Medial tendinosis, sometimes referred to as “golfer’s elbow” or medial epicondylitis, is a medical condition that causes a person to experience pain and tenderness around the inner bump located on the elbow. Pain symptoms may also radiate down the forearm and into the wrist. The condition typically develops from overuse of an elbow tendon through repetitive motions (such as a golf club swing). Other types of sports such as tennis, rowing, baseball, and weightlifting can also cause medial tendinosis. Butchers, cooks, assembly line workers, and regular computer users can also experience medial tendinosis due to the repetitive elbow motions required in these occupations.

Elbow/Forearm Anatomy

The medial epicondyle is a part of a bony protrusion at the end of the humerus (upper arm) bone. Among other things, the medial epicondyle serves as an area of attachment for certain muscles, tendons, and ligaments. Some of the muscles attached to the medial epicondyle include the pronator teres, the flexor carpi radialis, the palmaris longus, and the flexor carpi ulnaris. All of these muscles play an important role in allowing a person to bend and extend their arm at the elbow.

Tendons also play an important role in the elbow area as they are responsible for attaching these muscles to a portion of the medial epicondyle. Due to overuse or injury, sometimes these tendons will become irritated, leading to pain and swelling.

What Causes Medial Tendinosis?

As mentioned previously, this medical condition tends to occur from repetitive motion of the elbow. The wrist flexor tendons are particularly vulnerable to overuse. Forceful, repetitive motions in the elbow can occur in occupations such as plumbing, carpentry, and construction work. In addition, any sport or other activity that involves forceful motions of the elbow can lead to medial epicondylitis (medial tendinosis).

Symptoms

Inner elbow pain is a common symptom of medial tendinosis and symptoms can extend down the forearm as well. A person with medial tendinosis may experience decreased grip strength, along with pain and difficulty when attempting to grasp items. Both passive and active motions in the wrist and fingers may also trigger a painful reaction. In severe cases, a person may experience symptoms of nerve impingement such as numbness or tingling down the inner part of the forearm.

It’s very important not to ignore the symptoms associated with medial epicondylitis, especially if a person is experiencing symptoms of nerve impingement. Ignoring these symptoms can lead to permanent nerve damage if a person does not receive appropriate medical treatment.

Physical Therapy for Medial Tendinosis

Whether or not a patient requires surgery for their medial tendinosis, it’s not uncommon for a physician to refer their medial tendinosis patient to a physical therapist for a series of rehabilitation treatments.

Physical therapists are specially trained in procedures designed to reduce the pain and swelling a patient may be experiencing around the elbow, forearm, and/or wrist areas. Along with reducing a patient’s pain levels, physical therapists will also introduce specific exercises designed to gently stretch tense, overused muscles in and around the elbow, forearm, wrist, and hand. These stretches will also help to increase a patient’s range of motion (ROM) throughout the injured area.

When the patient is ready, their therapist will introduce strengthening exercises for muscles throughout the arm, wrist, and hands. This is so the muscles will be able to provide proper support for the elbow area when repetitive motions are required.

Lastly, a physical therapist will also provide instruction on how to properly perform activities that do require repetitive motions, so the patient can avoid re-injury.

If you have elbow pain and would like to know how physical therapy can help you get back to your former levels of activity, we can help. Please contact Cawley Physical Therapy & Rehab at 570-208-2787.