to be painful and limits activities after several months of non-surgical treatment, surgery may be recommended. Surgery typically involves the removal of diseased tendon at the bone. Sometimes repair of structures are recommended as well. The procedure is done as an outpatient. Therapy is usually started early but full recovery can take several months. Pain and limitations may still persist even after surgery in a small percentage of patients. Typically, the procedure is done in an outpatient setting and can be done under local anesthetic to numb the area. There typically is some discomfort, tenderness and swelling after this surgery. Stiffness is common as well and a hand therapist may be recommended to assist with the recovery