Golfer's Elbow

Golfer's elbow is a condition that causes pain where the tendons of your forearm muscles attach to the bony bump on the inside of your elbow. The pain might spread into your forearm and wrist. Golfer's elbow is similar to tennis elbow, which occurs on the outside of the elbow. It's not limited to golfers. Tennis players and others who repeatedly use their wrists or clench their fingers also can develop golfer's elbow.

People who are suffering from golfer’s elbow often experience pain when making a fist or twisting the forearm. In many cases, the affected area is tender to the touch or slightly swollen. If you are suffering from golfer’s elbow, pain often seems to worsen when you attempt to flex your wrist, pick up something with your palm down or squeeze a ball.

If the condition is not treated promptly, golfer’s elbow can cause weakness in the hands or wrist as well as stiffness in the elbow. The treatments for golfer’s elbow and tennis elbow are similar in most cases, but you will need to seek medical care to learn the best way to handle your condition.

Golfer's elbow is characterized by:

• Pain and tenderness. Usually felt on the inner side of your elbow, the pain sometimes extends along the inner side of your forearm. Pain typically worsens with certain movements.

• Stiffness. Your elbow may feel stiff, and making a fist might hurt.

• Weakness. You may have weakness in your hands and wrists.

• Numbness or tingling. These sensations might radiate into one or more fingers - usually the ring and little fingers.

The pain of golfer's elbow can come on suddenly or gradually. The pain might worsen with certain movements, such as swinging a golf club.

There is widespread confusion about how golfer’s and tennis elbow differ. And although they’re often confused, there are a few distinct characteristics of each condition that will help you tell them apart:

• Inflammation Location. The difference between golfer’s and tennis elbow centers on where the elbow is inflamed. A person suffering from tennis elbow will experience inflammation of the outside of the elbow and forearm areas, while a person suffering from golfer’s elbow will experience inflammation on the inner side of the arm and elbow.

• Tendon Affected. Tennis elbow affects the lateral (outside) epicondyle tendon. These are connected to the muscles that stretch your wrist backward and allow you to spread your fingers. Golfer’s elbow affects the medial (inside) epicondyle tendon. This is attached to the muscles you use to flex your wrist and contract your fingers, like when you grip something.

• Symptoms. The side effects of these conditions can be very similar, but they are on opposite sides of the elbow and arm. Tennis elbow presents with pain and tenderness experienced on the outside of your elbow, while golfer’s elbow can be felt on the inside of your elbow and down your arm. Golfer’s elbow can also cause numbness or tingling in your fingers.

Golfer's elbow, also known as medial epicondylitis, is caused by damage to the muscles and tendons that control your wrist and fingers. The damage is typically related to excess or repeated stress - especially forceful wrist and finger motions. Improper lifting, throwing or hitting, as well as too little warmup or poor conditioning, also can contribute to golfer's elbow.

Besides golf, many activities and occupations can lead to golfer's elbow, including:

• Racket sports. Improper technique with tennis strokes, especially the backhand, can cause injury to the tendon. Excessive use of topspin and using a racket that's too small or heavy also can lead to injury.

• Throwing sports. Improper pitching technique in baseball or softball can be another culprit. Football, archery and javelin throwing also can cause golfer's elbow.

• Weight training. Lifting weights using improper technique, such as curling the wrists during a biceps exercise, can overload the elbow muscles and tendons.

• Forceful, repetitive occupational movements. These occur in fields such as construction, plumbing and carpentry.

To cause golfer's elbow, the activity generally needs to be done for more than an hour a day on many days.

You could be at higher risk of developing golfer's elbow if you're:

• Age 40 or older
• Performing repetitive activity at least two hours a day
•  Obese
• A smoker

You can take steps to prevent golfer's elbow:

• Strengthen your forearm muscles. Use light weights or squeeze a tennis ball. Even simple exercises can help your muscles absorb the energy of sudden physical stress.

• Stretch before your activity. Walk or jog for a few minutes to warm up your muscles. Then do gentle stretches before you begin your game.

• Fix your form. Whatever your sport, ask an instructor to check your form to avoid overload on muscles.

• Use the right equipment. If you're using older golfing irons, consider upgrading to lighter graphite clubs. If you play tennis, make sure your racket fits you. A racket with a small grip or a heavy head may increase the risk of elbow problems.

• Lift properly. When lifting anything — including free weights — keep your wrist rigid and stable to reduce the force to your elbow.

• Know when to rest. Try not to overuse your elbow. At the first sign of elbow pain, take a break.

Consult your doctor if rest, ice and over-the-counter pain relievers don't ease your elbow pain and tenderness. Seek immediate care if:

• Your elbow is hot and inflamed, and you have a fever

• You can't bend your elbow

• Your elbow looks deformed

• You suspect you've broken a bone

Treatment begins with avoiding activity that causes pain. To help relieve pain, use ice.

• Medication: You can take an over-the-counter pain reliever. Try ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others). Corticosteroid injections are not commonly given because they haven't been shown to be effective long-term. A newer treatment being tried is platelet-rich plasma. This involves drawing a small amount of your blood and injecting a concentrated amount of platelets and other anti-inflammatory factors into the tender area. More studies are needed to evaluate the effectiveness of this treatment.

• Surgery: Surgery is seldom necessary. But if your signs and symptoms don't respond to conservative treatment in six to 12 months, surgery might be an option. A new approach called the TENEX procedure involves minimally invasive, ultrasound-guided removal of scar tissue in the region of the tendon pain. More study is needed.

Most people will get better with rest, ice and pain relievers. Depending on the severity of your condition, the pain might linger for months to years — even if you take it easy and follow instructions on exercising your arm. Sometimes the pain returns or becomes chronic.